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A qualitative study of stakeholder perspectives on adopting a digital tool to measure child development at the 2-21/2 year review in England

Lysons, Joanna L; Mendez, Rocio Pineda; Aquino, Maria Raisa Jessica; Cann, Hannah; Fearon, Pasco; Kendall, Sally; Kirman, Jennifer; ... Woodman, Jenny; + view all (2026) A qualitative study of stakeholder perspectives on adopting a digital tool to measure child development at the 2-21/2 year review in England. Journal of Public Health 10.1007/s10389-025-02632-9. Green open access

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Abstract

Aim The 2–2½-year review is the final universal mandated contact in England’s Healthy Child Programme, with a child development assessment using the Ages and Stages Questionnaire-3 (AQ®-3). Amid a wider digitisation agenda, the UK government is exploring digital alternatives to the paper-based ASQ®-3 tool. Understanding stakeholder perspectives is critical for informing implementation. Subject and methods 15 focus groups (63 participants), including parents, health visiting professionals, local authority colleagues, and policy officials, analysed using Framework Analysis. Results Stakeholders reported potential benefits of a digital tool: user experience, service efficiency, and alignment with national digital priorities. However, where services were trying to meet the mandate to review every child aged 2–2½-years with limited resources and workforce, our participants saw a risk that a digital tool might replace a full in-person assessment. Parents and professionals agreed that any digital tool must not compromise the holistic, relational nature of the 2–2½-year review or undermine the universal coverage of in-person contacts with families. Participants highlighted the complexities of digital exclusion, incompatibility with local data systems, and staff training. Conclusions Digitisation must be implemented carefully to avoid undermining service equity and the core components of the service (universal in-person assessments), must include system interoperability, professional training.

Type: Article
Title: A qualitative study of stakeholder perspectives on adopting a digital tool to measure child development at the 2-21/2 year review in England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s10389-025-02632-9
Publisher version: https://doi.org/10.1007/s10389-025-02632-9
Language: English
Additional information: Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Keywords: Science & Technology, Life Sciences & Biomedicine, Public, Environmental & Occupational Health, Health visiting, Early child development, Child health, Healthy Child Programme, Digitisation, CARE
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Social Research Institute
URI: https://discovery.ucl.ac.uk/id/eprint/10220551
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