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Spronz RG, Dudovitz RN, Thomas K, Szilagyi PG, Vizueta N, Vangala S, Kapteyn A. Changes in School-Age Children's Well-being and School-Related Needs Post COVID-19 Pandemic. Clin Pediatr (Phila) 2024:99228241273343. [PMID: 39215459 DOI: 10.1177/00099228241273343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
COVID-19 highlighted the importance of schools for child health, as emerging data suggest that pandemic-related school closures may have led to worsening child health and exacerbated health disparities. This study examines school-aged children's well-being, and characterizes changes in school-related needs, from 2021 to 2022. This is a secondary analysis of a longitudinal cohort study, where a nationally representative sample of parents of school-aged children were surveyed in June 2021 and 2022. The percentage of children with deficits in total difficulties, hyperactivity, and prosocial behavior decreased at follow-up, while a high percentage of children continued to experience peer problems. At least one school-related need remained for most parents. Highest priority needs were academic enrichment, socialization, physical activity, tutoring, and coping with stress. Academic support and social-emotional well-being remained major parental concerns, with social development showing significant deficit. Improvements in child well-being were experienced unequally across demographic groups.
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Affiliation(s)
| | - Rebecca N Dudovitz
- UCLA Department of Pediatrics and Children's Discovery and Innovation Institute, UCLA Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, CA, USA
| | - Kyla Thomas
- Center for Economic and Social Research, Dornsife College of Letters Arts and Sciences, University of Southern California, Los Angeles, CA, USA
| | - Peter G Szilagyi
- UCLA Department of Pediatrics and Children's Discovery and Innovation Institute, UCLA Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, CA, USA
| | - Nathalie Vizueta
- UCLA Department of Pediatrics and Children's Discovery and Innovation Institute, UCLA Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, CA, USA
| | - Sitaram Vangala
- Department of Medicine Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Arie Kapteyn
- Center for Economic and Social Research, Dornsife College of Letters Arts and Sciences, University of Southern California, Los Angeles, CA, USA
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Henderson KH, Helmkamp LJ, Steiner JF, Havranek EP, Vupputuri SX, Hanratty R, Blair IV, Maertens JA, Dickinson M, Daugherty SL. Relationship Between Social Vulnerability Indicators and Trial Participant Attrition: Findings From the HYVALUE Trial. Circ Cardiovasc Qual Outcomes 2022; 15:e007709. [PMID: 35418247 PMCID: PMC9117483 DOI: 10.1161/circoutcomes.120.007709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Social vulnerability indicators are associated with health care inequities and may similarly impede ongoing participation in research studies. We evaluated the association of social vulnerability indicators and research participant attrition in a trial focused on reducing health disparities. METHODS Self-identified White or Black adults enrolled in the HYVALUE trial (Hypertension and VALUEs), a randomized trial testing a values-affirmation intervention on medication adherence, from February 2017 to September 2019 were included. The self-reported measures of social vulnerability indicators included: (1) Black race; (2) female gender; (3) no health insurance; (4) unemployment; (5) a high school diploma or less; and (6) financial-resource strain. Full attrition was defined as not completing at least one 3- or 6-month follow-up study visit. Log-binomial regression models adjusted for age, gender, race, medical comorbidities, and the other social vulnerability indicators to estimate the relative risk of each social vulnerability indicator with study attrition. RESULTS Among 825 participants, the mean age was 63.3 years (±11.7 years), 60% were women, 54% were Black, and 97% reported at least one social vulnerability. Overall, 21% participants had full attrition after study enrollment. After adjustment for all other social vulnerabilities, only financial-resource strain remained consistently associated with full attrition (relative risk, 1.71 [95% CI, 1.28-2.29]). In a secondary analysis of partial attrition (completed only one follow-up visit), financial-resource strain (relative risk, 1.40 [95% CI, 1.09-1.81]) and being uninsured (relative risk, 1.54 [95% CI, 1.01-2.34]) were associated with partial attrition. CONCLUSIONS In a trial aimed at reducing disparities in medication adherence, participants who reported financial-resource strain had a higher risk of participant attrition independent of race or gender. Our findings suggest that efforts to retain diverse populations in clinical trials should extend beyond race and gender to consider other social vulnerability indicators. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT03028597.
