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Archuleta S, Allison-Burbank JD, Ingalls A, Begay R, Begaye V, Howe L, Tsosie A, Keryte AP, Haroz EE. Baseline Sociodemographic Characteristics and Mental Health Status of Primary Caregivers and Children Attending Schools on the Navajo Nation During COVID-19. THE JOURNAL OF SCHOOL HEALTH 2024; 94:808-819. [PMID: 38936839 PMCID: PMC11323252 DOI: 10.1111/josh.13487] [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] [Received: 05/02/2024] [Accepted: 05/29/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Despite historical and contemporary trauma, American Indian and Alaska Native (AIAN; Indigenous) communities responded with resilience to the COVID-19 pandemic. However, AIANs experienced disproportionate rates of infection, hospitalization, death, and reduced life expectancy. School closures exacerbated disparities, leading to learning loss, economic instability, and mental health challenges among AIAN youth. METHODS The Project SafeSchools cohort study employed a comprehensive longitudinal convergent mixed-methods approach, integrating community-based participatory research principles. The study enrolled Navajo Nation caregivers whose children were eligible to attend local reservation-based schools. We conducted an analysis of caregiver self-report baseline data collected between August 2021 and May 2022. RESULTS A total of 242 caregivers completed at least part of the baseline assessment and were included in data analysis. Caregivers were primarily female (88.7%), non-Hispanic (97%), and Indigenous (97%). Most caregivers were in their late 30s (mean age 38), with varying educational backgrounds and employment statuses. Children were evenly split between males and females and distributed across different age groups. Most children attended school at baseline in various formats, including in-person, hybrid, and online-only settings. Caregivers reported a range of psychosocial and behavioral risks, including general mental distress, depressive symptoms, and anxiety for themselves and their children. Furthermore, caregivers and children exhibited various protective factors, such as strong cultural identity, resilience, and academic self-efficacy. CONCLUSIONS This study highlights the higher rates of mental health distress among participating caregivers and children compared to national averages. Despite these challenges, cultural protective factors remained strong and should guide future crisis response efforts.
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Affiliation(s)
- Shannon Archuleta
- Department of International Health, Center for Indigenous Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Joshuaa D Allison-Burbank
- Department of International Health, Center for Indigenous Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Allison Ingalls
- Department of International Health, Center for Indigenous Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Renae Begay
- Department of International Health, Center for Indigenous Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Vanessa Begaye
- Department of International Health, Center for Indigenous Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Lacey Howe
- Department of International Health, Center for Indigenous Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Alicia Tsosie
- Department of International Health, Center for Indigenous Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Angelina Phoebe Keryte
- Department of International Health, Center for Indigenous Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Emily E Haroz
- Department of International Health, Center for Indigenous Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Dinh J, Edwards LV, Calderon G, Klein LM, Wang J, Marrero N, Johnson SB, Hager ER. Parents' Perceptions of Schools' COVID-19 Mitigation Strategies: A Phenomenological Study. THE JOURNAL OF SCHOOL HEALTH 2024; 94:791-799. [PMID: 38936963 PMCID: PMC11323178 DOI: 10.1111/josh.13480] [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] [Received: 10/26/2023] [Revised: 04/23/2024] [Accepted: 05/15/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND At the onset of the COVID-19 pandemic, schools closed across the United States. Given the impact of virtual learning and lost access to school resources, schools eventually reopened with COVID-19 mitigation protocols in place. This qualitative study sought to understand parental perceptions of school-based COVID-19 mitigation strategies. METHODS Using a phenomenology approach, nine focus groups were completed with 40 parents of children in grades K-8 representing eight Maryland counties. Based on acceptance of masking policies (as indicated on a survey), parents were sorted into 2 groups-lower and higher masking acceptance. A thematic analysis was conducted for each group and themes were compared between the 2 groups. RESULTS The main themes were related to parents' general sentiments regarding COVID-19, compliance, pandemic-related changes over time, changes in personal opinions, and in-person learning. Both groups described challenges related to inconsistent COVID-19 mitigation policies and practices, the challenges of rapid and frequent changes in guidelines during the pandemic, and the benefits of in-person learning. CONCLUSIONS Parents of elementary and middle school children, regardless of general acceptance of masking policies, shared concerns about implementation and guidance regarding school-based mitigation strategies.
