Process Evaluation of the Child and Youth Healthcare Intervention 'Medical Advice for Sick-Reported Students in Primary School' (MASS-PS)

How to deal with sickness absence among primary school pupils? Adaptation of the "Medical Advice for Sick-reported Students" intervention

Background

Missing school impacts both education and health. The purpose of this study was to address sickness absence in primary schools by adjusting the 'Medical Advice for Sick-reported Students' intervention for secondary schools. This was necessary because of fundamental differences in relation to the children's age and in the schools' organizational structure.

Methods

The intervention mapping approach steps 1 through 4 were used to adapt 'Medical Advice for Sick-reported Students' to primary schools (MASS-PS), including a literature search, stakeholder interviews, establishing a planning group and pre-testing.

Results

In step 1, a planning group was formed and a logic model of the problem was created. In step 2, a logic model of change was created. In step 3, a theoretical basis and practical strategies were determined. In step 4, practical support materials were designed, and two pre-tests of the materials were performed.

Conclusion

Intervention mapping was successfully used to adapt MASS to primary schools. The main changes were the lowering of the threshold for extensive sickness absence, consultations between teacher and attendance coordinator, and addition of two experts. With MASS-PS, sickness absence can be addressed as a "red flag" for underlying problems.

The Preventive Child and Youth Healthcare Service in the Netherlands: The State of the Art and Challenges Ahead

The Netherlands has a unique system for promoting child and youth health, known as the preventive Child and Youth Healthcare service (CYH). The CYH makes an important contribution to the development and health of children and young people by offering (anticipatory) information, immunisation, and screening, identifying care needs and providing preventive support to children and their families from birth up to the age of 18 years. The CYH is offered free of charge and offers basic preventive care to all children and special preventive care to children who grow up in disadvantaged situations, such as children growing up in poverty or in a family where one of the members has a chronic health condition. Basic care is supported by 35 evidence-based guidelines and validated screening tools. Special care is supported by effective interventions. The impact of the CYH is high. It is estimated that every EUR 1 spent on the CYH provides EUR 11 back. Although the Dutch CYH is a solid public health system with a reach of up to 95% among young children, the access to this service could be further improved by paying more attention to health literacy, making special care available to all children in need and improving transmural and integrated care coordination. In addition, the generation of nationwide data could help to demonstrate the impact of the CYH and will direct and prioritise the necessary care. By continuously developing care on the basis of new (scientific) insights and (societal) issues, the CYH will continue to offer all children in the Netherlands the best preventive healthcare.