Targeting Infant Development With Early Screening

Study Overview
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Brief Summary
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The purpose of this study is to assess feasibility and acceptability of parent-completed screeners of child social/emotional development, social determinants of health, and adverse childhood experiences in the setting of a pediatrics primary care clinic.

Detailed Description
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Local pediatric primary care practices are beginning to implement universal screening. The investigators plan to assess feasibility and acceptability of screening by querying parents of children in order to determine their expectations, perceptions, and opinions about the screeners. The investigators will also use data from electronic health records to examine the impact of screeners on referrals and healthcare utilization. The investigators will be examining screening rates and outcomes, and correlations with demographics and changes over time.

Official Title
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Targeting Infant Development With Early Screening

Conditions
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Development, Child

Participation Criteria
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Eligibility Criteria
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Inclusion for general practice retrospective reviews: Seen for a well child check at Duke Children's Primary Care Roxboro Road. Age 0 to 4 at day of visit Inclusion for targeted retro reviews: Seen for well check at Duke Children's Primary Care Roxboro Road Determined by HealthySteps to require Tier 2 or Tier 3 behavioral support services Age 0 to 4 at day of visit

Ages Eligible for Study
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Maximum Age: 3 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Age 0 to 4 at day of visit<br>This study is based on chart reviews of data collected as part of clinical care. Data collected as part of this study will not directly inform the care of participating patients and families. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Screening results | We will use data extracts from the electronic health system to examine rates of meeting positive/negative thresholds on screening tools used as part of clinical care. | 18 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Screening compliance | We will use data extracts from the electronic health system to examine screening compliance rate | 18 months | 
| Rate of attending scheduled appointments (show rate) | We will use data extracts from the electronic health system to examine rate of families attending their scheduled appointments and no-show rate | 18 months | 
| Healthcare utilization | Data extracts from Epic and/or from DEDUCE will be used to evaluate healthcare utilization. For the targeted chart review, we will look specifically at families who are enrolled in or who qualify for Healthy Steps Tier 2 and Tier 3, subsets of the whole practice who are receiving additional co-located behavioral supports during standard well child care. | 18 months | 
| Referral rates | Data extracts from Epic and/or from DEDUCE will be used to evaluate rates of referrals to other services. For the targeted chart review, we will look specifically at families who are enrolled in or who qualify for Healthy Steps Tier 2 and Tier 3, subsets of the whole practice who are receiving additional co-located behavioral supports during standard well child care. | 18 months |