scholarly journals How universal are universal preschool health checks? An observational study using routine data from New Zealand’s B4 School Check

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025535 ◽  
Author(s):  
Sheree Gibb ◽  
Barry Milne ◽  
Nichola Shackleton ◽  
Barry J Taylor ◽  
Richard Audas
Keyword(s):  
Routine Data ◽  
Population Level ◽  
Participation Rates ◽  
Hearing Tests ◽  
Universal Preschool ◽  
Emergency Admissions ◽  
Health Checks ◽  
Strengths And Difficulties ◽  
Parental Evaluation ◽  
Health Screen

ObjectivesWe aimed to estimate how many children were attending a universal preschool health screen and to identify characteristics associated with non-participation.DesignAnalysis of population-level linked administrative data.ParticipantsChildren were considered eligible for a B4 School Check for a given year if:(1) they were ever resident in New Zealand (NZ),(2) lived in NZ for at least 6 months during the reference year, (3) were alive at the end of the reference year, (4) either appeared in any hospital (including emergency) admissions, community pharmaceutical dispensing or general practitioner enrolment datasets during the reference year or (5) had a registered birth in NZ. We analysed 252 273 records over 4 years, from 1 July 2011 to 30 June 2015.ResultsWe found that participation rates varied for each component of the B4 School Check (in 2014/2015 91.8% for vision and hearing tests (VHTs), 87.2% for nurse checks (including height, weight, oral health, Strengths and Difficulties Questionnaire [SDQ] and parental evaluation of development status) and 62.1% for SDQ – Teacher [SDQ-T]), but participation rates for all components increased over time. Māori and Pacific children were less likely to complete the checks than non-Māori and non-Pacific children (for VHTs: Māori: OR=0.60[95% CI 0.61 to 0.58], Pacific: OR=0.58[95% CI 0.60 to 0.56], for nurse checks: Māori: OR=0.63[95% CI 0.64 to 0.61], Pacific: OR=0.67[95% CI 0.69 to0.65] and for SDQ-T: Māori: OR=0.76[95% CI 0.78 to 0.75], Pacific: OR=0.37[95% CI 0.38 to 0.36]). Children from socioeconomically deprived areas, with younger mothers, from rented homes, residing in larger households, with worse health status and with higher rates of residential mobility were less likely to participate in the B4 School Check than other children.ConclusionThe patterns of non-participation suggest a reinforcing of existing disparities, whereby the children most in need are not getting the services they potentially require. There needs to be an increased effort by public health organisations, community and whānau/family to ensure that all children are tested and screened.

scholarly journals Improving the usefulness of mortality data in Brazil: reclassification of ill-defined causes of death

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E França ◽  
L Ishitani ◽  
R Teixeira ◽  
C Cunha ◽  
F Marinho
Keyword(s):  
Interpersonal Violence ◽  
Large Scale ◽  
Causes Of Death ◽  
Age Groups ◽  
Family Health ◽  
Routine Data ◽  
Population Level ◽  
Mortality Data ◽  
Access To Health Services ◽  
Underlying Causes

