The healthcare needs of a cohort of kindergarten children in a rural New South Wales community: a medical record review

Catherine V. Sanford; Emily K. Saurman; Danielle K. White; Karen Harding-Smith; Rebecca J. Smith; Sarah M. Dennis; Armando Teixeira-Pinto; David M. Lyle

doi:10.1071/PU24010

RESEARCH ARTICLE (Open Access)

The healthcare needs of a cohort of kindergarten children in a rural New South Wales community: a medical record review

Catherine V. Sanford ^A ^* , Emily K. Saurman ^B ^C , Danielle K. White ^A , Karen Harding-Smith ^A ^D , Rebecca J. Smith ^D , Sarah M. Dennis ^E ^F , Armando Teixeira-Pinto ^C ^G and David M. Lyle ^H

+ Author Affiliations

- Author Affiliations

^A Broken Hill University Department of Rural Health, Sydney School of Nursing, Faculty of Medicine and Health, The University of Sydney, Broken Hill, NSW, Australia.

^B School of Rural Health (Dubbo/Orange), Faculty of Medicine and Health, The University of Sydney, Dubbo/Orange, NSW, Australia.

^C Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.

^D Far West Local Health District, NSW Health, Broken Hill, NSW, Australia.

^E Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.

^F Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.

^G Centre for Kidney Research (Westmead), Westmead, NSW, Australia.

^H The University of Sydney, Sydney, NSW, Australia.

^* Correspondence to: catherine.sanford@sydney.edu.au

Public Health Research and Practice 35, PU24010 https://doi.org/10.1071/PU24010

Submitted: 8 February 2024 Accepted: 25 September 2024 Published: 23 April 2025

© 2025 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of the Sax Institute. This is an open access article distributed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC)

Abstract

Objective

To quantitatively describe the healthcare needs of a cohort of kindergarten children in a low-socioeconomic rural community to inform school entry health check programs and school-based healthcare services.

Study type

Medical record review.

Methods

Data were extracted from the community health electronic medical records of children who started primary school in 2019 at one of the five study schools and who received at least one occasion of service from a nurse-led School-Based Primary Health Care Service for a health or developmental concern. Data extracted included demographics, presenting concerns, challenges to accessing care, service activities, and referrals.

Results

Of the 140 children enrolled in kindergarten in the sample schools, 84 (60%) had an occasion of service for a health or developmental concern. Of these 84 children, speech and language concerns (43%) were most frequently observed, followed by metabolic/nutrition (26%), behaviour (16%), and vision (16%) concerns. Evidence of challenges to accessing care was identified in 40% of cases. Sixty percent of identified children were referred to another provider.

Conclusion

The high prevalence of health and developmental concerns and challenges to accessing care found in this study supports the need for school entry health check models that provide ongoing support to families.

Keywords: access to care, Australia, health and development, kindergarten children, low-socioeconomic communities, primary health care, rural communities, school entry health checks, school health services.

References

1 Dockett S, Perry B. Research to Policy: Transition to School Position Statement. In: Perry B, Dockett S, Petriwskyj A, editors. Transitions to School - International Research, Policy and Practice. Dordrecht: Springer Netherlands; 2014. pp. 277–94.

2 Margetts K. Preparing Children for School - Benefits and Privileges. Australas J Early Childhood 2007; 32(2): 43-50.
| Crossref | Google Scholar |

3 Goldfeld S, O’Connor M, Quach J, Tarasuik J, Kvalsvig A. Learning trajectories of children with special health care needs across the severity spectrum. Acad Pediatr 2015; 15(2): 177-84.
| Crossref | Google Scholar | PubMed |

4 Schmied V, Kruske S, Barclay L, Fowler C. National Framework for Universal Child and Family Health Services. Adelaide: Australian Health Ministers’ Advisory Council; 2011. Available at www.health.gov.au/resources/publications/national-framework-for-universal-child-and-family-health-services [cited 20 June 2024].

5 Bull C, Howie P, Callander EJ. Inequities in vulnerable children’s access to health services in Australia. BMJ Global Health 2022; 7(3): e007961.
| Crossref | Google Scholar | PubMed |

6 Neilsen-Hewett C. A brighter beginning for every child and family in NSW. Brighter Beginnings Newsletter, 2022 August. New South Wales: NSW Government. Available at https:mailchi.mp/be5151c51ed1/brighter-beginnings-newsletter-aug-2022 [cited 20 June 2024].

7 Mendoza Diaz A, Leslie A, Burman C, Best J, Goldthorp K, Eapen V. School-based integrated healthcare model: how Our Mia Mia is improving health and education outcomes for children and young people. Aust J Prim Health 2021; 27(2): 71-5.
| Crossref | Google Scholar | PubMed |

8 State of Victoria (Department of Education and Training). Victorian School Nursing Program Guidelines. Melbourne: Victoria State Government; 2019. Available at https://content.sdp.education.vic.gov.au/media/victorian-school-nursing-program-guidelines-934 [cited 25 June 2024].

9 State of Western Australia Child and Adolescent Health Service. WA School Health Program Guide. WA: State of Western Australia; 2022. Available at https://cahs.health.wa.gov.au/~/media/HSPs/CAHS/Documents/Health-Professionals/Schools-and-Child-Care/WA-School-Health-Program-Guide-FINAL.pdf [cited 25 June 2024].

