Evidence map›Paper›PMID 33485333›Full record

ArticleBMC health services research2021

Implementation of the norwegian 'Starting right' child health service innovation: implementation adjustments, adoption, and acceptability.

Thomas Westergren, Eirin Mølland, Kristin Haraldstad, Åshild Tellefsen Håland, Unni Mette Stamnes Köpp, Liv Fegran, Eirik Abildsnes

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Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Article
  4. Health-related quality of life and its association with socioeconomic status and mental health in 5- to 7-year-old children: a cross-sectional study.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025
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  6. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Thomas WestergrenFaculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway. thomas.westergren@uia.no.ORCID http://orcid.org/0000-0003-4253-1996
Eirin MøllandFaculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway.
Kristin HaraldstadFaculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway.
Åshild Tellefsen HålandFaculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway.
Unni Mette Stamnes KöppSørlandet Hospital, P.O. Box 416 Lundsiden, 4604, Kristiansand, Norway.
Liv FegranFaculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway.
Eirik AbildsnesFaculty of Health and Sports Sciences, University of Agder, P.O. Box 422, 4604, Kristiansand, Norway.

Funding

Regional Research Fund in Agder 285009
6 · The paper itself

Abstract

backgroundAn increased and/or stable proportion of the child and adolescent population reports symptoms of impaired health, and the symptoms can be identified early. Therefore, structured child- and parent-reported outcome measures need to be implemented in child and school health services for decision support and identification of children at risk. We aimed to (a) qualitatively examine adjustments of active implementation from the pilot implementation of the Norwegian 'Starting Right' health service innovation including an online child health assessment tool and practical routines, and (b) measure practitioners´ adoption and parental acceptability.

methodsWe used a mixed-methods design to qualitatively examine adjustments from working notes and meeting memoranda, and quantitatively assess adoption and acceptability from user rates provided by the systems log. Twenty-one child and school health nurses (CSHNs) from two child health centers participated in the implementation pilot of online health assessments in children aged 2-, 4- and 6-year. We used a deductive and narrative analysis approach using Fixsen et al.´s core implementation components to code and sort adjustments.

resultsCore implementation components were adjusted throughout the pilot implementation. Researchers´ increased their availability in reciprocity with staff evaluation to integrate active implementation adjustments. We launched a project for improved data systems integration. The overall CSHNs adoption rate was satisfactory and higher in center A, where a medical secretary supported the nurses through the entire pilot phase, than in center B (96 vs. 55 %). Parental acceptability rate was overall high (77 %) with increased rates among parents of 6-year-old children (98 %) compared with younger ones (78-85 %), and in cases where both parents received the questionnaires.

conclusionsThe 'Starting Right' health service innovation implementation was actively adjusted by integration of core implementation components mainly based on staff evaluation. The CSHNs adopted the innovation which was also acceptable to parents.

Indexed as

Child Health ServicesChildChild, PreschoolFemaleHumansNorwayParentsSchool Health ServicesSurveys and QuestionnairesChild healthCore conceptsDecision supportEvidence‐based practiceHealth service innovationImplementationPublic health nursesSchool health

Identifiers

PMID33485333
PMCPMC7824922

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.