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Affiliation(s)
- Janny Dinh
- Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health
| | | | | | | | - June Wang
- Johns Hopkins University Krieger School of Arts and Sciences
| | | | - Sara B. Johnson
- Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health
- Johns Hopkins School of Medicine, Department of Pediatrics
| | - Erin R. Hager
- Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health
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Meza-Miranda ER, Parra-Soto SL, Durán-Agüero S, Gomez G, Carpio-Arias V, Ríos-Castillo I, Murillo AG, Araneda J, Morales G, Cavagnari BM, Nava-González EJ, Bejarano-Roncancio JJ, Núñez B, Cordón-Arrivillaga K, Mauricio-Alza S, Landaeta-Díaz L. Body weight in relation to hours of sleep, and physical activity in Latin American university students during the Covid-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1753-1758. [PMID: 35816742 DOI: 10.1080/07448481.2022.2089848] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 05/23/2022] [Accepted: 06/09/2022] [Indexed: 06/15/2023]
Abstract
Introduction: Short sleep, physical inactivity, and being locked up are risk factors for weight gain. Objective: We evaluated weight gain according to sex, age, hours of sleep and physical activity in university students from 10 Latin American countries during the COVID-19 pandemic. Methods: Cross-sectional and multicenter study (n = 4880). Results: The average age was 22.5 ± 4.4 years. 60.2% were currently locked up. 73.6% were women, 48.2% increased their body weight, 66% reported insufficient sleep hours, and 65.9% were inactive. Women gained more weight than men (73.2%) and younger students gained more weight (85.1%). Those who had insufficient sleep hours gained most weight (67.6%). Inactive participants gained most weight (74.7%). Students who have insufficient sleep are 21% more likely to have changes in body weight compared to students who have optimal sleep. Conclusion: The increase in body weight and its risk factors during confinement should be considered as emerging from public health.
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Affiliation(s)
- Eliana Romina Meza-Miranda
- Universidad Nacional de Asunción - Centro Multidisciplinario de Investigaciones Tecnológicas, Asunción, Paraguay
| | - Solange Liliana Parra-Soto
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Samuel Durán-Agüero
- Escuela de Nutrición y Dietética, Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Los Leones, Chile
| | - Georgina Gomez
- Department of Biochemistry, School of Medicine, University of Costa Rica, Ciudad de San José, Costa Rica
| | - Valeria Carpio-Arias
- Grupo de Investigación en Alimentación y Nutrición Humana (GIANH), Facultad de Salud Pública, Escuela Superior Politécnica de Chimborazo, Riobamba, Ecuador
| | - Israel Ríos-Castillo
- Organización de las Naciones Unidas para la Alimentación y la Agricultura (FAO), Oficina Subregional de la FAO para Mesoamérica, Ciudad de Panamá, Panamá
| | - Ana Gabriela Murillo
- Department of Biochemistry, School of Medicine, University of Costa Rica, Ciudad de San José, Costa Rica
| | - Jacqueline Araneda
- Departamento de Nutrición y Salud Pública, Facultad de Ciencias de la Salud y de los Alimentos, Universidad del Bío-Bío, Chillán, Chile
| | - Gladys Morales
- Departamento de Salud Pública, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
- Centro de Investigación en Epidemiología Cardiovascular y Nutricional (EPICYN), Universidad de La Frontera, Temuco, Chile
| | - Brian M Cavagnari
- Escuela de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Caba, Argentina
| | - Edna J Nava-González
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Jhon J Bejarano-Roncancio
- Departamento de Nutrición Humana, Facultad de Medicina, Universidad Nacional de Colombia, Sede Bogotá, Colombia
| | | | - Karla Cordón-Arrivillaga
- Unidad de Investigación en Seguridad Alimentaria y Nutricional (UNISAN), Escuela de Nutrición, Facultad de Ciencias Químicas y Farmacia, Universidad de San Carlos de Guatemala, Guatemala
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Zviedrite N, Jahan F, Zheteyeva Y, Gao H, Uzicanin A. School closures due to seasonal influenza: a prospective data collection-based study of eleven influenza seasons-United States, 2011-2022. LANCET REGIONAL HEALTH. AMERICAS 2024; 34:100741. [PMID: 38654749 PMCID: PMC11035104 DOI: 10.1016/j.lana.2024.100741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 03/25/2024] [Accepted: 04/01/2024] [Indexed: 04/26/2024]
Abstract
Background While numerous studies explore pandemic-associated school closures, literature is scant regarding seasonal influenza-associated closures. We previously reported summaries on COVID-19 pandemic-related school closures in the United States (US), which affected virtually all schools in the nation. The current prospective study aims to address the knowledge gap for seasonal influenza-related closures in the United States. Methods We conducted systematic daily online searches from August 1, 2011 to June 30, 2022, to identify public announcements of unplanned school closures in the US lasting ≥1 day, selecting those that mentioned influenza and influenza-like illness (ILI) as reason for school closure (ILI-SCs). We studied ILI-SC temporal patterns and compared them with reported outpatient ILI-related healthcare visits. Findings We documented that ILI-SCs occurred annually, with yearly totals ranging from 11 ILI-SCs in both the 2013-2014 and 2020-2021 school years to 2886 ILI-SCs in the 2019-2020 school year among more than 100,000 kindergarten through twelfth grade schools in the US. ILI-SCs occurred concurrently with widespread illness and the strongest correlations were observed during influenza A (H3N2)-dominant seasons, most notably in the 2016-2017 (Spearman rank correlation (rs) = 0.83) and the 2017-2018 (rs = 0.84) school years. ILI-SCs were heavily centered in U.S. Department of Health and Human Services Region 4 (states of Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee) [60% (6040/9166, Region 4/Total school closures)] and disproportionately impacted rural and lower-income communities. Interpretation Outside of a pandemic, disease-related school closures are extreme and generally rare events for US schools and communities. Timely compilation of publicly available ILI-SC announcements could enhance influenza surveillance, particularly in severe influenza seasons or pandemics when ILI-SCs are prevalent. Funding This work was supported by the U.S. Centers for Disease Control and Prevention. Co-authors (NZ, YZ, HG, AU) were or are US CDC employees, and FJ was a contractor through Cherokee Nation Operational Solutions, LLC, which supported FJ's salary, but had no additional role in the study.
