How widely are personal child health records used and are they effective health education tools? A comparison of two records.

Abstract Background Although the Personal Child Health Records (PCHR) has been in use for 15 years, its efficacy as a health education tool has not been evaluated. The phased introduction of a new, professionally designed record within a large cohort study provided the opportunity to compare parental rating and use of the different records and recall of health topics covered. Subjects and methods All babies born over a 15-month period were eligible. Half (679) were born during study recruiting periods and received an expanded version of the new record; 30% (411) were born in non-recruiting periods and received the old record and 20% (279) were born after the new record had been fully introduced. Parents completed a one-page postal questionnaire when their child was aged 6-17 months. Results Parents rated both record types highly and the majority used them regularly to take to baby clinics and for information. Health visitors wrote frequently in the record, compared with only half of parents and less than a quarter of family doctors. Old format records were significantly more likely to be taken to and written in by the family doctor. Parents used new format records less as a source of information, but were no more likely to use other recommended information sources. Parents with new format records showed better recall of information found only, or more prominently in the new records, but the actual differences were small. Conclusions The PCHR remains popular with parents, but is still underused except by health visitors. Recall of health information in the record is fairly poor, but families make little use of other, better information sources. Professional redesign did not improve the efficacy of the record.