Conversation in preventive health care: needs assessment and tool development

Aim Conversation between Child Healthcare Professionals (CHPs) and parents and adolescents plays an important role in the quality and success of preventive health care delivery. However, there is no practice guideline on conversation. This study aimed to study 1) the needs of parents, adolescents, and Child Healthcare professionals regarding conversations, and 2) the extent to which available guidelines meet their needs. Method A written needs survey was conducted among parents (n= 302), youth (n=308), and professionals (n=165). In addition to the written survey, focus groups were convened with each target group. To answer the second question, 13 guidelines with a focus on psychosocial problems of youth and/or family problems were analyzed to list all information on conversation management and compare it to the needs. Results The survey showed that parents as well as young people need a listening ear on an equal level, without judgment. Young people find it important that there is room to get acquainted so that trust can be gained. They ask their question sometime indirectly to a CHP, as if it were a friend. Especially then it is important that the professional continues to ask questions. Professionals find it difficult to discuss suspicions of abuse, obesity, smoking, selfharm or depression among young people. Preconditions that can support the conversation are, according to professionals, a pleasant place with privacy and knowledge about intercultural communication or cultural sensitivity. Next, comparison of the results of the needs assessment with 13 CHP guidelines showed that information on conversation management in guidelines is usually implicit. Also, recommendations with regard to dealing with diversity or working interculturally are brief. Conclusion Based on needs survey of parents, youth and professionals, tips and recommendations for conversation were made explicit. In order to make the results of the needs assessment practically applicable, we have developed a tool in which all information from the needs assessment and the guidelines are summarized. This has resulted in a set of 100 conversation cards. Each card contains a tip or recommendation. The card set can be used for training, peer review or reflection on one's own practice.