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Brackney D, Daughtridge E, Jensen M, Childers S, Tocci N, Wilson T, Meucci M. Feasibility of Play-Based Dance to Promote Physical Activity in Second Grade Students. AMERICAN JOURNAL OF HEALTH EDUCATION 2021. [DOI: 10.1080/19325037.2021.1955228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Chambers RA, Begay J, Patel H, Richards J, Nelson D, Rosenstock S, Huskon R, Mitchell K, Begay T, Tingey L. Rigorous evaluation of a substance use and teen pregnancy prevention program for American Indian girls and their female caregivers: a study protocol for a randomized controlled trial. BMC Public Health 2021; 21:1179. [PMID: 34154552 PMCID: PMC8218410 DOI: 10.1186/s12889-021-11131-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
Background Early sexual initiation is associated with higher risk for sexually transmitted infection, teen pregnancy, domestic violence and substance use in later adolescence and early adulthood. Native American adolescents are more likely to have early sexual initiation compared to other racial/ethnic groups. Few programs designed with and for Native adolescents to delay sexual initiation and substance use have been tested through rigorous evaluations. This is the protocol for the randomized controlled trial of the Asdzáán Be’eena’ program, a teen pregnancy and substance use prevention program for young Native girls and their female caregivers. Methods N = 410 female adolescents ages 10–14 and their female caregivers will be enrolled in the study and randomized to the intervention or control arm. The intervention consists of the 11-session Asdzáán Be’eena’ program. The control arm consists of mailed non-monetary incentives. All participants will complete evaluations at baseline and 3 follow-up timepoints (immediate, 6 and 12 months post intervention). Evaluations include measures to assess protective factors associated with delayed sexual initiation and substance use. Discussion This is one of the first rigorous evaluations of a gender-specific, culturally tailored teen pregnancy and substance use primary prevention program for Native girls and their female caregivers. If proven efficacious, Native communities will have a culturally appropriate program for promoting protective factors associated with delayed substance use and sexual risk taking. Trial registration NCT04863729; April 27, 2021.
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Affiliation(s)
- Rachel A Chambers
- Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD, 21231, USA.
| | - Jaime Begay
- Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD, 21231, USA
| | - Hima Patel
- Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD, 21231, USA
| | - Jennifer Richards
- Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD, 21231, USA
| | - Danielle Nelson
- Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD, 21231, USA
| | - Summer Rosenstock
- Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD, 21231, USA
| | - Ronni Huskon
- Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD, 21231, USA
| | - Kristin Mitchell
- Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD, 21231, USA
| | - Tiffani Begay
- Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD, 21231, USA
| | - Lauren Tingey
- Johns Hopkins Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD, 21231, USA
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Predicting youth diabetes risk using NHANES data and machine learning. Sci Rep 2021; 11:11212. [PMID: 34045491 PMCID: PMC8160335 DOI: 10.1038/s41598-021-90406-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 04/30/2021] [Indexed: 01/21/2023] Open
Abstract
Prediabetes and diabetes mellitus (preDM/DM) have become alarmingly prevalent among youth in recent years. However, simple questionnaire-based screening tools to reliably assess diabetes risk are only available for adults, not youth. As a first step in developing such a tool, we used a large-scale dataset from the National Health and Nutritional Examination Survey (NHANES) to examine the performance of a published pediatric clinical screening guideline in identifying youth with preDM/DM based on American Diabetes Association diagnostic biomarkers. We assessed the agreement between the clinical guideline and biomarker criteria using established evaluation measures (sensitivity, specificity, positive/negative predictive value, F-measure for the positive/negative preDM/DM classes, and Kappa). We also compared the performance of the guideline to those of machine learning (ML) based preDM/DM classifiers derived from the NHANES dataset. Approximately 29% of the 2858 youth in our study population had preDM/DM based on biomarker criteria. The clinical guideline had a sensitivity of 43.1% and specificity of 67.6%, positive/negative predictive values of 35.2%/74.5%, positive/negative F-measures of 38.8%/70.9%, and Kappa of 0.1 (95%CI: 0.06–0.14). The performance of the guideline varied across demographic subgroups. Some ML-based classifiers performed comparably to or better than the screening guideline, especially in identifying preDM/DM youth (p = 5.23 × 10−5).We demonstrated that a recommended pediatric clinical screening guideline did not perform well in identifying preDM/DM status among youth. Additional work is needed to develop a simple yet accurate screener for youth diabetes risk, potentially by using advanced ML methods and a wider range of clinical and behavioral health data.