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Affiliation(s)
- Kamal H Henderson
- Rocky Mountain Regional Veteran Affairs Medical Center, Aurora, CO (K.H.H.).,Division of Cardiology (K.H.H., E.P.H., S.L.D.), University of Colorado School of Medicine, Aurora, CO
| | - Laura J Helmkamp
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (L.J.H., E.P.H., J.A.M., M.D., S.L.D.), University of Colorado School of Medicine, Aurora, CO
| | - John F Steiner
- Kaiser Permanente Colorado, Institute for Health Research, Denver, CO (J.F.S.)
| | - Edward P Havranek
- Division of Cardiology (K.H.H., E.P.H., S.L.D.), University of Colorado School of Medicine, Aurora, CO.,Adult and Child Consortium for Health Outcomes Research and Delivery Science (L.J.H., E.P.H., J.A.M., M.D., S.L.D.), University of Colorado School of Medicine, Aurora, CO.,Department of Medicine, Denver Health and Hospital Authority, CO (E.P.H., R.H.)
| | - Suma X Vupputuri
- Kaiser Permanente Mid-Atlantic States, Mid-Atlantic Permanente Research Institute, Rockville, MD (S.X.V.)
| | - Rebecca Hanratty
- Department of Medicine, Denver Health and Hospital Authority, CO (E.P.H., R.H.)
| | - Irene V Blair
- Department of Psychology and Neuroscience, University of Colorado Boulder (I.V.B.)
| | - Julie A Maertens
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (L.J.H., E.P.H., J.A.M., M.D., S.L.D.), University of Colorado School of Medicine, Aurora, CO
| | - Miriam Dickinson
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (L.J.H., E.P.H., J.A.M., M.D., S.L.D.), University of Colorado School of Medicine, Aurora, CO
| | - Stacie L Daugherty
- Division of Cardiology (K.H.H., E.P.H., S.L.D.), University of Colorado School of Medicine, Aurora, CO.,Adult and Child Consortium for Health Outcomes Research and Delivery Science (L.J.H., E.P.H., J.A.M., M.D., S.L.D.), University of Colorado School of Medicine, Aurora, CO
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Burchenal C, Tucker S, Soroka O, Antoine F, Ramos R, Anderson H, Tettey NS, Phillips E. Developing Faith-Based Health Promotion Programs that Target Cardiovascular Disease and Cancer Risk Factors. JOURNAL OF RELIGION AND HEALTH 2022; 61:1318-1332. [PMID: 34851497 PMCID: PMC11135629 DOI: 10.1007/s10943-021-01469-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 06/13/2023]
Abstract
The aim of this study was to evaluate the impact of a faith-based health promotion program on the ideal health behaviors shared between cardiovascular disease (CVD) and cancer. The primary purpose was to measure the individual-level change in three categories of shared risk behaviors between CVD and cancer (body weight, physical activity, and nutrition) among program participants. Additionally, we evaluated the association of churches' perceived environmental support on these ideal health behaviors. Baseline and 10-week surveys were conducted to assess BMI, ideal health behaviors (diet and physical activity), and a Healthy Lifestyle Score (HLS) was created to measure adherence to health behaviors. A Supportive Church Environment Score (SCES) was designed to address the second objective. Psychosocial factors (stress and coping skills) and demographics were also measured. The percentage of participants meeting diet and exercise recommendations significantly increased with the completion of the program. Whole-grain intake increased by 64% (p = 0.085), vegetable intake increased by 58% (p = < 0.001), fruit intake increased by 39% (p = < 0.001), physical activity increased by 14% (p = < 0.001), and red meat consumption decreased by 19% (p = < 0.001). The median HLS increased from 7 to 8 (p = < 0.001). At baseline the association between ideal health behaviors and the SCES was significant for fruit intake (r = 0.22, p-value = 0.003) and red meat consumption (r = 0.17, p-value = 0.02). The aggregate behaviors as represented by the HLS were associated with the SCES (r = 0.19, p-value = 0.03). The significant increase in the HLS indicates an average improvement in the degree to which participants were meeting recommendations after completing the program. Therefore, adherence to these ideal health behaviors increased over the 10-week program.
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Affiliation(s)
- Clare Burchenal
- Division of General Internal Medicine, 338 East 66th Street, Box #46, New York, NY, 10021, USA
| | - Shanna Tucker
- Division of General Internal Medicine, 338 East 66th Street, Box #46, New York, NY, 10021, USA
| | - Orysya Soroka
- Division of General Internal Medicine, 338 East 66th Street, Box #46, New York, NY, 10021, USA
| | - Francesse Antoine
- Division of General Internal Medicine, 338 East 66th Street, Box #46, New York, NY, 10021, USA
| | - Rosio Ramos
- Division of General Internal Medicine, 338 East 66th Street, Box #46, New York, NY, 10021, USA
| | - Holly Anderson
- Division of General Internal Medicine, 338 East 66th Street, Box #46, New York, NY, 10021, USA
| | - Naa-Solo Tettey
- Division of General Internal Medicine, 338 East 66th Street, Box #46, New York, NY, 10021, USA
| | - Erica Phillips
- Division of General Internal Medicine, 338 East 66th Street, Box #46, New York, NY, 10021, USA.
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