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Affiliation(s)
| | - Ferdous Jahan
- Centers for Disease Control and Prevention, Atlanta, GA, USA
- Cherokee Nation Operational Solutions, LLC, Tulsa, OK, USA
| | | | - Hongjiang Gao
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Amra Uzicanin
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Withdrawal: Baseline Sociodemographic Characteristics and Mental Health Status of Primary Caregivers and Children Attending Schools on the Navajo Nation and White Mountain Apache Tribe During COVID-19. THE JOURNAL OF SCHOOL HEALTH 2024; 94:481. [PMID: 38225814 PMCID: PMC10987271 DOI: 10.1111/josh.13419] [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] [Received: 05/24/2023] [Revised: 10/25/2023] [Accepted: 11/13/2023] [Indexed: 01/17/2024]
Abstract
Withdrawal: 'Baseline Sociodemographic Characteristics and Mental Health Status of Primary Caregivers and Children Attending Schools on the Navajo Nation and White Mountain Apache Tribe During COVID-19' by Shannon Archuleta MPH, Joshuaa D. Allison-Burbank PhD, Allison Ingalls MPH, Renae Begay MPH, Ryan Grass BS, Francene Larzelere PhD, Vanessa Begaye BS, Lacey Howe BS, Alicia Tsosie BS, Angelina Phoebe Keryte BA, Emily E. Haroz PhD, J Sch Health 2024, 10.1111/josh.13419. The above article, published online on 15 January 2024 in Wiley Online Library (https://onlinelibrary.wiley.com/doi/full/10.1111/josh.13419) has been withdrawn by agreement between the authors, the journal's Editor in Chief, Michael W. Long, the American School Health Association and Wiley Periodicals LLC. The withdrawal has been agreed because consent for publication from one of the tribes participating in the study was pending at the time of publication.
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Bui T, Melnick EM, Tong D, Acciai F, Yedidia MJ, Ohri-Vachaspati P. Emergency Free School Meal Distribution During the COVID-19 Pandemic in High-Poverty Urban Settings. J Acad Nutr Diet 2024; 124:636-643. [PMID: 37935347 PMCID: PMC11032230 DOI: 10.1016/j.jand.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 09/02/2023] [Accepted: 11/02/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND The coronavirus disease 2019 pandemic triggered nationwide school closures in March 2020, putting millions of children in the United States who were reliant on subsidized school meals at risk of experiencing hunger. In response, the US Department of Agriculture mobilized the Summer Food Service Program and Seamless Summer Option program to provide emergency free school meals. There is a need to investigate the effectiveness of these programs in covering underresourced communities during the pandemic. OBJECTIVE This study assessed associations between meal distribution and census tract demographics (ie, poverty level, race/ethnicity, and deprivation level based on social deprivation index score). DESIGN An observational study using longitudinal meal distribution data collected over an 18-month period following school closures (March 2020 to August 2021). PARTICIPANTS AND SETTING Monthly meal distribution data were collected for community sites serving 142 census tracts within 4 urban New Jersey cities predominantly populated by people with low incomes and from racial and ethnic minority groups. MAIN OUTCOME MEASURES Main outcome measures were the number of meals served monthly by Summer Food Service Program and Seamless Summer Option meal sites. STATISTICAL ANALYSES PERFORMED A 2-part multivariable regression approach was used to analyze the data. RESULTS In the first step, logistic regression models showed that high-deprivation tracts were more likely to serve meals during the observed period (odds ratio 3.43, 95% CI 1.001 to 11.77; P = 0.0499). In the second step, among tracts that served any meals during the observed period, mixed effects negative binomial regression models showed that high-poverty and high-deprivation tracts served comparatively more meals (incidence rate ratio [IRR] 2.83, 95% CI 2.29 to 3.51; P < 0.001 and IRR 1.94, 95% CI 1.65 to 2.28; P < 0.001, respectively). CONCLUSIONS Findings show that meal distribution during the pandemic was higher within census tracts with higher poverty and deprivation levels, indicating that underresourced communities with higher need had more free meals available during this unprecedented public health emergency.
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Affiliation(s)
- Theresa Bui
- College of Medicine, University of Arizona, Phoenix, Arizona
| | - Emily M Melnick
- College of Health Solutions, Arizona State University, Phoenix, Arizona.
