[Case finding in early prevention networks - a heuristic for ambulatory care settings]

Background: One goal of early prevention is the support of families with small children up to three years who are exposed to psychosocial risks. The identification of these cases is often complex and not well-directed, especially in the ambulatory care setting.

Objective: Development of a model of a feasible and empirical based strategy for case finding in ambulatory care.

Methods: Based on the risk factors of postpartal depression, lack of maternal responsiveness, parental stress with regulation disorders and poverty a lexicographic and non-compensatory heuristic model with simple decision rules, will be constructed and empirically tested. Therefore the original data set from an evaluation of the pediatric documentary form on psychosocial issues of families with small children in well-child visits will be used and reanalyzed.

Results: The first diagnostic step in the non-compensatory and hierarchical classification process is the assessment of postpartal depression followed by maternal responsiveness, parental stress and poverty. The classification model identifies 89.0 % cases from the original study. Compared to the original study the decision process becomes clearer and more concise.

Conclusions: The evidence-based and data-driven model exemplifies a strategy for the assessment of psychosocial risk factors in ambulatory care settings. It is based on four evidence-based risk factors and offers a quick and reliable classification. A further advantage of this model is that after a risk factor is identified the diagnostic procedure will be stopped and the counselling process can commence. For further validation of the model studies, in well suited early prevention networks are needed.