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Nguyen L, Phan TL, Falini L, Chang D, Cottrell L, Dawley E, Hockett CW, VanWagoner T, Darden PM, Davis AM. Rural Family Satisfaction With Telehealth Delivery of an Intervention for Pediatric Obesity and Associated Family Characteristics. Child Obes 2024; 20:147-154. [PMID: 37036783 PMCID: PMC10979670 DOI: 10.1089/chi.2022.0210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Objective: To describe satisfaction with the telehealth aspect of a pediatric obesity intervention among families from multiple rural communities and assess differences in satisfaction based on sociodemographic factors. Methods: This is a secondary analysis of data from a pilot randomized controlled trial of a 6-month intensive lifestyle intervention (iAmHealthy) delivered through telehealth to children 6-11 years old with BMI ≥85th%ile and their parents from rural communities. Parents completed a sociodemographic survey and a validated survey to assess satisfaction with the telehealth intervention across four domains (technical functioning, comfort of patient and provider with technology and perceived privacy, timely and geographic access to care, and global satisfaction) on a 5-point Likert scale. Kruskal-Wallis nonparametric rank test were used to compare mean satisfaction scores based on parent sociodemographics. Results: Forty-two out of 52 parents (67% White, 29% Black, 5% multiracial, and 50% with household income <$40,000) completed the survey. Mean satisfaction scores ranged from 4.16 to 4.54 (standard deviation 0.44-0.61). Parents without a college degree reported higher satisfaction across all domains compared with parents with a college degree, including global satisfaction (mean 4.64 vs. 4.31, p = 0.03). Parents reporting a household income <$40,000 (mean 4.70) reported higher scores in the comfort with technology and perceived privacy domain compared with parents with higher incomes (mean 4.30-4.45, p = 0.04). Discussion: Parents from rural communities, especially those from lower socioeconomic backgrounds, were highly satisfied with the iAmHealthy telehealth intervention. These findings can be used to inform future telehealth interventions among larger more diverse populations. ClinicalTrials.gov Identifier: NCT04142034.
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Affiliation(s)
- Linhda Nguyen
- Department of Pediatrics, Healthy Weight and Wellness Clinic, Nemours Children's Health, DE, Wilmington, DE, USA
| | - Thao-Ly Phan
- Department of Pediatrics, Healthy Weight and Wellness Clinic, Nemours Children's Health, DE, Wilmington, DE, USA
- Center for Healthcare Delivery Science, Nemours Children's Health, DE, Wilmington, DE, USA
| | - Lauren Falini
- Department of Pediatrics, Healthy Weight and Wellness Clinic, Nemours Children's Health, DE, Wilmington, DE, USA
| | - Di Chang
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Lesley Cottrell
- Department of Pediatrics, West Virginia University, Morgantown, WV, USA
- West Virginia University Center for Excellence in Disabilities, Morgantown, WV, USA
| | - Erin Dawley
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Christine W. Hockett
- Avera Research Institute, Sioux Falls, SD, USA
- Department of Pediatrics, School of Medicine, University of South Dakota, Vermillion, SD, USA
| | - Timothy VanWagoner
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Paul M. Darden
- Population Health Research Program, Arkansas Children's Research Institute, Little Rock, Arkansas, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Ann M. Davis
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA
- Center for Children's Healthy Lifestyles and Nutrition, Kansas City, MO, USA
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Varadharajan V, Subramaniyan B, Ramkumar V, Venkatesh L, Chandrasekar K. Field validation of an app based developmental and speech language screening (SRESHT screener) conducted by grass root workers. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2024; 26:101529. [PMID: 38623525 PMCID: PMC7615829 DOI: 10.1016/j.cegh.2024.101529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024] Open
Abstract
This study validated an app-based developmental and speech language screening (SRESHT screener) conducted by Grass Roots Workers (GRWs) among children below six years of age in a rural community in the state of Tamil Nadu (the field). Method The study was carried out in two phases, first the training of GRWs and then the validation of the screening conducted by them using the app. For the training, suitable materials were developed, and the GRW's knowledge and skills were evaluated pre- and post-training. Two closed-ended questionnaires were used to evaluate the GRWs' knowledge about the screening tools. The Observed Structured Practical Examination (OSPE) method was used to evaluate their skill. All the participants were selected by convenience sampling and were screened independently by both a Speech Language Pathologist (SLP) and a GRW using the application. Cohen's kappa and percent agreement were used to determine agreement in screening results between the SLP and GRWs. Results All the GRWs scored at least 75 % and above in both the knowledge and skill assessments conducted post-training. "Substantial agreement" on kappa-based extent of agreement and "almost perfect" agreement on percent agreement were obtained between GRWs and SLP for the app-based screening. Conclusion The findings of this study imply that the app-based developmental and speech language screening performed in the community by GRWs is valid.