Abstract Background Garbage codes (GC) among registered causes of death can bias mortality analysis. In Brazil, more than one million deaths occurred annually in 2006-2017 and around 100,000 deaths per year were originally attributed to GC ill-defined causes of death (IDCD) in the Mortality Information System (SIM - Sistema de Informação sobre Mortalidade). To provide more accurate cause-of-death analysis, routine investigations of IDCD in the health surveillance system have been implemented in the country since 2005. The objective of this study was to analyze specific underlying causes for deaths originally assigned as IDCD in the SIM in 2006-2017. Methods For all IDCD (ICD codes from chapter 18, or R-codes) identified in the SIM, municipal health professionals collected information about the final disease obtained from hospital records, autopsies, forms of family health teams, and home investigation. Proportions of reclassified deaths by cause-specific mortality fractions (CSMF) derived from the reclassified IDCD by age and four calendar periods were analyzed to assess specific causes detected after investigation. Results A high proportion of deaths due to IDCD was investigated in 2006-2017 (32%). From a total of 257,367 IDCD reclassified, chronic diseases (56.6%), injuries (7.2%), and infectious (5.2%) or neonatal, maternal, malnutrition (1.7%) were the underlying causes detected among IDCD. Neonatal-related conditions, interpersonal violence, ischemic heart disease and stroke were the leading causes detected in the age groups 0-9 years, 10-29 years, 30-69 years, 70 years and over, respectively. Conclusions High proportions of IDCD reassigned to more informative causes after review indicate the success of this approach to correct misclassification in the SIM, an initiative that should be maintained. Training physicians on death certification along with better quality of medical care and access to health services would lead to further improvement. Key messages Investigation of IDCD as part of routine data collection on a large scale as had occurred in Brazil in 2006-2017 is an innovative approach to strengthen population-level mortality statistics. In addition to reducing the proportions of IDCD by their reclassification into specific causes, this initiative opens up the prospect of using these results for redistributing remaining cases of IDCD.

scholarly journals PTH-062 Emergency Admissions For Alcohol Related Conditions: Making Sense Of Routine Data

Gut ◽  
2014 ◽  
Vol 63 (Suppl 1) ◽  
pp. A236.1-A236 ◽  
Author(s):  
P Lekharaju ◽  
E Thompson ◽  
M Shawihdi ◽  
M Pearson ◽  
S Hood ◽  
...  
Keyword(s):  
Routine Data ◽  
Emergency Admissions ◽  
Making Sense

scholarly journals Rolling out new biomedical HIV prevention tools: what can be learned from Avahan, the India AIDS initiative?

Sexual Health ◽  
2014 ◽  
Vol 11 (2) ◽  
pp. 207 ◽  
Author(s):  
Gina Dallabetta ◽  
Padma Chandrasekaran ◽  
Tisha Wheeler ◽  
Anjana Das ◽  
Lakshmi Ramakrishnan ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Health Services ◽  
Routine Data ◽  
Population Level ◽  
Great Promise ◽  
Data Systems ◽  
African Countries ◽  
Hiv Prevention Intervention ◽  
Frontline Workers ◽  
Biomedical Hiv Prevention

More than 30 years after HIV was first identified as a disease, with disastrous consequences for many subpopulations in most countries and for entire populations in some African countries, it continues to occupy centre stage among the world’s many global health challenges. Prevention still remains the primary long-term focus. New biomedical tools such as pre-exposure propyhlaxis (PrEP) and treatment hold great promise for select groups such as key populations (KPs) who are critical to transmission dynamics, and serodiscordant couples. Programs delivering these new tools will need to layer them over existing services, with potential modifications for increased and sustained engagement between health services and beneficiaries owing to the nature of the interventions. Avahan, an HIV prevention intervention for KPs in six states in India, achieved population-level impact with conventional prevention programming, which, however, required high program–beneficiary engagement. Avahan’s implementation strategy included articulating clear service definitions and denominator-based targets; establishing routine data systems with regular, multilevel supervision that allowed for cross-learning across the program; and developing a cadre of frontline workers through KP peer outreach workers who addressed structural issues and provided viable and sustainable mechanisms for sustained interaction between health services and KPs. This basic prevention implementation infrastructure was used to expand clinical services over time. Many of the lessons from programs such as Avahan can be applied to KP programs that are expanding service scope, including PrEP and treatment.

scholarly journals Sport policy and practice: Why a focus on retention is required for both health and performance

2020 ◽  
Author(s):  
Rochelle Eime ◽  
Melanie Charity ◽  
Hans Westerbeek
Keyword(s):  
Leisure Time ◽  
Sport Participation ◽  
Leisure Time Physical Activity ◽  
Population Level ◽  
Developed Countries ◽  
Drop Out ◽  
Participation Rates ◽  
Pathway Model ◽  
Significant Drop ◽  
Sport Policy

