{
  "abstract": "Background The interval between the 6-8 week and 9-12 month mandated reviews in the Healthy Child Programme is lengthy and may lead to delayed intervention. Rotherham introduced a universal 3-4 month review to support child development and earlier identification of parent and child needs. This study evaluated the review’s reach, effectiveness, and acceptability.Methods Mixed methods, analysing administrative records and qualitative interviews/focus groups with parents (n=31), nursery nurses (n=7), and commissioners (n=4). Qualitative data were analysed thematically. Multivariate logistic regression assessed uptake and maternal mood recording across deprivation, ethnicity, age, and parity. Developmental outcomes were assessed by comparing Ages and Stages Questionnaire (ASQ-3) scores at 9-12 months between universal and pre-intervention cohorts.Results Between January 2024 and February 2025, uptake of the 3-4 month review stabilised at ~80%, lower than mandated-visit contacts (~95%). Uptake was equitable across deprivation and ethnicity but had lower odds among multiparous mothers (AOR 0.29, 95% CI 0.22-0.37). Recording of maternal mood was less likely for younger mothers (AOR 0.32, 95% CI 0.18-0.57) and multiparous mothers (AOR 0.77, 95% CI 0.63–0.94). At 9-12 months, the universal visit cohort had higher odds of scoring above the cut-off in problem solving on the ASQ-3 (AOR 1.41, 95% CI 1.03–1.95), with no significant differences for other ASQ-3 domains between cohorts. Qualitative data indicated high acceptability: parents valued the review for reassurance, tailored advice, and signposting but suggested moving the review to align with weaning. Parental concerns included inconsistent advice and maternal mood screening, all-day appointment windows, and unclear review purpose. Staff endorsed the review’s developmental focus but reported capacity pressures despite added posts.Conclusion Rotherham’s universal 3-4 month review was feasible, tailored to families, and perceived as beneficial, with some association with improved child problem-solving. Visits require clear communication of purpose, consistent maternal mood screening, and staff resource planning.",
  "authors": [
    {
      "affiliations": [
        "School of Medicine, University of Nottingham, Nottingham, UK"
      ],
      "name": "Nathan Davies"
    },
    {
      "affiliations": [
        "School of Medicine, University of Nottingham, Nottingham, UK"
      ],
      "name": "Holly Knight"
    },
    {
      "affiliations": [
        "Centre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UK"
      ],
      "name": "Denise Kendrick"
    },
    {
      "affiliations": [
        "School of Health Sciences, University of Nottingham, Nottingham, UK"
      ],
      "name": "Jessica Jackson"
    },
    {
      "affiliations": [
        "Centre for Evidence Based Healthcare, School of Medicine, University of Nottingham, Nottingham, UK"
      ],
      "name": "Jo Leonardi-Bee"
    },
    {
      "affiliations": [
        "School of Medicine, University of Nottingham, Nottingham, UK"
      ],
      "name": "Elizabeth Orton"
    }
  ],
  "title": "P10-5 Mixed methods evaluation of a universal 3–4 month healthy child programme review in Rotherham, England",
  "uid": "6e20c756-41a9-5e3b-9717-695ac2a02ec4"
}