84 Methods to screen caregivers for previous and current substance use in the paediatric office: A scoping review
Notice bibliographique
Résumé
Abstract Background Paediatric healthcare providers have been shown to miss opportunities to screen caregivers for substance use. Individuals who use or have used substances face general healthcare barriers and may disengage with the system to avoid stigma or discrimination. Poorly worded or administered substance use screening practices by paediatricians could lead to retraumatization or judgment of caregivers that may affect the ability to continue providing healthcare to the child. There is limited information in the literature regarding best approaches for screening caregivers for substance use in paediatrics. Objectives The unique objective of this review was to identify current methods for, approaches to, and acceptability of caregiver substance use screening in paediatric offices. Design/Methods Searches were performed in CINAHL, PsycInfo, MEDLINE, and Social Sciences Abstracts databases with results limited from 2000 to 2023. Keywords included “perinatal”, “postnatal” “paediatric OR paediatric”, “substance use” OR “substance abuse” OR substances OR “alcohol use” OR “alcohol abuse” OR “addiction”, AND “screening”. Studies must have been conducted in Canada, the USA, Australia, or Scandinavia. Literature that was published in a language other than English, described screening caregivers for substance use using biological samples, or that focused solely on screening pregnant caregivers for substance use was excluded. Individual approaches to and provider and patient perspectives on screening were identified. Three authors completed title, abstract, and full text screening in Covidence screening software. Qualitative thematic coding identified geographical setting, the specific paediatric clinical setting, substances for which each study screened, characteristics of the participants, method of screening, and feedback related to acceptability, outcomes, or methods of screening. Results Practitioners used standardized and informal substance use screening tools. This review found that paediatric practitioners reported gaps in guidance on how best to screen caregivers for substance use and a desire for more improvement. Lack of guidance made it uncomfortable to screen caregivers. Increased comfort with screening was noted when a social needs survey was used as guidance. Caregivers were generally highly comfortable being screened for substance use and felt it was an acceptable action for paediatricians to undertake. However, the input of families in caregiver substance use screening methods was otherwise lacking. Substance use questions were often paired with questions asking caregivers to rate acceptability while other studies simply used the openness of being approached or absence of objections as acceptance of being screened. None of the studies identified in this review included the ability for families to participate more fully in screening acceptability or design. Conclusion Family engagement in research regarding the ideal acceptability and design of screening methods is lacking while paediatric healthcare providers continue to be uncomfortable screening caregivers for substance use and wish for improved methods that facilitate trust with families. Further research into the design of trauma-informed caregiver substance use screening in paediatric settings may be needed.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,025 | 0,097 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,002 |
| Méta-épidémiologie (sens large) | 0,006 | 0,006 |
| Bibliométrie | 0,033 | 0,030 |
| Études des sciences et des technologies | 0,002 | 0,002 |
| Communication savante | 0,006 | 0,007 |
| Science ouverte | 0,003 | 0,004 |
| Intégrité de la recherche | 0,003 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,011 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».