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Klein NJ, Evans-Agnew R. Flying by the seat of their pants: A grounded theory of school nurse case management. J Adv Nurs 2019; 75:3677-3688. [PMID: 31566808 DOI: 10.1111/jan.14204] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 09/04/2019] [Accepted: 09/12/2019] [Indexed: 01/03/2023]
Abstract
AIMS To develop a theory describing the processes and actions involved with school nurse case management for school-aged children with chronic conditions in the K12 system. DESIGN Case management is an essential practice for the school nurse. Little is known about actual case management practice in real-world settings. Grounded theory methodology following a literature-based conceptual model of school nurse case management. METHODS A purposive maximum variation sampling was used for data collection and analysis. Semi-structured interviews conducted in-person and via conferencing software from January to March 2017 with school nurses practicing in Washington State until data saturation was achieved. A condition lasting at least 6 months was also used to define a chronic condition. RESULTS In all, 14 school nurses with an average of 12 years of experience were interviewed. Analysis revealed that the core strategy used by participating nurses for case management involved navigating through ambiguity; balancing multiple roles; seeking guidance and training; acknowledging imperfect functioning and navigating poor system supports. CONCLUSION The findings suggest that actual school nurse case management practice differs from best practice recommendations. Participants did not discuss health promotion or environmental management and did not act to set goals or prioritize care as suggested in the literature. IMPACT This article informs nursing leadership of the real-world challenges faced by nurses performing case management in the school setting. These findings indicate that improvements in system supports and training, together with tolerance for the challenges nurses face in providing such care, might improve case management practice in the schools.
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Affiliation(s)
- Nicole J Klein
- Office of Superintendent of Public Instruction, Olympia, WA, USA
| | - Robin Evans-Agnew
- Nursing and Healthcare Leadership, University of Washington Tacoma, Tacoma, WA, USA
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Everhart RS, Miller S, Leibach GG, Dahl AL, Koinis-Mitchell D. Caregiver Asthma in Urban Families: Implications for School Absenteeism. J Sch Nurs 2018; 34:108-113. [PMID: 28093030 PMCID: PMC5608627 DOI: 10.1177/1059840516689326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Asthma is a significant contributor to missed school days, especially for children living in urban settings. This preliminary study examined the impact of caregiver asthma on school absenteeism in a sample of 102 urban children with asthma from African American, Latino, and non-Latino White backgrounds. Caregivers and children participated in a single research session; 32 caregivers had asthma. Children of caregivers with asthma missed more days of school than children whose caregivers did not have asthma (3.97 vs. 2.43 days, p < .05, Cohen's d = .40). Other indicators of child asthma morbidity (e.g., hospitalizations) did not differ across caregiver asthma status. Findings highlight that caregiver asthma may be an added risk factor for school absenteeism among children with asthma. For children with a high frequency of asthma-related school absenteeism, school nurses may find it useful to provide educational resources and referrals for caregivers with asthma.