| | - Daoqin Tong
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, Arizona
| | - Francesco Acciai
- College of Health Solutions, Arizona State University, Phoenix, Arizona
| | - Michael J Yedidia
- Center for State Health Policy, Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, New Jersey
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Bell C, Goss M, Norton D, Barlow S, Temte E, He C, Hamer C, Walters S, Sabry A, Johnson K, Chen G, Uzicanin A, Temte J. Descriptive Epidemiology of Pathogens Associated with Acute Respiratory Infection in a Community-Based Study of K-12 School Children (2015-2023). Pathogens 2024; 13:340. [PMID: 38668295 PMCID: PMC11053468 DOI: 10.3390/pathogens13040340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/10/2024] [Accepted: 04/17/2024] [Indexed: 04/29/2024] Open
Abstract
School-based outbreaks often precede increased incidence of acute respiratory infections in the greater community. We conducted acute respiratory infection surveillance among children to elucidate commonly detected pathogens in school settings and their unique characteristics and epidemiological patterns. The ORegon CHild Absenteeism due to Respiratory Disease Study (ORCHARDS) is a longitudinal, laboratory-supported, school-based, acute respiratory illness (ARI) surveillance study designed to evaluate the utility of cause-specific student absenteeism monitoring for early detection of increased activity of influenza and other respiratory viruses in schools from kindergarten through 12th grade. Eligible participants with ARIs provided demographic, epidemiologic, and symptom data, along with a nasal swab or oropharyngeal specimen. Multipathogen testing using reverse-transcription polymerase chain reaction (RT-PCR) was performed on all specimens for 18 respiratory viruses and 2 atypical bacterial pathogens (Chlamydia pneumoniae and Mycoplasma pneumoniae). Between 5 January 2015 and 9 June 2023, 3498 children participated. Pathogens were detected in 2455 of 3498 (70%) specimens. Rhinovirus/enteroviruses (36%) and influenza viruses A/B (35%) were most commonly identified in positive specimens. Rhinovirus/enteroviruses and parainfluenza viruses occurred early in the academic year, followed by seasonal coronaviruses, RSV, influenza viruses A/B, and human metapneumovirus. Since its emergence in 2020, SARS-CoV-2 was detected year-round and had a higher median age than the other pathogens. A better understanding of the etiologies, presentations, and patterns of pediatric acute respiratory infections can help inform medical and public health system responses.
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Affiliation(s)
- Cristalyne Bell
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (C.B.); (S.B.); (E.T.); (C.H.); (C.H.); (S.W.); (A.S.); (K.J.); (J.T.)
| | - Maureen Goss
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (C.B.); (S.B.); (E.T.); (C.H.); (C.H.); (S.W.); (A.S.); (K.J.); (J.T.)
| | - Derek Norton
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (D.N.); (G.C.)
| | - Shari Barlow
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (C.B.); (S.B.); (E.T.); (C.H.); (C.H.); (S.W.); (A.S.); (K.J.); (J.T.)
| | - Emily Temte
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (C.B.); (S.B.); (E.T.); (C.H.); (C.H.); (S.W.); (A.S.); (K.J.); (J.T.)
| | - Cecilia He
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (C.B.); (S.B.); (E.T.); (C.H.); (C.H.); (S.W.); (A.S.); (K.J.); (J.T.)
| | - Caroline Hamer
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (C.B.); (S.B.); (E.T.); (C.H.); (C.H.); (S.W.); (A.S.); (K.J.); (J.T.)
| | - Sarah Walters
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (C.B.); (S.B.); (E.T.); (C.H.); (C.H.); (S.W.); (A.S.); (K.J.); (J.T.)
| | - Alea Sabry
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (C.B.); (S.B.); (E.T.); (C.H.); (C.H.); (S.W.); (A.S.); (K.J.); (J.T.)
| | - Kelly Johnson
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (C.B.); (S.B.); (E.T.); (C.H.); (C.H.); (S.W.); (A.S.); (K.J.); (J.T.)
| | - Guanhua Chen
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (D.N.); (G.C.)
| | - Amra Uzicanin
- Centers for Disease Control and Prevention, Atlanta, GA 30329, USA;
| | - Jonathan Temte
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53706, USA; (C.B.); (S.B.); (E.T.); (C.H.); (C.H.); (S.W.); (A.S.); (K.J.); (J.T.)
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Crouch E, Radcliff E, Probst J. Changes in Positive Childhood Experiences During the COVID-19 Pandemic. Acad Pediatr 2024; 24:254-257. [PMID: 37354948 PMCID: PMC10286521 DOI: 10.1016/j.acap.2023.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/13/2023] [Accepted: 06/16/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVE Changes in family life associated with COVID-19 precautions may have reduced children's access to positive childhood experiences (PCEs). The purpose of this study is to examine the prevalence of PCEs before and during the COVID-19 pandemic among school-age children. METHODS This cross-sectional study used data from the 2018-19 National Survey of Children's Health (NSCH, n = 42,464) and the 2020-21 NSCH (n = 54,256) to examine the pre-pandemic period (June 2018-January 2020) and compared results to information obtained during the early pandemic period (June 2020-January 2022) using bivariate analyses and Z-tests. RESULTS PCEs declined in four of the seven PCEs measured, from 2018 to 2019-2020-2021: after-school activities, community volunteerism, guiding mentor, and resilient family, with all differences significant by P < .0001. After-school activities decreased from 79.8% to 72.2%, community volunteering decreased from 43.9% to 35.1%, guiding mentor decreased from 88.8% to 86.3%, and resilient family decreased from 92.7% to 84.6%. PCEs increased for safe neighborhood (64.7-67.2%), supportive neighborhood (55.8-57.5%), and connected caregiver (65.3-94.7%). CONCLUSIONS As children have experienced higher levels of parental stress and disruption during their lives during the COVID-19 pandemic, policymakers and program makers must find ways to increase exposure to PCEs following the pandemic. The quantification of these PCEs is a great start, with further research needed to describe ways that schools and community organizations have found to expose children to PCEs in safe ways.