10 Sanford C, Saurman E, Dennis S, Lyle D. ‘We’re definitely that link’: the role of school-based primary health care registered nurses in a rural community. Aust J Prim Health 2021; 27(2): 76-82.
| Crossref | Google Scholar | PubMed |

11 Dennis S, Noon T, Liaw ST. Is there a role for a primary health nurse in a learning support team in a disadvantaged high school? Evaluation of a pilot study. Aust J Prim Health 2016; 22(6): 530-8.
| Crossref | Google Scholar | PubMed |

12 NSW Government. Wellbeing and Health In-reach Nurse Coordinator Program Operational Guidelines December 2022. NSW: NSW Government; 2022. Available at www.health.nsw.gov.au/kidsfamilies/youth/Documents/whinc-coord-prog-operational-guideline.pdf [cited 25 June 2024].

13 NSW Department of Education. Best Start Kindergarten Assessment. NSW: NSW Government; 2022. Available at https://education.nsw.gov.au/teaching-and-learning/curriculum/literacy-and-numeracy/assessment-resources/best-start-kindergarten#:~:text=Best%20Start%20Kindergarten%20Assessment%20identifies,Literacy%20and%20Numeracy%20Learning%20Progressions [cited 25 June 2024].

14 Squires J, Bricker D. Ages & Stages Questionnaires®, Third Edition (ASQ®-3): A Parent-Completed Child Monitoring System. Baltimore: Paul H. Brookes Publishing Co. Inc.; 2009.

15 Wells KJ, Valverde P, Ustjanauskas AE, Calhoun EA, Risendal BC. What are patient navigators doing, for whom, and where? A national survey evaluating the types of services provided by patient navigators. Patient Educ Couns 2018; 101(2): 285-94.
| Crossref | Google Scholar | PubMed |

16 Data NSW. Full-time equivalent (FTE) enrolments by individual NSW government schools, grade and calendar year. Sydney: Education Statistics and Measurement Unit Centre for Education Statistics and Evaluation; 2010–2022. Available at https://data.nsw.gov.au/data/dataset/nsw-education-full-time-equivalent-fte-enrolments-by-individual-nsw-government-schools-and-calendar- [cited 28 June 2024].

17 Australian Curriculum Assessment and Reporting Authority. School Profile 2008-2023. Australian Curriculum Assessment and Reporting Authority; 2024. Available at www.acara.edu.au/contact-us/acara-data-access [cited 28 June 2024].

18 Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap) - A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42: 377-81.
| Crossref | Google Scholar | PubMed |

19 International Classification Committee The World Organization of Family Doctors. ICPC-2-R: International Classification of Primary Care, Revised 2nd edn. Oxford: Oxford University Press; 2005.

20 Australian Early Development Census. Community Profile 2021 Far West NSW, NSW. Commonwealth of Australia; 2022. Available at https://aedc-gov-au-static-files.s3.ap-southeast-2.amazonaws.com/community-profiles/10047.pdf [cited 28 June 2024].

21 Howells S, Nguyen HT, Brinkman S, Mitrou F. Investigating the Validity of the Australian Early Development Census. Child Psychiatry Hum Dev 2024; 55: 1564-81.
| Crossref | Google Scholar | PubMed |

22 Jones DM, Lyle D, Brunero C, McAllister L, Webb T, Riley S. Improving Health and Education Outcomes for Children in Remote Communities A cross-sector and developmental evaluation approach. Gateways 2015; 8: 1-22.
| Crossref | Google Scholar |

23 Department of Education and Training. State findings from the School Entrant Health Questionnaire. Vic: State of Victoria; 2020. Available at https://www.vic.gov.au/school-entrant-health-questionnaire [cited 28 June 2024].

24 Langbecker D, Snoswell CL, Smith AC, Verboom J, Caffery LJ. Long-term effects of childhood speech and language disorders: A scoping review. S Afr J Childhood Educ 2020; 10(1): a801.
| Crossref | Google Scholar |

25 Bevilacqua L, Hale D, Barker ED, Viner R. Conduct problems trajectories and psychosocial outcomes: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2018; 27(10): 1239-60.
| Crossref | Google Scholar | PubMed |

26 Anderson LM, Shinn C, Fullilove MT, Scrimshaw SC, Fielding JE, Normand J, Carande-Kulis VG. The effectiveness of early childhood development programs: A systematic review. Am J Prev Med 2003; 24(suppl 3): 32-46.
| Crossref | Google Scholar | PubMed |

27 O’Connor M, O’Connor E, Gray S, Goldfeld S. Trends in preschool attendance in Australia following major policy reform: Updated evidence six years following a commitment to universal access. Early Child Res Q 2020; 51: 93-9.
| Crossref | Google Scholar |

28 Kenny B, Lincoln M, Balandin S. Experienced Speech-Language Pathologists’ Responses to Ethical Dilemmas: An Integrated Approach to Ethical Reasoning. Am J Speech Lang Pathol 2010; 19: 121-34.
| Crossref | Google Scholar | PubMed |

29 Woodman K. Evidence briefing in support of the Universal Health Visiting Pathway. Edinburgh: NHS Health Scotland; 2016. www.healthscotland.com/documents/27638.aspx (URL no longer active) [cited 28 June 2024].