Abstract Background: Australia like many developed countries is largely an inactive nation. Participation in sport, a form of leisure-time physical activity, can contribute to a range of individual and community health benefits. National sport policy often has a dual focus on population-based participation, and elite performance. Whist there are various sport models depicting the pathway to elite, there has been no strategic population-level sport participation pathway model developed as a guide towards increasing sport participation across the lifespan. The aim of this study therefore is to explore sport participation across the lifespan and develop a neutral model that does not favour community or elite sport and that highlights the critical participation transition points including drop-out. Methods: We conducted a longitudinal analysis of sport participation records for 8 major sports from 2015-2017, whereby individual participation within sports was tracked from 2015 and subsequent years 2016 and 2017. Results: The total number of participants analysed was 579,696. In 2017, port participation rates were highest for those aged 10-14 years (61.3%), followed by those children within the 5-9 year age group (51.7%). However, 44.7% of all participants dropped out within two years of the base year. From these participation rates across the lifespan in conjunction with the published literature, on sport policy and participation, we developed the Sport Participation Pathway Model (SPPM). The SPPM depicts current sport participation and in doing so emphasises the significant drop-out of sport across the lifespan. Conclusion: At a population level, competitive club-based sport alone is not going to solve the physical inactivity epidemic. Our SPPM, and the new (retention related) data presented in this paper, demonstrates the population trends in participation in sport and the high drop-out of competitive club-based sport. We suggest that for people to (eventually) become active sport participants, the (recruitment) narrative could be changed towards (first) engaging people in leisure time physical activities. We feel that this can only be done by developing an integrated policy system across the PA-sport spectrum rather than looking at sport participation in a closed (club-based) system. The SPPM can be used to developing a more integrated PA-Sport participation model.

Using routine data to monitor population level interventions: the example of the Keep Well health check programme in Scotland

2014 ◽  
Vol 24 (suppl_2) ◽  
Author(s):  
CM Fischbacher ◽  
J Muirie ◽  
G McCartney ◽  
J Lewsey ◽  
D McKay ◽  
...  
Keyword(s):  
Routine Data ◽  
Population Level ◽  
Health Check

scholarly journals Mixed method estimation of population level HIV viral suppression rate in the Western Cape, South Africa

2020 ◽  
Author(s):  
Elton Mukonda ◽  
Nei-Yuan Hsiao ◽  
Lara Vojnov ◽  
Landon Myer ◽  
Maia Lesosky
Keyword(s):  
Viral Suppression ◽  
Routine Data ◽  
Population Level ◽  
Hiv Prevalence ◽  
Sub Saharan Africa ◽  
Sensitivity Analyses ◽  
People Living With Hiv ◽  
Western Cape ◽  
Test Results ◽  
Individual Level

AbstractIntroductionThere are few population-wide data on viral suppression (VS) that can be used to monitor programmatic targets in sub-Saharan Africa. We describe how routinely collected viral load (VL) data from ART programmes can be extrapolated to estimate population VS and validate this using a combination of empiric and model-based estimates.MethodsVL test results from were matched using a record linkage algorithm to obtain linked results for individuals. Test- and individual-level VS rates were based on test VL values <1000 cps/ml, and individual VL <1000 cps/mL in a calendar year, respectively. We calculated population VS among people living with HIV (PLWH) in the province by combining census-derived mid-year population estimates, HIV prevalence estimates and individual level VS estimates from routine VL data.ResultsApproximately 1.9 million VL test results between 2008 – 2018 were analysed. Among individuals in care, VS increased from 85.5% in 2008 to 90% in 2018. Population VS among all PLWH in the province increased from 12.2% in 2008 to 51.0% in 2017. The estimates derived from this method are comparable to those from other published studies. Sensitivity analyses showed that the results are robust to variations in linkage method, but sensitive to the extreme combinations of assumed ART coverage and population HIV prevalence.ConclusionWhile validation of this method in other settings is required, this approach provides a simple, robust method for estimating population VS using routine data from ART services that can be employed by national programmes in high-burden settings.

scholarly journals Evaluating the implementation of the Inverse Care Law Programme in Wales, a population based intervention in primary care