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Affiliation(s)
- Elizabeth Crouch
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia.
| | - Elizabeth Radcliff
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia
| | - Janice Probst
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia
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Uppal PA, Jayapal A, Jetjomlong T, Merchant R, Khatiashvili A, Moritz E, Feustel PJ, Reichert L. Myringotomy tube placement: understanding the impact of the coronavirus disease 2019 pandemic. J Laryngol Otol 2024; 138:279-283. [PMID: 37311736 DOI: 10.1017/s0022215123001020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Otolaryngologists perform bilateral myringotomy and tube placement for surgical management for otitis media with effusion. This retrospective study aimed to address the extent to which the coronavirus disease 2019 pandemic and season impact the number of bilateral myringotomy and tube placement procedures performed at a tertiary care centre. METHODS A total of 1248 charts of children who underwent bilateral myringotomy and tube placement from January 2018 through February 2021 were reviewed. RESULTS The cohort included 41.6 per cent females and 58.4 per cent males, with 63.7 per cent having private insurance. The median age at surgery was 2.6 years. The spring season had the most bilateral myringotomy and tube placement procedures per week. The number of bilateral myringotomy and tube placement procedures performed per week after the onset of the coronavirus disease 2019 pandemic was significantly lower compared to the years prior. There was no difference in number of intra-operative effusions pre-pandemic versus after the pandemic onset. CONCLUSION This study sheds light on the impact of the coronavirus disease 2019 pandemic and seasonality on the rates of tympanostomy tube procedures, vital for understanding the temporality of ear infections.
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Affiliation(s)
| | | | | | | | | | - Ethan Moritz
- Otolaryngology, Albany Medical Center, New York, USA
| | - Paul J Feustel
- Neuroscience and Experimental Therapeutics, Albany Medical Center, New York, USA
| | - Lara Reichert
- Otolaryngology, Albany Medical Center, New York, USA
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10
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Zviedrite N, Jahan F, Moreland S, Ahmed F, Uzicanin A. COVID-19-Related School Closures, United States, July 27, 2020-June 30, 2022. Emerg Infect Dis 2024; 30:58-69. [PMID: 38086396 PMCID: PMC10756369 DOI: 10.3201/eid3001.231215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023] Open
Abstract
As part of a multiyear project that monitored illness-related school closures, we conducted systematic daily online searches during July 27, 2020-June 30, 2022, to identify public announcements of COVID-19-related school closures (COVID-SCs) in the United States lasting >1 day. We explored the temporospatial patterns of COVID-SCs and analyzed associations between COVID-SCs and national COVID-19 surveillance data. COVID-SCs reflected national surveillance data: correlation was highest between COVID-SCs and both new PCR test positivity (correlation coefficient [r] = 0.73, 95% CI 0.56-0.84) and new cases (r = 0.72, 95% CI 0.54-0.83) during 2020-21 and with hospitalization rates among all ages (r = 0.81, 95% CI 0.67-0.89) during 2021-22. The numbers of reactive COVID-SCs during 2020-21 and 2021-22 greatly exceeded previously observed numbers of illness-related reactive school closures in the United States, notably being nearly 5-fold greater than reactive closures observed during the 2009 influenza (H1N1) pandemic.
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11
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Dvir Y, Ryan C, Lee J. School Closures and ED Visits for Suicidality in Youths Before and During the COVID-19 Pandemic. JAMA Netw Open 2023; 6:e2343001. [PMID: 37948084 PMCID: PMC10638653 DOI: 10.1001/jamanetworkopen.2023.43001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/03/2023] [Indexed: 11/12/2023] Open
Abstract
This cohort study investigates the association of COVID-19–related school closures with rates of emergency department suicidality visits among youths ages 12 to 25 years.
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Affiliation(s)
- Yael Dvir
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Massachusetts Chan Medical School/UMass Memorial Medical Center, Worcester
| | - Clare Ryan
- Department of Psychiatry, University of Massachusetts Chan Medical School/UMass Memorial Medical Center, Worcester
| | - JungAe Lee
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester
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Archuleta S, Ingalls A, Allison-Burbank JD, Begay R, Harvey B, Grass R, Haroz EE. Summarizing Implementation Support for School-Based COVID-19 Testing Programs in Southwest American Indian Communities. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:E223-E230. [PMID: 37738603 PMCID: PMC10550253 DOI: 10.1097/phh.0000000000001793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
CONTEXT American Indian communities have been disproportionately affected by the COVID-19 pandemic, with school closures exacerbating health and education disparities. PROGRAM Project SafeSchools' COVID-19 school-based testing program utilized federal and state funding to provide weekly pooled testing with follow-up rapid antigen testing to students and staff from the White Mountain Apache Tribe and Navajo Nation. IMPLEMENTATION The project provided partner schools with training and continual logistical and technical support to aid in school-based testing and adherence to state and local reporting requirements. EVALUATION Using the EPIS (Exploration, Preparation, Implementation, and Sustainment) framework, we identified facilitators and barriers to successful program function. While community support and buy-in were essential for successfully implementing school-based testing in these communities, communication, school staff turnover, and funding are among the most significant challenges. DISCUSSION Community partnerships in American Indian communities involving schools and local health authorities can successfully implement testing protocols by remaining flexible and working together to maintain strong lines of communication.
