Knowledge and Awareness of Family Physicians as Key Stakeholders Regarding Developmental Dysplasia of the Hip and the Nationwide Screening Program

Abstract

Objective: The aim of this study was to examine the knowledge levels and awareness of family physicians about Developmental Dysplasia of the Hip (DDH) and the Nationwide Newborn Hip Screening Program in Turkey.

Methods: This observational, cross-sectional study was conducted between May and August 2021, involving 401 family physicians working at Family Health Centers (FHC) in Istanbul. A face-to-face survey, developed based on the literature and validated by experts, assessed participants' knowledge, awareness, and practices regarding DDH and the nationwide screening program. The survey consisted of two sections: a Participant Information Form (14 socio-demographic and professional questions) and 30 knowledge-based questions (8 using a Likert scale).

Results: Among the 401 family physicians who participated in the study, 109 (27.2%) reported actively managing patients diagnosed with DDH. Over the past year, 20,124 babies were stated to be screened, with 2.98% identified as having pathological ultrasonography results. The overall knowledge and awareness score (for DDH, program details and practices) was 66.59 ± 8.4%, positively associated with following babies with DDH (p=0.042), attending congresses/symposiums (p=0.008), specialty training (p=0.022; r=0.156), receiving in-service training and online education on hip screening program (p=0.002; r=0.167), and screening a higher number of babies (p<0.001). 71.3% of participants recommended double diapering for babies with high risk factors, while 70.3% used provocative tests such as the Barlow-Ortolani. Knowledge awareness scores about the hip screening program were significantly higher in those who followed DDH patients (p<0.001), attended congress and symposiums (p=0.006), screened higher number of babies (r=0.216, p<0.001), had specialty training (p=0.005), female physicians (p=0.012), used multiple training resources (p=0.002), and considered themselves competent in DDH (p<0.001). Awareness of DDH risk factors and treatment remained relatively low (49.2% and 64.1%, respectively). Perception of self-competency scores were significantly higher in family medicine specialists (p=0.020), those with 10+ years of experience (p=0.003), and those managing DDH cases (p<0.001).

Conclusion: Family physicians in Istanbul demonstrate adequate knowledge and awareness regarding DDH and the nationwide screening program, influenced by factors such as managing DDH cases, postgraduate training, access to educational resources, and participation in professional events. Female physicians have greater knowledge and awareness about the hip screening program. Higher perception of self-competency levels were observed in family medicine specialists, and those with over 10 years of experience or active involvement in DDH care. Addressing gaps in knowledge about risk factors, diagnostic methods, and treatments is critical. Targeted educational initiatives, periodic in-service training, and updated guidelines can enhance DDH management and screening practices, while correcting misconceptions such as the e!ectiveness of double diapering.

Level of evidence: Level IV, Diagnostic Study.

Keywords: Family practice; hip dysplasia; neonatal screening; selective screening program; ultrasonography.

Figure 1.

Percentage of benefiting from the educational and informational sources.