Smartphone-based developmental screening by community health care workers

Abstract

Developmental delays are more prevalent in lower income countries such as South Africa. However, access to developmental screening is severely limited. This study evaluated an mHealth version of a standard developmental screening tool, Parents Evaluation Developmental Status (PEDS) and PEDS: Developmental Milestones (PEDS:DM) for use by community health workers (CHWs) in terms of (1) correspondence with conventional paper-based testing by a speech language pathologist (SLP) and (2) inter-rater reliability compared to an SLP. CHWs were trained in a primary health care (PHC) setting to administer the newly developed smartphone application version of the PEDS tools. A quantitative cross sectional, within subject research design was followed, by implementing a survey method. One SLP and two CHWs recruited 207 caregivers who were attending a baby wellness clinic. Caregivers were tested by one CHW using the smartphone application of the PEDS tools, a qualified SLP simultaneously recorded and scored the PEDS tools on the same participants. High positive (100%) and negative correspondence (96%) was found between the paper-based PEDS tools and the smartphone application PEDS tools and between the SLP and CHW. Almost perfect (Cohen s Kappa) inter-rater agreement between conditions was demonstrated (??=0.873 to ??=0.961). Outcomes of the smartphone application, operated by a CHW, corresponded closely to the gold standard PEDS tools operated by a health professional. Trained CHWs can conduct accurate developmental screening using the smartphone version of the PEDS tools. The smartphone version of the PEDS tools could be used as part of the Community Oriented Primary Care (COPC).