Preventive healthcare for young children : a systematic review of interventions in primary care

Karyn E Alexander, Bianca Brijnath, Ruby Biezen, Kerry Hampton, Danielle Mazza

Research output: Contribution to journalReview articlepeer-review

14 Citations (Scopus)


High rates of preventable health problems amongst children in economically developed countries have prompted governments to seek pathways for early intervention. We systematically reviewed the literature to discover what primary care-targeted interventions increased preventive healthcare (e.g. review child development, growth, vision screening, social-emotional health) for preschool children, excluding vaccinations.
MEDLINE, EMBASE, CINAHL, and Cochrane databases were searched for published intervention studies, between
years 2000 and 2014, which reflected preventive health activities for preschool children, delivered by health practitioners. Analysis included an assessment of study quality and the primary outcome measures employed.
Of the 743 titles retrieved, 29 individual studies were selected, all originating from the United States. Twentyfour studies employed complex, multifaceted interventions and only two were rated high quality. Twelve studies addressed childhood overweight and 11 targeted general health and development. Most interventions reported outcomes that increased rates of screening, recording and recognition of health risks. Only six studies followed up
children post-intervention, noting low referral rates by health practitioners and poor follow-through by parents
and no study demonstrated clear health benefits for children. Preliminary evidence suggests that multi-component interventions, that combine training of health practitioners and office staff with modification of the physical environment and/or practice support, may be more effective than single component interventions. Quality Improvement interventions have been extensively replicated but their success may have relied on factors beyond the confines of individual or practice-led behaviour. This research reinforces the need for high quality studies
of pediatric health assessments with the inclusion of clinical end-points.
Original languageEnglish
Pages (from-to)236-250
Number of pages15
JournalPreventive Medicine
Publication statusPublished - 1 Jun 2017
Externally publishedYes


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