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Affiliation(s)
- Shannon Archuleta
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Remien KA, Amarin JZ, Horvat CM, Nofziger RA, Page-Goertz CK, Besunder JB, Potts BK, Forbes ML, Halasa N, Pelletier JH. Admissions for Bronchiolitis at Children's Hospitals Before and During the COVID-19 Pandemic. JAMA Netw Open 2023; 6:e2339884. [PMID: 37883085 PMCID: PMC10603547 DOI: 10.1001/jamanetworkopen.2023.39884] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/12/2023] [Indexed: 10/27/2023] Open
Abstract
Importance The COVID-19 pandemic has been associated with a transient decrease in bronchiolitis hospitalizations compared with prepandemic patterns, but current effects remain unknown. Objective To analyze changes in patterns of bronchiolitis admissions at US children's hospitals during the 2020-2023 bronchiolitis seasons compared with the 2010-2019 seasons. Design, Setting, and Participants This retrospective cross-sectional study used data from 41 US children's hospitals in the Pediatric Health Information System database. Bronchiolitis has winter-predominant seasonality, so hospitalizations were grouped according to bronchiolitis season (from July through June). This study included all patients aged younger than 2 years admitted with a diagnosis of bronchiolitis between July 1, 2010, and June 30, 2023. Bronchiolitis seasons from July through June between 2010-2011 and 2019-2020 were classified as the prepandemic era, and seasons between 2020-2021 and 2022-2023 were classified as the pandemic era. Data analysis was performed from July 1, 2010, through June 30, 2023. Exposures Admission date. Main Outcomes and Measures The primary outcome was number of hospitalizations for bronchiolitis by season and month. Monthly admission counts from the prepandemic era were transformed into time series and used to train seasonal ensemble forecasting models. Forecasts were compared to monthly admissions during the pandemic era. Results In this study, there were 400 801 bronchiolitis admissions among 349 609 patients between July 1, 2010, and June 30, 2023. The median patient age was 6 (IQR, 2-12) months; 58.7% were boys and 43.7% were White. Hospitalizations increased gradually during the prepandemic era (median, 29 309 [IQR, 26 196-34 157]), decreased 69.2% (n = 9030) in the 2020-2021 season, and increased 75.3% (n = 51 397) in the 2022-2023 season. Patients in the pandemic era were older than those in the prepandemic era (median, 7 [IQR, 3-14] vs 6 [2-12] months; P < .001). Intensive care unit (ICU) admissions increased from 32.2% (96 245 of 298 535) in the prepandemic era to 36.7% (37 516 of 102 266) in the pandemic era (P < .001). The seasonality of bronchiolitis admissions changed during the pandemic era. Admissions peaked in August 2021 (actual 5036 vs 943 [95% CI, 0-2491] forecasted) and November 2022 (actual 10 120 vs 5268 [95% CI, 3425-7419] forecasted). These findings were unchanged in sensitivity analyses excluding children with complex chronic conditions and excluding repeat admissions. In a sensitivity analysis including all viral lower respiratory tract infections in children aged younger than 5 years, there were 66 767 admissions in 2022-2023 vs 35 623 (31 301-41 002) in the prepandemic era, with the largest increase in children aged 24 to 59 months. Conclusions and Relevance The findings of this cross-sectional study suggest that bronchiolitis hospitalizations decreased transiently and then increased markedly during the COVID-19 pandemic era. Patients admitted during the pandemic era were older and were more likely to be admitted to an ICU. These findings suggest that bronchiolitis seasonality has not yet returned to prepandemic patterns, and US hospitals should prepare for the possibility of atypical timing again in 2023.
