Assessing the associations between selected screening variables from the Healthy Babies Healthy Children (HBHC) screening tool in relation to mortality, hospitalizations and emergency room visits among infants and children
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Authors
Kern, Allison Ruth
Date
2025-05-02
Type
thesis
Language
eng
Keyword
Healthy Babies Health Children Program , Screening , Adverse infant outcomes , Adverse child outomes , Social determinants of health , Screening tool , Postpartum
Alternative Title
Abstract
Background. Identifying infant and child risk, monitoring outcomes, and implementing supportive community programs are significant public health priorities. Screening for risk during the early postpartum period is optimal, and Canadian public health programs include a variety of screening tools and processes.
Aim. This research aimed to inform the Ontario Healthy Babies Healthy Children (HBHC) screening process for identifying infants and children who may be at potential risk of mortality, hospital admissions, and emergency room visits.
Methods. We conducted a retrospective longitudinal cohort study that included all women and their infants, meeting study criteria, who were born in 2013 in Ontario (N = 128,875). Using administrative data housed in ICES, 18 variables representing responses from the HBHC Screening Tool were evaluated to determine associations with the study outcomes. Associations with the outcomes were measured for infants from birth to 1 year and children from 1- 6 years. Sensitivity and specificity testing were completed to determine optimal cutoff points for identifying risk mortality and hospital admissions.
Results. We demonstrated that the risk of infant mortality was associated with a cutoff point of 4 and 18 variables representing the HBHC screening responses. We further demonstrated that a reduced 9-variable model was equally as sensitive to establishing the risk of infant mortality using a cutoff point of 2. Other tested infant and child models were not as robust or sensitive, suggesting that additional variables influence the tested outcomes.
Contribution. This study contributes to an existing body of knowledge that can inform the current HBHC screening protocol and process. Early postpartum screening is an initial step in risk identification. Further validation of tools and processes is warranted.
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This publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.