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Affiliation(s)
- Vasudharany Varadharajan
- Sri Ramachandra Faculty of Audiology & Speech Language Pathology, Sri Ramachandra Institute of Higher Education & Research, Chennai, India
| | - B Subramaniyan
- The Cleft & Craniofacial Centre, Department of Speech Language Pathology & Audiology, Sree Balaji Medical College and Hospital, Bharath Institute of Higher Education and Research, Chennai, India
| | - Vidya Ramkumar
- Sri Ramachandra Faculty of Audiology & Speech Language Pathology, Sri Ramachandra Institute of Higher Education & Research, Chennai, India
| | - Lakshmi Venkatesh
- Sri Ramachandra Faculty of Audiology & Speech Language Pathology, Sri Ramachandra Institute of Higher Education & Research, Chennai, India
| | - Kavyashree Chandrasekar
- Sri Ramachandra Faculty of Audiology & Speech Language Pathology, Sri Ramachandra Institute of Higher Education & Research, Chennai, India
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Goulding R, Goodwin J, O'Donovan A, Saab MM. Transgender and gender diverse youths' experiences of healthcare: A systematic review of qualitative studies. J Child Health Care 2023:13674935231222054. [PMID: 38131632 DOI: 10.1177/13674935231222054] [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: 12/23/2023]
Abstract
Transgender and gender-diverse (TGD) populations are identified as high-risk for negative healthcare outcomes. Limited data exists on experiences of TGD youths in healthcare. The review aim is to systematically review literature on healthcare experiences of TGD youths. Seven electronic databases were systematically searched for relevant studies. Pre-determined eligibility criteria were used for inclusion with a double-screening approach. Sixteen studies were included. Studies included were quality appraised, data were extracted, and findings were synthesized narratively. Four narratives were identified including experiences of: accessing care, healthcare settings and services, healthcare providers, and healthcare interventions. Long waiting times, lack of competent providers, and fear were reported as challenges to accessing gender-affirming care. Negative experiences occurred in mental health services and primary care, while school counseling and gender clinics were affirming. Puberty blockers and hormone-replacement therapy were identified as protective factors. TGD youths are at risk of negative health outcomes due to an under resourced healthcare system. Further research is needed to assess interventions implemented to improve TGD youth's experiences.
