A mixed-methods study of the feasibility and acceptability of using the Alarm Distress Baby Scale (ADBB) within universal health visiting practice in England

Project outline

The Alarm Distress BaBy (ADBB) scale developed by Guedeney and Fermanian in 2001, is a validated screening tool designed for use by healthcare practitioners to identify infant social withdrawal. This study explored the acceptability and feasibility of the use of the full ADBB scale and a modified ADBB (m-ADBB) scale as part of routine health visiting in England.

Methods and analysis

A mixed methods sequential exploratory design was used. Five health visitors were trained in the use of the ADBB scale and 20 in the m-ADBB scale, from two National Health Service sites in England. Qualitative semi-structured interviews were carried out with health visitors after they received the training and again 2 months after using the scales in routine family health visits. Quantitative data was collected from the same participants for a range of items during the study period. The theoretical framework of Normalisation Process Theory was utilised to underpin the study, in order to provide in-depth explanations of the implementation process. Qualitative data was analysed using thematic analysis and quantitative data was analysed using descriptive analysis. Read the study protocol

Ethics and dissemination 

Ethical approval was granted by the University of Oxford Departmental Research Ethics Committee.

Findings and conclusion 

The study provides useful information about the feasibility and benefits of training health visitors in the ADBB/m-ADBB in the context of health visiting in England and how, once trained, health visitors can integrate their new learning into routine health visitor practice. Read the full report.