Evaluation of healthcare personnel's competence and attitudes in child protection reporting: A nationwide survey of hospital employees in Norway

Background Timely identification of children at risk of maltreatment (CM) is essential for prevention. A Dutch screening protocol for parental medical conditions linked to CM was adapted to Norwegian legislation and piloted in 14 hospitals. Hospital staff participating in the related capacity-building program were assessed for knowledge of legislation, reporting duties, and factors influencing reporting behavior using the Theory of Planned Behavior (TPB). Methods The study included 1,546 hospital employees across Norway. TPB constructs—attitudes, social norms (SN), perceived behavioral control (PBC), and knowledge—were validated via confirmatory factor analysis and assessed descriptively. Latent regression examined their relationship with reporting behavior. Results Forty-four percent had reported to child welfare services in the past two years. The TPB measure was validated. Social workers showed more positive attitudes than healthcare professionals. PBC was positively associated with reporting behavior (β = 0.88, 95% CI = 0.75–1.01, p < 0.001), while SN and knowledge were negatively associated. Roles requiring higher education were linked to increased reporting, but attitudes were not. Conclusions TPB highlights key areas for improving reporting behavior. Strengthening healthcare personnel’s confidence—e.g., through better familiarity with procedures—may enhance PBC and promote consistent, accurate reporting. Social workers can play a vital role in supporting and advocating for improved practices within healthcare settings.