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Affiliation(s)
- Ryan Goulding
- Catherine McAuley School of Nursing & Midwifery, University College Cork, Cork, Ireland
| | - John Goodwin
- Catherine McAuley School of Nursing & Midwifery, University College Cork, Cork, Ireland
| | - Aine O'Donovan
- Catherine McAuley School of Nursing & Midwifery, University College Cork, Cork, Ireland
| | - Mohamad M Saab
- Catherine McAuley School of Nursing & Midwifery, University College Cork, Cork, Ireland
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Abdoola S, Swanepoel DW, Graham MA, van der Linde J. Developmental characteristics of young children in a low-income South African community. J Child Health Care 2023:13674935231173023. [PMID: 37150599 DOI: 10.1177/13674935231173023] [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: 05/09/2023]
Abstract
Adequate early childhood development is critical for later-life success. Developmental profiles of specific populations are required to support implementation of early intervention services. Three hundred fifty-three caregivers of children with mean age 17.9 months (SD = 10.5) were selected from a primary healthcare clinic. Overall positive identification of signs of a developmental delay, with the Bayley Scales of Infant and Toddler Development III, was 51.8% (n = 183). Logistic regression analysis determined the effect of age and gender on results. Prevalence of developmental delay increased with age from 33.1% for children under 12 months to 61.7% and 66.3% for children between 13-24 months and 25-36 months, respectively. Females were 1.82 times (95% CI [1.16, 2.85]) more likely to have had no signs of developmental delay; 2.30 times (95% CI [1.14, 4.65]) in motor and 2.06 times (95% CI [1.23, 3.45]) in adaptive behaviour domains. One-third of children presented with low levels of adaptive behaviour functioning. One hundred and one (28.6%) participants across age groups displayed superior social-emotional ability, possibly due to familial structures and relationships. One-third of children presented with poor adaptive behaviour function, attributed to cultural differences. This study contributes to information on developmental characteristics of children in South Africa.
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Affiliation(s)
- Shabnam Abdoola
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Marien Alet Graham
- Department of Science Mathematics and Technology Education, Faculty of Education, University of Pretoria, Pretoria, South Africa
| | - Jeannie van der Linde
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
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Owoyemi A, Osuchukwu JI, Azubuike C, Ikpe RK, Nwachukwu BC, Akinde CB, Biokoro GW, Ajose AB, Nwokoma EI, Mfon NE, Benson TO, Ehimare A, Irowa-Omoregie D, Olaniran S. Digital Solutions for Community and Primary Health Workers: Lessons From Implementations in Africa. Front Digit Health 2022; 4:876957. [PMID: 35754461 PMCID: PMC9215204 DOI: 10.3389/fdgth.2022.876957] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
The agenda for Universal Health Coverage has driven the exploration of various innovative approaches to expanding health services to the general population. As more African countries have adopted digital health tools as part of the strategic approach to expanding health services, there is a need for defining a standard framework for implementation across board. Therefore, there is a need to review and employ an evidence-based approach to inform managing challenges, adopting best approaches, and implement informed recommendations. We reviewed a variety of digital health tools applied to different health conditions in primary care settings and highlighted the challenges faced, approaches that worked and relevant recommendations. These include limited coverage and network connectivity, lack of technological competence, lack of power supply, limited mobile phone usage and application design challenges. Despite these challenges, this review suggests that mHealth solutions could attain effective usage when healthcare workers receive adequate onsite training, deploying applications designed in an intuitive and easy to understand approach in a manner that fits into the users existing workflows, and involvement of the stakeholders at all levels in the design, planning, and implementation stages of the interventions.
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Affiliation(s)
- Ayomide Owoyemi
- Department of Biomedical and Health Information Sciences, Chicago, IL, United States
- *Correspondence: Ayomide Owoyemi
| | | | - Clark Azubuike
- Social and Behavioral Sciences Department, T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
| | | | - Blessing C. Nwachukwu
- Department of Biomedical and Health Information Sciences, Chicago, IL, United States
| | | | - Grace W. Biokoro
- Department of Human and Health Sciences, Northern Illinois University, DeKalb, IL, United States
| | - Abisoye B. Ajose
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | | | - Nehemiah E. Mfon
- Department of Obstetrics and Gynecology, National Hospital, Abuja, Nigeria
| | - Temitope O. Benson
- Institute for Computational and Data Sciences, University at Buffalo, State University of New York, Albany, NY, United States
| | - Anthony Ehimare
- Department of Health Informatics, Swansea University, Wales, United Kingdom
| | | | - Seun Olaniran
- Department of Integrated Information Technology, College of Engineering and Computing, University of South Carolina, Columbia, SC, United States
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