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Affiliation(s)
- Kailey A. Remien
- Department of Medical Education, Akron Children’s Hospital, Akron, Ohio
| | - Justin Z. Amarin
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Christopher M. Horvat
- Division of Pediatric Critical Care Medicine, Department of Critical Care Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ryan A. Nofziger
- Division of Critical Care Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, Ohio
- Department of Pediatrics, College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio
| | - Christopher K. Page-Goertz
- Division of Critical Care Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, Ohio
- Department of Pediatrics, College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio
| | - James B. Besunder
- Division of Critical Care Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, Ohio
- Department of Pediatrics, College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio
| | - Brittany K. Potts
- Department of Pediatrics, College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio
- Division of Hospital Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, Ohio
| | - Michael L. Forbes
- Division of Critical Care Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, Ohio
- Department of Pediatrics, College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio
- Rebecca D. Considine Research Institute, Akron Children’s Hospital, Akron, Ohio
| | - Natasha Halasa
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jonathan H. Pelletier
- Division of Critical Care Medicine, Department of Pediatrics, Akron Children’s Hospital, Akron, Ohio
- Department of Pediatrics, College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio
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Baker C, Jones J, Weiss CR, Harpin SB. A qualitative study of school nurses' moral distress related to COVID-19. Public Health Nurs 2023; 40:629-640. [PMID: 37475212 DOI: 10.1111/phn.13228] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/14/2023] [Accepted: 07/09/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE To understand school nurses' perceptions and experiences of moral distress related to COVID-19 case management in the school systems. DESIGN A descriptive qualitative study guided by Braun and Clarke's reflexive thematic analysis. SAMPLE Twelve school nurses practicing in Colorado from December 2021 to January 2022. MEASUREMENTS Semi-structured interviews about school nurses' experiences of COVID-19. Investigators utilized an iterative reflexive thematic analysis process engaging the participants' and researchers' subjective experiences. RESULTS Four themes were created: (1) keeping kids and the community safe, (2) caught in the middle of the "tug of war" between health and politics, (3) distress amid an ocean of COVID-19 uncertainty, and (4) visibility as a bright spot shining through the COVID-19 cloud. CONCLUSIONS Two research questions examined school nurses' experiences of moral distress and their role and scope of practice that affected their relationships in the educational and public health systems. The results of this study confirm the important role of school nurses and interprofessional case management in school environments in the fight against infectious diseases and pandemics. Building stronger relationships between school nurses and public health is imperative for future collaborative and cohesive public health responses to pandemics.
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Affiliation(s)
- Christina Baker
- College of Nursing, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Jacqueline Jones
- College of Nursing, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Charlotte R Weiss
- College of Nursing, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Scott B Harpin
- College of Nursing, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
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Park J, Joo H, Maskery BA, Zviedrite N, Uzicanin A. Productivity costs associated with reactive school closures related to influenza or influenza-like illness in the United States from 2011 to 2019. PLoS One 2023; 18:e0286734. [PMID: 37279211 DOI: 10.1371/journal.pone.0286734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/19/2023] [Indexed: 06/08/2023] Open
Abstract
INTRODUCTION Schools close in reaction to seasonal influenza outbreaks and, on occasion, pandemic influenza. The unintended costs of reactive school closures associated with influenza or influenza-like illness (ILI) has not been studied previously. We estimated the costs of ILI-related reactive school closures in the United States over eight academic years. METHODS We used prospectively collected data on ILI-related reactive school closures from August 1, 2011 to June 30, 2019 to estimate the costs of the closures, which included productivity costs for parents, teachers, and non-teaching school staff. Productivity cost estimates were evaluated by multiplying the number of days for each closure by the state- and year-specific average hourly or daily wage rates for parents, teachers, and school staff. We subdivided total cost and cost per student estimates by school year, state, and urbanicity of school location. RESULTS The estimated productivity cost of the closures was $476 million in total during the eight years, with most (90%) of the costs occurring between 2016-2017 and 2018-2019, and in Tennessee (55%) and Kentucky (21%). Among all U.S. public schools, the annual cost per student was much higher in Tennessee ($33) and Kentucky ($19) than any other state ($2.4 in the third highest state) or the national average ($1.2). The cost per student was higher in rural areas ($2.9) or towns ($2.5) than cities ($0.6) or suburbs ($0.5). Locations with higher costs tended to have both more closures and closures with longer durations. CONCLUSIONS In recent years, we found significant heterogeneity in year-to-year costs of ILI-associated reactive school closures. These costs have been greatest in Tennessee and Kentucky and been elevated in rural or town areas relative to cities or suburbs. Our findings might provide evidence to support efforts to reduce the burden of seasonal influenza in these disproportionately impacted states or communities.
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Affiliation(s)
- Joohyun Park
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Heesoo Joo
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Brian A Maskery
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Nicole Zviedrite
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Amra Uzicanin
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Rich C, Hanson L, Daniel L, Davis A. Temperature screening and detection of Covid‐19 in school‐aged children: A retrospective cohort study assessing the efficacy of temperature screening in schools. WORLD MEDICAL & HEALTH POLICY 2023. [DOI: 10.1002/wmh3.567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Affiliation(s)
- Courtney Rich
- Magnolia Regional Health Center Emergency Medicine Residency Corinth Mississippi USA
| | - Laura Hanson
- Magnolia Regional Health Center Emergency Medicine Residency Corinth Mississippi USA
| | - Luther Daniel
- Debusk College of Osteopathic Medicine Lincoln Memorial University Harrogate Tennessee USA
| | - Amy Davis
- Magnolia Regional Health Center Emergency Medicine Residency Corinth Mississippi USA
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The Impacts of the COVID-19 Pandemic on Therapy Utilization Among Racially/Ethnically and Socio-Economically Diverse Autistic Children. J Autism Dev Disord 2023; 53:918-933. [PMID: 36757541 PMCID: PMC9909136 DOI: 10.1007/s10803-023-05905-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2023] [Indexed: 02/10/2023]
Abstract
PURPOSE The purpose of current study was to evaluate change in hours of Applied Behavior Analysis (ABA) therapy utilization for autistic children during the year prior to the COVID-19 pandemic, the first three months of the pandemic (crisis phase), and the following 9 months of the pandemic (mitigation phase). Additionally, this study aimed to evaluate if change in therapy utilization differed based on child race, ethnicity, and primary payer of services. Finally, we aimed to identify potential mechanisms of ABA therapy disruption by interpreting findings using an extended version of Donabedian's structure-process-outcome model. METHODS Retrospective clinical data on client demographics and therapy utilization (n = 283) were collected from ABA clinics in California and analyzed with four piecewise growth multi-level models. RESULTS We found that therapy utilization dropped during the first three months of the pandemic (-10.65 h/month; p < .001) and increased during the following 9 months (2.39 h/month; p < .001). Moderator analyses revelated that Asian, Non-Latinx and school-district funded children had significantly different trajectories of change in therapy utilization compared to white, non-Latinx participants and private insurance funded participants, respectively. CONCLUSION Findings suggest that utilization of ABA therapy was disrupted for a full year following the onset of the COVID-19 pandemic and that child race/ethnicity and primary payer influenced the degree to which autistic children were impacted by service disruption. These findings have implications for autistic children who lost therapy access during key developmental periods and for the ABA care delivery system.