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Ashley Akbari ◽  
Jiao Song ◽  
Caryn Cox ◽  
Leon May ◽  
Williams Watkins ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Query Language ◽  
Routine Data ◽  
Population Level ◽  
Medical Intervention ◽  
Health Check ◽  
Inverse Care Law

IntroductionThe Inverse Care Law (ICL) programme in Wales was setup to identify people in deprived communities at risk of cardiovascular disease (CVD) through a health check; offering lifestyle and medical intervention as appropriate. Evaluation of this programme to tackle health inequalities ensuring services are available is vital. Objectives and ApproachTo evaluate the uptake and long term outcomes of the programme, using longitudinal evidence-based results, it was necessary to develop an efficient and cost effective approach with a readily available source of data. To achieve this, the Welsh Longitudinal General Practice (WLGP) data held in Secure Anonymised Information Linkage (SAIL) databank was utilised, with programme-specific code deployed within primary care at the point of the health check, which identified the intervention, potential CVD risks, referrals and any follow-up. Lifestyle risk factors could be evaluated such as poor diet, physical inactivity, smoking and high alcohol intake. ResultsUtilising routine data sources and reproducible SQL (Standard Query Language), we evaluated the programme initialisation between February 2015 and November 2016, and found of 55 General Practices who participated, 31 of 35 in Aneurin Bevan (AB) and 17 of 20 in Cwm Taf (CT) University Health Boards, providing data which allowed identification of the health check and associated outcomes of interest in the routine data, with 3 (2 AB, 1 CT) since delivering. There are ongoing evaluations on the various risk factors longitudinally as well as the overall implementation of the programme itself, with this collaborative approach succeeding in utilising existing powerful data linkage within the SAIL databank to identify our intervention and facilitate long-term follow-up at an individual level using robust information governance mechanisms. Conclusion/ImplicationsLessons learned and challenges encountered are being fed back as part of our evaluation, with further work assessing the long term population level outcomes and impact of the health check and services provided across these deprivation groups, informing and refining programme delivery of similar work across Wales in the future.

scholarly journals Mixed-method estimation of population-level HIV viral suppression rate in the Western Cape, South Africa

2020 ◽  
Vol 5 (8) ◽  
pp. e002522
Author(s):  
Elton Mukonda ◽  
Nei-Yuan Hsiao ◽  
Lara Vojnov ◽  
Landon Myer ◽  
Maia Lesosky
Keyword(s):  
Viral Suppression ◽  
Routine Data ◽  
Population Level ◽  
Hiv Prevalence ◽  
Sub Saharan Africa ◽  
Sensitivity Analyses ◽  
People Living With Hiv ◽  
Western Cape ◽  
Test Results ◽  
Individual Level

IntroductionThere are few population-wide data on viral suppression (VS) that can be used to monitor programmatic targets in sub-Saharan Africa. We describe how routinely collected viral load (VL) data from antiretroviral therapy (ART) programmes can be extrapolated to estimate population VS and validate this using a combination of empiric and model-based estimates.MethodsVL test results from were matched using a record linkage algorithm to obtain linked results for individuals. Test-level and individual-level VS rates were based on test VL values <1000 cps/mL, and individual VL <1000 cps/mL in a calendar year, respectively. We calculated population VS among people living with HIV (PLWH) in the province by combining census-derived midyear population estimates, HIV prevalence estimates and individual level VS estimates from routine VL data.ResultsApproximately 1.9 million VL test results between 2008 and 2018 were analysed. Among individuals in care, VS increased from 85.5% in 2008 to 90% in 2018. Population VS among all PLWH in the province increased from 12.2% in 2008 to 51.0% in 2017. The estimates derived from this method are comparable to those from other published studies. Sensitivity analyses showed that the results are robust to variations in linkage method, but sensitive to the extreme combinations of assumed VL testing coverage and population HIV prevalence.ConclusionWhile validation of this method in other settings is required, this approach provides a simple, robust method for estimating population VS using routine data from ART services that can be employed by national programmes in high-burden settings.

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