Continuing education on child development for primary healthcare professionals: a prospective before-and-after study

CONTEXT AND OBJECTIVE: Children's developmental disorders are often identified late by healthcare professionals working in primary care. The aim of this study was to assess the impact of a continuing education program on child development, on the knowledge and practices of these professionals.DESIGN AND SETTING: Prospective single-cohort study (before-and-after study), conducted in the city of Belém, Pará , Brazil.METHODS: Two hundred and twenty-one professionals working in primary healthcare (82.2%) participated in a continuing education program on child development and were assessed before and after implementation of the program through tests on their knowledge of child development, consisting of 19 questions for physicians and 14 for nurses, and questionnaires on their professional practices.RESULTS: One to three years after the program, the mean number of correct answers in the tests had increased from 11.5 to 14.3 among physicians in the Healthy Family Program (Programa Família Saudável, PFS); 13.0 to 14.3 among physicians in Municipal Health Units (Unidades Municipais de Saúde, UMS); 8.3 to 10.0 among PFS nurses; and 7.8 to 9.4 among UMS nurses. In interviews with mothers attended by these professionals before the program, only 21.7% reported that they were asked about their children's development, 24.7% reported that the professional asked about or observed their children's development and 11.1% received advice on how to stimulate them. After the program, these percentages increased to 34.5%, 54.2% and 30.3%, respectively.CONCLUSIONS: Professionals who participated in the program showed improved performance regarding child development knowledge and practices.研究背景与目的：儿童发育障碍常被初级医疗保健从业人员延迟识别。本研究旨在评估儿童发育继续教育项目对该类从业人员的儿童发育相关知识与执业行为的影响。 研究设计与实施场景：前瞻性单队列研究（前后对照研究），于巴西帕拉州贝伦市开展。 研究方法：共有221名初级医疗保健从业人员（占比82.2%）参与了儿童发育相关继续教育项目，并在项目实施前后通过儿童发育知识测试及执业行为问卷进行评估。其中，医师组知识测试题共19道，护理组知识测试题共14道。 研究结果：项目实施后1至3年，健康家庭项目（Programa Família Saudável, PFS）医师组的知识测试平均正确答题数从11.5提升至14.3；市级卫生单位（Unidades Municipais de Saúde, UMS）医师组从13.0提升至14.3；PFS护理组从8.3提升至10.0；UMS护理组从7.8提升至9.4。在项目实施前对该类从业人员服务的母亲进行的访谈显示，仅21.7%的母亲表示曾被询问儿童发育情况，24.7%的母亲表示曾被从业人员询问或观察儿童发育情况，11.1%的母亲获得过儿童发育刺激相关指导。项目实施后，上述三项占比分别提升至34.5%、54.2%与30.3%。 研究结论：参与本继续教育项目的从业人员，其儿童发育相关知识掌握水平与执业行为均得到显著改善。