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| Name | Class |
|---|---|
| Päivikki and Sakari Sohlberg Foundation, Finland | OTHER |
| City of Helsinki | OTHER |
| Finnish Foundation for General Practice | UNKNOWN |
| General Practitioners in Finland |
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The aims of the study are 1) to evaluate the potential benefits or harm of school doctors' routine health checks and 2) to explore whether part of the school doctors' routine health checks can be omitted using study questionnaires which address the parents', school nurses' and teachers' concerns regarding each child.
The aim is to include 4 cities, 21 schools, 14 doctors and 1050 children from Southern Finland. From each doctor the aim is to get 25 children from both grades 1 and 5 (at ages 7 and 11) from 1-2 schools. Before the school doctor's check-up, the parents, nurses and teachers fill a questionnaire to identify any potential concerns about each child. The questions were partly chosen from the Strengths and Difficulties Questionnaire (SDQ). Additional questions concerning the child's growth, physical well-being, learning, school absenteeism and the well-being of the whole family are included. The doctor is blinded to the answers of the questionnaires. After the health check the doctors fill an electronic report including any instructions given, significant discussions and follow-up plans and their estimate of the potential benefit or harm of the medical appointment. The child and the parent fill patient-reported experience measure (PREM) forms where they evaluate the benefit or harm of the health check. The researchers compare the need for a doctor's appointment to the benefit gained. At one year after the check-up, the implementations of the follow-up plans are analyzed.
A data balance sheet has been prepared. The coordinating ethics committee of the Hospital District of Helsinki and Uusimaa (HUS) has approved the study protocol. Permissions for the study from the Department of Social Services and Healthcare and the Department of Education from all participating cities have been obtained. Informed consent will be obtained from all participating children, parents, doctors, nurses and teachers.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Grade 1 children | Areas of concern in study questionnaires: growth, physical symptom, hearing, school absenteeism, learning, concentration, behavior, emotions, getting on with others, eating, sleeping, wellbeing of family, free description of concern, wish to talk about concerns with the school doctor |
| |
| Grade 5 children | Areas of concern in study questionnaires: growth, physical symptom, hearing, school absenteeism, learning, concentration, behavior, emotions, getting on with others, eating, sleeping, wellbeing of family, free description of concern, wish to talk about concerns with the school doctor |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Study questionnaires | Other | filled by parents, school nurse and teacher |
|
| Measure | Description | Time Frame |
|---|---|---|
| The need for a school doctor's health check | The need for a school doctor's health check according to the study questionnaires filled by parents, nurse and teacher. Areas of concern in study questionnaires: growth, physical symptom, hearing, school absenteeism, learning, concentration, behavior, emotions, getting on with others, eating, sleeping, wellbeing of family, free description of concern, wish to talk about concerns with the school doctor The responses will be categorized into three groups: 1) "Needs doctor's health check" 2) "No need for doctor's health check and 3) "Consultation of the nurse or doctor may be sufficient". | Baseline |
| The benefit/harm of school doctors' routine health checks | A seven point likert scale that is based on:
| Baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Interventions and plans arising from school doctors' routine health checks | Measures from the doctor's electronic report: instruction, other significant discussion, referral to laboratory test/physiotherapist/speech therapist/nutritionist/secondary care, guidance to or contact of a specialised worker or other unit: teacher/special education teacher/school psychologist/school social worker/health center/family guidance center/home service/child welfare, prescription, medical imaging, individual follow-up plan |
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Inclusion Criteria:
Grade 1 and grade 5 children
Exclusion Criteria:
Children studying mainly in special education groups or the need of an interpreter
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Finnish public primary schools from four urban municipalities (Helsinki, Tampere, Kirkkonummi and Kerava) in Southern Finland
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| Name | Affiliation | Role |
|---|---|---|
| Kirsi M Nikander, MD, PhD | Doctoral School in Health Sciences, University of Helsinki, Finland | Principal Investigator |
| Elina Hermanson, MD, PhD | Pikkujätti Medical Centre for Children and Youth, Finland | Study Director |
| Silja Kosola, MD, PhD | Helsinki University Hospital and University of Helsinki, Finland | Study Director |
| Minna Kaila, Professor | Faculty of Medicine, University of Helsinki, Finland | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| School and Student Health Services | Helsinki | Finland | ||||
| School and Student Health Services |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36379665 | Derived | Nikander K, Hermanson E, Vahlberg T, Kaila M, Kosola S. Parent, teacher, and nurse concerns and school doctor actions: an observational study of general health checks. BMJ Open. 2022 Nov 15;12(11):e064699. doi: 10.1136/bmjopen-2022-064699. | |
| 36053658 | Derived | Nikander K, Kosola S, Vahlberg T, Kaila M, Hermanson E. Associating school doctor interventions with the benefit of the health check: an observational study. BMJ Paediatr Open. 2022 Feb;6(1):e001394. doi: 10.1136/bmjpo-2021-001394. |
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| UNKNOWN |
| Network of Academic Health Centres, Finland | UNKNOWN |
| Foundation for Paediatric Research, Finland | OTHER |
| Pediatric Research Center, University of Helsinki | UNKNOWN |
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| Baseline |
| The implementations of the school doctors' follow-up plans | The implementations of measures from the doctor's electronic report (yes, no, information not accessible): instruction, referral to laboratory test/physiotherapist/speech therapist/nutritionist/secondary care, guidance to or contact of a specialised worker or other unit: teacher/special education teacher/school psychologist/school social worker/health center/family guidance center/home service/child welfare, prescription, medical imaging, individual follow-up plan | 12 months |
| Kerava |
| Finland |
| School and Student Health Services | Kirkkonummi | Finland |
| School and Student Health Services | Tampere | Finland |
| 34399731 | Derived | Nikander K, Hermanson E, Vahlberg T, Kaila M, Sannisto T, Kosola S. Associations between study questionnaire-assessed need and school doctor-evaluated benefit of routine health checks: an observational study. BMC Pediatr. 2021 Aug 16;21(1):346. doi: 10.1186/s12887-021-02810-0. |
| 29945604 | Derived | Nikander K, Kosola S, Kaila M, Hermanson E. Who benefit from school doctors' health checks: a prospective study of a screening method. BMC Health Serv Res. 2018 Jun 27;18(1):501. doi: 10.1186/s12913-018-3295-3. |