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Abstract：
OBJECTIVE: To develop, implement, and assess implementation outcomes for a developmental monitoring and referral program for children in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
METHODS: Based on Centers for Disease Control and Prevention\'s Learn the Signs. Act Early. campaign, the program was developed and replicated in two phases at 20 demographically diverse WIC clinics in eastern Missouri. Parents were asked to complete developmental milestone checklists for their children, ages 2 months to 4 years, during WIC eligibility recertification visits; WIC staff referred children with potential concerns to their healthcare providers for developmental screening. WIC staff surveys and focus groups were used to assess initial implementation outcomes.
RESULTS: In both phases, all surveyed staff (n = 46) agreed the program was easy to use. Most (≥ 80%) agreed that checklists fit easily into clinic workflow and required ≤ 5 min to complete. Staff (≥ 55%) indicated using checklists with ≥ 75% of their clients. 92% or more reported referring one or more children with potential developmental concerns. According to 80% of staff, parents indicated checklists helped them learn about development and planned to share them with healthcare providers. During the second phase, 18 of 20 staff surveyed indicated the program helped them learn when to refer children and how to support parents, and 19 felt the program promoted healthy development. Focus groups supported survey findings, and all clinics planned to sustain the program.
CONCLUSIONS: Initial implementation outcomes supported this approach to developmental monitoring and referral in WIC. The program has potential to help low-income parents identify possible concerns and access support.
METHODS: Based on Centers for Disease Control and Prevention\'s Learn the Signs. Act Early. campaign, the program was developed and replicated in two phases at 20 demographically diverse WIC clinics in eastern Missouri. Parents were asked to complete developmental milestone checklists for their children, ages 2 months to 4 years, during WIC eligibility recertification visits; WIC staff referred children with potential concerns to their healthcare providers for developmental screening. WIC staff surveys and focus groups were used to assess initial implementation outcomes.
RESULTS: In both phases, all surveyed staff (n = 46) agreed the program was easy to use. Most (≥ 80%) agreed that checklists fit easily into clinic workflow and required ≤ 5 min to complete. Staff (≥ 55%) indicated using checklists with ≥ 75% of their clients. 92% or more reported referring one or more children with potential developmental concerns. According to 80% of staff, parents indicated checklists helped them learn about development and planned to share them with healthcare providers. During the second phase, 18 of 20 staff surveyed indicated the program helped them learn when to refer children and how to support parents, and 19 felt the program promoted healthy development. Focus groups supported survey findings, and all clinics planned to sustain the program.
CONCLUSIONS: Initial implementation outcomes supported this approach to developmental monitoring and referral in WIC. The program has potential to help low-income parents identify possible concerns and access support.
摘要：
目标：开发，工具，并评估妇女特别补充营养方案中儿童发育监测和转诊方案的实施结果，婴儿,儿童（WIC）。
方法：基于疾病控制和预防中心的了解迹象。行动早。竞选,该计划在密苏里州东部的20个人口统计学上不同的WIC诊所分两个阶段进行开发和复制.父母被要求为他们的孩子完成发展里程碑清单，年龄2个月到4岁，在WIC资格重新认证访问期间；WIC工作人员将有潜在担忧的儿童转介给其医疗保健提供者进行发育筛查。WIC工作人员调查和焦点小组用于评估初步实施成果。
结果：在这两个阶段，所有接受调查的工作人员（n=46）都同意该程序易于使用。大多数（≥80％）同意检查表易于纳入临床工作流程，并且需要≤5分钟才能完成。员工(≥55%)使用检查表指示其客户≥75%。92%或更多的人报告称一个或多个有潜在发育问题的儿童。根据80%的员工，父母表示清单帮助他们了解发展，并计划与医疗保健提供者分享。在第二阶段,接受调查的20名员工中有18名表示，该计划帮助他们了解何时转介孩子以及如何支持父母，19人认为该计划促进了健康发展。焦点小组支持调查结果，所有诊所都计划维持该计划。
结论：初步实施结果支持在WIC中采用这种方法进行发育监测和转诊。该计划有可能帮助低收入父母确定可能的问题并获得支持。
方法：基于疾病控制和预防中心的了解迹象。行动早。竞选,该计划在密苏里州东部的20个人口统计学上不同的WIC诊所分两个阶段进行开发和复制.父母被要求为他们的孩子完成发展里程碑清单，年龄2个月到4岁，在WIC资格重新认证访问期间；WIC工作人员将有潜在担忧的儿童转介给其医疗保健提供者进行发育筛查。WIC工作人员调查和焦点小组用于评估初步实施成果。
结果：在这两个阶段，所有接受调查的工作人员（n=46）都同意该程序易于使用。大多数（≥80％）同意检查表易于纳入临床工作流程，并且需要≤5分钟才能完成。员工(≥55%)使用检查表指示其客户≥75%。92%或更多的人报告称一个或多个有潜在发育问题的儿童。根据80%的员工，父母表示清单帮助他们了解发展，并计划与医疗保健提供者分享。在第二阶段,接受调查的20名员工中有18名表示，该计划帮助他们了解何时转介孩子以及如何支持父母，19人认为该计划促进了健康发展。焦点小组支持调查结果，所有诊所都计划维持该计划。
结论：初步实施结果支持在WIC中采用这种方法进行发育监测和转诊。该计划有可能帮助低收入父母确定可能的问题并获得支持。