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Affiliation(s)
- Robin S. Everhart
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Sarah Miller
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Gillian G. Leibach
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Alexandra L. Dahl
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Daphne Koinis-Mitchell
- Bradley/Hasbro Children’s Research Center, Alpert Medical School of Brown University, Providence, RI, USA
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Leahy-Warren P, Mulcahy H, Benefield L, Bradley C, Coffey A, Donohoe A, Fitzgerald S, Frawley T, Healy E, Healy M, Kelly M, McCarthy B, McLoughlin K, Meagher C, O'Connell R, O'Mahony A, Paul G, Phelan A, Stokes D, Walsh J, Savage E. Conceptualising a model to guide nursing and midwifery in the community guided by an evidence review. BMC Nurs 2017; 16:35. [PMID: 28670202 PMCID: PMC5492933 DOI: 10.1186/s12912-017-0225-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 06/05/2017] [Indexed: 01/08/2023] Open
Abstract
Background Successful models of nursing and midwifery in the community delivering healthcare throughout the lifespan and across a health and illness continuum are limited, yet necessary to guide global health services. Primary and community health services are the typical points of access for most people and the location where most care is delivered. The scope of primary healthcare is complex and multifaceted and therefore requires a practice framework with sound conceptual and theoretical underpinnings. The aim of this paper is to present a conceptual model informed by a scoping evidence review of the literature. Methods A scoping evidence review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Databases included CINAHL, MEDLINE, PsycINFO and SocINDEX using the EBSCO platform and the Cochrane Library using the keywords: model, nursing, midwifery, community, primary care. Grey literature for selected countries was searched using the Google ‘advanced’ search interface. Data extraction and quality appraisal for both empirical and grey literature were conducted independently by two reviewers. From 127 empirical and 24 non-empirical papers, data extraction parameters, in addition to the usual methodological features, included: the nature of nursing and midwifery; the population group; interventions and main outcomes; components of effective nursing and midwifery outcomes. Results The evidence was categorised into six broad areas and subsequently synthesised into four themes. These were not mutually exclusive: (1) Integrated and Collaborative Care; (2) Organisation and Delivery of Nursing and Midwifery Care in the Community; (3) Adjuncts to Nursing Care and (4) Overarching Conceptual Model. It is the latter theme that is the focus of this paper. In essence, the model depicts a person/client on a lifespan and preventative-curative trajectory. The health related needs of the client, commensurate with their point position, relative to both trajectories, determines the nurse or midwife intervention. Consequently, it is this need, that determines the discipline or speciality of the nurse or midwife with the most appropriate competencies. Conclusion Use of a conceptual model of nursing and midwifery to inform decision-making in primary/community based care ensures clinical outcomes are meaningful and more sustainable. Operationalising this model for nursing and midwifery in the community demands strong leadership and effective clinical governance. Electronic supplementary material The online version of this article (doi:10.1186/s12912-017-0225-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Patricia Leahy-Warren
- School of Nursing & Midwifery, Brookfield health Sciences Complex, University College, Cork, Ireland
| | - Helen Mulcahy
- School of Nursing & Midwifery, Brookfield health Sciences Complex, University College, Cork, Ireland
| | | | - Colin Bradley
- Department of General Practice, University College, Cork, Ireland
| | - Alice Coffey
- School of Nursing & Midwifery, Brookfield health Sciences Complex, University College, Cork, Ireland
| | - Ann Donohoe
- School of Health Sciences, University College, Dublin, Ireland
| | - Serena Fitzgerald
- School of Nursing & Midwifery, Brookfield health Sciences Complex, University College, Cork, Ireland
| | - Tim Frawley
- School of Health Sciences, University College, Dublin, Ireland
| | | | - Maria Healy
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - Marcella Kelly
- School of Nursing & Midwifery, NUI Galway, Galway, Ireland
| | | | - Kathleen McLoughlin
- School of Nursing & Midwifery, Brookfield health Sciences Complex, University College, Cork, Ireland
| | | | - Rhona O'Connell
- School of Nursing & Midwifery, Brookfield health Sciences Complex, University College, Cork, Ireland
| | - Aoife O'Mahony
- School of Nursing & Midwifery, Brookfield health Sciences Complex, University College, Cork, Ireland
| | - Gillian Paul
- School of Health Sciences, University College, Dublin, Ireland
| | - Amanda Phelan
- School of Health Sciences, University College, Dublin, Ireland
| | - Diarmuid Stokes
- Health Sciences Library, University College, Dublin, Ireland
| | - Jessica Walsh
- School of Health Sciences, University College, Dublin, Ireland
| | - Eileen Savage
- School of Nursing & Midwifery, Brookfield health Sciences Complex, University College, Cork, Ireland
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Viner R, White B, Christie D. Type 2 diabetes in adolescents: a severe phenotype posing major clinical challenges and public health burden. Lancet 2017; 389:2252-2260. [PMID: 28589895 DOI: 10.1016/s0140-6736(17)31371-5] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 04/27/2017] [Accepted: 05/10/2017] [Indexed: 01/14/2023]
Abstract
Type 2 diabetes in adolescence manifests as a severe progressive form of diabetes that frequently presents with complications, responds poorly to treatment, and results in rapid progression of microvascular and macrovascular complications. Although overall still a rare disease, adolescent type 2 diabetes now poses major challenges to paediatric and adult diabetes services in many countries. Therapeutic options are heavily curtailed by a dearth of knowledge about the condition, with low numbers of participants and poor trial recruitment impeding research. Together with lifestyle modification, metformin remains the first-line therapy for adolescents with type 2 diabetes, although the majority rapidly progress to treatment failure and insulin therapy. Early bariatric surgery is controversial but has great potential to transform outcomes. Health systems must respond by both concentrating patients in specialist clinical services integrated with translational research programmes, but also by joining up with local health and social care services to improve engagement and uptake of services.
