Determinants influencing the implementation of a guideline to detect child abuse and neglect (the ‘Child Check’) in Dutch mental healthcare organisations

Abstract Background Although Dutch mental healthcare organisations (MHCOs) state that they have implemented the ‘Child Check’, a mandatory guideline to detect child abuse and neglect based on parental characteristics, it is unclear to what extent this guideline is used by professionals. We aimed to assess the level of implementation and associated determinants of the Child Check by mental healthcare professionals. Methods A total of 200 questionnaires, based on the Measurement Instrument for Determinants of Innovations (MIDI), was completed by mental healthcare professionals. Univariate and multiple regression analyses were performed to assess the relationship between implementation levels and determinants. Results The implementation level was moderate (2.55[0.74], on a score of 1 to 5). It was found that the use of the Child Check by colleagues (β = 0.30, p<.001, 95% confidence interval (CI) [0.21–0.43]), the extent to which professionals felt obligated to use the Child Check (β = 0.32, p<.001, 95% CI [0.26–0.55]), procedural clarity (β = 0.22, p<.01, 95% CI [0.07–0.30]), habit formation (β = 0.14, p<.05, 95% CI [0.03–0.20]), and healthcare professionals’ experience with the Reporting Center for Child Abuse and Neglect (RCCAN) (β = 0.10, p<.05, 95% CI [0.01–0.25]) were determinants positively associated with implementation levels. A positive experience of the adult client with the RCCAN in the perception of the healthcare professional was negatively associated with high levels of implementation (β=-0.10, p<.05, 95% CI [-0.22–0.01]). Conclusions To better target the implementation of guidelines in mental healthcare, we suggest an emphasis not only on the formulation of basic requirements and the use of an implementation coach but also on education, training, user-friendly decision tools, ongoing feedback to healthcare professionals, and collaborative learning between RCCAN and healthcare professionals.