Screening tools used in primary health care settings to identify health behaviours in children (birth – 16 years); A systematic review of their effectiveness, feasibility and acceptability

ABSTRACT Background Child health behaviour screening tools used in primary health care have potential as a transformative and effective strategy to support growth monitoring and the early identification of suboptimal behaviours to target strategies for intervention. This systematic review aimed to examine the effectiveness, acceptability and feasibility of child health behaviour screening tools used in primary health care settings. Methods A systematic review of studies published in English in five databases (CINAHL, Medline, Scopus, PsycINFO and Web of Science) prior to July 2022 was undertaken using a PROSPERO protocol and PRISMA guidelines. Eligible studies: 1) described screening tools for health behaviours (dietary, physical activity, sedentary or sleep-related behaviours) used in primary health care settings in children birth to 16 years of age; 2) reported their acceptability, feasibility or effectiveness on child or practitioner behaviour or 3) reported implementation of the screening tool. Study selection and data extraction were conducted in duplicate. Results were narratively synthesised. Results Of the 7145 papers identified, 22 studies reporting on 14 unique screening tools were included. Four screening tools measured diet, physical activity, sedentary and sleep behaviours domains, with most screening tools only measuring two or three behaviour domains. Ten studies reported screening tools were effective in changing practitioner self-reported behaviour, knowledge, self-efficacy and provision of health behaviour education. Administration of screening tools varied across studies including mode, timing and caregiver or practitioner completion. Implementation strategies described included practitioner training and integration into electronic medical records. Practitioners and caregivers identified numerous benefits and challenges to screening; however, child views were not captured. Conclusions Few screening tools exist to facilitate comprehensive screening of children’s health behaviours in primary health care. This review highlights the potential of health behaviour screening as an acceptable and feasible strategy to comprehensively assess and provide early intervention for children’s health behaviours in primary health care settings. Potential conflicts of interest All authors have no conflicts of interest to declare.