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Affiliation(s)
- Russell Viner
- UCL Great Ormond Street Institute of Child Health, London, UK; Child and Adolescent Diabetes Service, UCL Hospitals NHS Foundation Trust, London, UK.
| | - Billy White
- UCL Great Ormond Street Institute of Child Health, London, UK; Child and Adolescent Diabetes Service, UCL Hospitals NHS Foundation Trust, London, UK
| | - Deborah Christie
- Child and Adolescent Diabetes Service, UCL Hospitals NHS Foundation Trust, London, UK; UCL Institute of Epidemiology and Healthcare, London, UK
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Nadeau KJ, Anderson BJ, Berg EG, Chiang JL, Chou H, Copeland KC, Hannon TS, Huang TTK, Lynch JL, Powell J, Sellers E, Tamborlane WV, Zeitler P. Youth-Onset Type 2 Diabetes Consensus Report: Current Status, Challenges, and Priorities. Diabetes Care 2016; 39:1635-42. [PMID: 27486237 PMCID: PMC5314694 DOI: 10.2337/dc16-1066] [Citation(s) in RCA: 238] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Type 2 diabetes is a significant and increasing burden in adolescents and young adults. Clear strategies for research, prevention, and treatment of the disease in these vulnerable patients are needed. Evidence suggests that type 2 diabetes in children is different not only from type 1 but also from type 2 diabetes in adults. Understanding the unique pathophysiology of type 2 diabetes in youth, as well as the risk of complications and the psychosocial impact, will enable industry, academia, funding agencies, advocacy groups, and regulators to collectively evaluate both current and future research, treatment, and prevention approaches. This Consensus Report characterizes type 2 diabetes in children, evaluates the fundamental differences between childhood and adult disease, describes the current therapeutic options, and discusses challenges to and approaches for developing new treatments.
