56 Asking about psychosocial risk factors as part of developmental surveillance: what do parents think about it?

Abstract Background Child development is influenced by the psychosocial environment. As part of developmental surveillance, identifying psychosocial risk factors that could hinder optimal development is therefore important. However, whether parents consider this type of question pertinent and acceptable remains unknown. Objectives To examine parental perception regarding the acceptability of asking questions about psychosocial background as part of a standardized developmental surveillance questionnaire. Design/Methods Using an online questionnaire and a snowball sampling approach, we surveyed parents living with at least one child <12 years of age over a 6 week-period. They were asked to rank acceptability on a 5-point Likert scale of four psychosocial and two medical indicators related to child development and to justify their answer. Descriptive statistics were computed and qualitative thematic content analysis was done on textual comments. Results Of 1651 participants, 97% were mothers and 93% declared having a post-secondary degree. Median age was 34 years old (interquartile range 31-38). An overwhelming majority found acceptable the questions about concerns regarding their child development (99%) and family history of developmental problems (95%). Psychosocial indicators were considered acceptable in the following proportions: substance abuse (84%), food insecurity (77%), past maternal history of depression (74%), and education level (65%). Higher rates of acceptability correlated with higher educational levels. Main themes that emerged regarding unacceptability were as follows: questions being offensive or intrusive, questions not relevant to child development, improper physical environment to ask such questions and lack of relationship with the health care professional in charge. Conclusion As part of developmental surveillance, questions on psychosocial risk factors can be disturbing to parents and must be addressed in a trusting environment and with a sensitive manner.