Introduction:
Paediatric screening programmes are essential for the early detection of physical diseases that may appear during childhood or later in life, improving children's health outcomes. However, while clinical benefits are often indisputable, from a psychological perspective prevention is not always an easy choice, as it can cause anxiety and stress in parents who must make health decisions for their children. Understanding the psychological and social factors that influence these decisions is crucial to developing effective strategies to increase participation in screening programmes.
Purpose:
This systematic review aims to synthesise evidence on barriers, facilitators, and decision-making processes that influence parental adherence to preventive paediatric screening programmes for various physical health conditions.
Method:
The review is pre-registered in PROSPERO (CRD420251058370). A systematic search was conducted in PubMed, PsycInfo, Scopus, and the Science Citation Index, with no time limits, including studies in English and Italian. Quantitative, qualitative, and mixed-methods studies on caregiver participation in preventive paediatric screening for physical conditions (e.g., type 1 diabetes, congenital hypothyroidism, hearing loss, metabolic disorders) were included. Screening and data extraction are ongoing, and preliminary analyses are based on studies meeting inclusion criteria to date.
Preliminary results:
Three macro-categories of factors emerged.
Cognitive and informational: understanding the preventive purpose and benefits of screening motivates participation, though uncertainty about non-symptomatic positivity creates ambivalence and demand for clearer communication.
Emotional-relational: anxiety and responsibility may cause hesitation, but trust in professionals and relational support promote engagement.
Contextual and organisational: simplicity, free access, and active invitation increase participation, which is generally high. Overall, parents show strong preventive motivation but ambivalent feelings balancing reassurance and fear of early knowledge.
Conclusions:
Adherence to paediatric screening is generally good but shaped by emotional ambivalence. Recognising these dynamics can guide communication and psychoeducational strategies to promote informed and supported parental participation.