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Affiliation(s)
- Kristen J Nadeau
- Department of Pediatrics, University of Colorado School of Medicine, and Department of Endocrinology, Children's Hospital Colorado, Aurora, CO
| | - Barbara J Anderson
- Section of Psychology, Department of Pediatrics, Baylor College of Medicine Education at Texas Children's Hospital, Houston, TX
| | | | | | - Hubert Chou
- Clinical Development, Daiichi Sankyo, New York, NY
| | - Kenneth C Copeland
- Department of Pediatrics and Harold Hamm Diabetes Center-Children's, The University of Oklahoma College of Medicine, Oklahoma City, OK
| | | | - Terry T-K Huang
- School of Public Health, The City University of New York, New York, NY
| | - Jane L Lynch
- The University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Jeff Powell
- Pediatrics and Community Health, Northern Navajo Medical Center, Navajo Area Indian Health Service, Shiprock, NM
| | - Elizabeth Sellers
- Department of Pediatrics, Health Sciences Centre Winnipeg, Winnipeg, Canada
| | - William V Tamborlane
- Department of Pediatric Endocrinology and Yale Center for Clinical Investigation, Yale School of Medicine, New Haven, CT
| | - Philip Zeitler
- Department of Pediatrics, University of Colorado School of Medicine, and Department of Endocrinology, Children's Hospital Colorado, Aurora, CO
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Huang TTK, Ferris E, Tripathi D. An Integrative Analysis of the Effect of Lifestyle and Pharmacological Interventions on Glucose Metabolism in the Prevention and Treatment of Youth-Onset Type 2 Diabetes. Curr Diab Rep 2016; 16:78. [PMID: 27380713 DOI: 10.1007/s11892-016-0767-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Preventing and managing youth-onset type 2 diabetes are a major challenge. This paper reviews the evidence of lifestyle and drug therapies in improving glucose, insulin, and insulin sensitivity. Forty-four interventions were analyzed, of which 11 were drug (mainly metformin) interventions combined with lifestyle while the remainder used lifestyle strategies only. Fewer than a dozen out of 44 interventions reported significant improvements in glucose-related outcomes. Metformin in addition to lifestyle therapy did not necessarily enhance intervention effects. The overall lack of findings can be partially attributed to the heterogeneity of study populations, the lack of intervention intensity, under-powered study design, and the challenging lives of at-risk populations. New treatment options in both drugs and lifestyle strategies are direly needed.
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Affiliation(s)
- Terry T-K Huang
- Graduate School of Public Health and Health Policy, City University of New York, 55 W. 125th Street, #803, New York, NY, 10027, USA.
| | - Emily Ferris
- Graduate School of Public Health and Health Policy, City University of New York, 55 W. 125th Street, #803, New York, NY, 10027, USA
| | - Devanshi Tripathi
- Graduate School of Public Health and Health Policy, City University of New York, 55 W. 125th Street, #803, New York, NY, 10027, USA
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Hampl S, Campbell A. Recognizing obesity and its complications: the story of Score 1 for Health. NASN Sch Nurse 2015; 30:46-52. [PMID: 25626243 DOI: 10.1177/1942602x14559749] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This introductory article on the comorbidities of obesity in children is an overview and the first in a series of articles on the subject. One in three of our nation's school-age children is overweight or obese. The comorbidities they experience mirror those seen in adults, with over 60% of children having at least one complication. Virtually any body system may be affected. Complications include weight-related bullying and teasing, poor sleep hygiene, well-studied cardiovascular disease risk factors, liver disease, and musculoskeletal complications, to name a few. The article will further explore an exemplary program highlighting the important role that school nurses play in this child and adolescent health crisis.
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Minges KE, Chao A, Nam S, Grey M, Whittemore R. Weight status, gender, and race/ethnicity: are there differences in meeting recommended health behavior guidelines for adolescents? J Sch Nurs 2014; 31:135-45. [PMID: 25312400 DOI: 10.1177/1059840514554089] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Healthy behaviors including limited screen time (ST), high physical activity (PA), and adequate fruits and vegetables consumption (FV) are recommended for adolescents, but it is unclear how gender, race/ethnicity, and weight status relate to these public health guidelines in diverse urban adolescents. Participants (N = 384) were recruited from three public high schools in or near New Haven, Connecticut. Descriptive statistics and logistic regression analyses were conducted. Most adolescents exceeded recommended levels of ST (70.5%) and did not meet guidelines for PA (87.2%) and FV (72.6%). Only 3.5% of the sample met all three guidelines. Boys were more likely to meet guidelines for PA (p < .01), while girls were engaged in less ST (p < .001). Black, non-Latinos were less likely to meet PA guidelines (p < .05). There were no significant differences in meeting ST, PA, or FV guidelines by weight status for the overall sample or when stratified by gender or race/ethnicity. We found alarmingly low levels of healthy behaviors in normal weight and overweight/obese adolescents.
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Affiliation(s)
| | - Ariana Chao
- Yale University School of Nursing, Orange, CT, USA
| | - Soohyun Nam
- Yale University School of Nursing, Orange, CT, USA
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