Identification of children with psychosocial problems differed between preventive child health care professionals

Objective: To assess whether differences between individual Preventive Child Health Care (PCH) professionals in the percentage of children they identify as having psychosocial problems are larger than expected based on chance and whether such differences can be explained by differences in parent-reported problems or risk indicators. Study Design: We used data from three community-based studies among 3,170 Dutch children aged 8 till 12 years, invited for a routine health examination. Parents filled in the Child Behavior Checklist (CBCL) and questions on demographic characteristics. After the examination, PCH professionals registered whether they had identified any psychosocial problem in the child. We examined differences between professionals in the rate of identified children. We used multilevel logistic regression analysis to assess whether such differences could be explained by parent-reported problems or risk indicators. Results: Significant differences between PCH professionals were found (P < 0.001). These differences could not be explained by parent-reported problems or risk indicators. The differences were largest for children with a score above the CBCL clinical cut-off point. Conclusion: Some PCH professionals are more likely to identify psychosocial problems than others, independently from parentreported problems or other risk indicators. (C) 2008 Elsevier Inc. All rights reserved.