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Child Flourishing, School Engagement, Physical Activity, and Screen Time During the Coronavirus Disease 2019 Pandemic in 2020. Acad Pediatr 2023; 23:659-666. [PMID: 36623586 PMCID: PMC9822554 DOI: 10.1016/j.acap.2022.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To examine changes in flourishing, school engagement, physical activity, and recreational screen time among school-aged children in the United States during the Coronavirus Disease 2019 (COVID-19) pandemic in 2020. METHODS In this cross-sectional study, data come from the 2018-2020 National Survey of Children's Health for 68,203 children aged 6 to 17 years. Flourishing is always/usually curious to learn, resilient and having self-regulation. School engagement is always/usually completing homework and having interest in doing well in school. Other outcomes are daily 60+ minutes physical activity or number of such days, and daily recreational screen time or 2+ hours/day. Weighted regression models compare 2020 to 2019 and 2019 to 2018 adjusting for child/household covariates and state indicators. RESULTS Among children age 6 to 17 years in 2020, there was a decline in flourishing (OR = 0.69; 95% CI, 0.63, 0.75), school engagement (OR = 0.71; 95% CI, 0.64, 0.79), physically active days (0.26 days, 95% CI, 35, 0.17), and daily 60+ minutes activity (OR = 0.91; 95% CI, 0.83, 1.00), and increase in daily recreational screen time (0.29 hours; 95% CI, 0.25, 0.34) and 2+ hours/day (OR = 1.65; 95% CI, 1.49-1.83) compared to 2019. These differences were observed across all evaluated demographic and socioeconomics subgroups. There were no significant differences between 2019 and 2018, indicating that the 2020-2019 differences were related to the pandemic rather than a continuation of prepandemic trends. CONCLUSIONS Children's flourishing, school engagement, and physical activity declined while recreational screen time increased during the COVID-19 pandemic in 2020. Monitoring these outcomes in the long-run is important to assessing needs and promoting children's learning and development.
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Markiewitz ND, Garcia-Munoz J, Lilley BM, Oduwole S, Shah AS, Williams BA. Epidemiologic Changes in Pediatric Fractures Presenting to Emergency Departments During the COVID-19 Pandemic. J Pediatr Orthop 2022; 42:e815-e820. [PMID: 35818171 PMCID: PMC9351512 DOI: 10.1097/bpo.0000000000002194] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Fractures are a common pediatric injury. The coronavirus disease 2019 (COVID-19) pandemic resulted in significant changes in daily life that could impact the incidence of pediatric fractures. The purpose of this study was to compare the incidence of pediatric fractures in the United States during the COVID-19 pandemic to previous seasonally adjusted fracture incidence rates using the National Electronic Injury Surveillance System (NEISS) database and the American Community Survey (ACS). METHODS The NEISS database was queried from 2016 to 2020 for fractures occurring in pediatric (0 to 17 y) patients. ACS population data allowed for the estimation of fracture incidence per 1000 person-years. Using a quasiexperimental interrupted time series design, Poisson regression models were constructed to test the overall and differential impact of COVID-19 on monthly fracture rate by age, sex, fracture site, injury location, and disposition. RESULTS Our sample consisted of 121,803 cases (mean age 9.6±4.6 y, 36.1% female) representing 2,959,421±372,337 fractures nationally. We identified a stable 27% decrease in fractures per month after February 2020 [risk difference (RD) per 1000 youth years=-2.3; 95% confidence interval: -2.98, -1.57]). We found significant effect modification by age, fracture site and injury location ( P <0.05). The fracture incidence among children 5 years or older significantly decreased, as well as the incidence of fractures at school [RD=-0.96 (-1.09, -0.84)] and during sports [risk difference=-1.55 (-1.77, -1.32)]. There was also a trend toward a reduction in upper extremity fractures and fractures requiring admission. CONCLUSION A nationally representative injury database demonstrated a 27% decline in monthly pediatric fractures during the COVID-19 pandemic that persisted into the latter half of 2020. These trends appeared most attributable to a reduction in fractures discharged home and upper extremity fractures among older children sustained at school and in sports. Our findings provide unique insight into the epidemiology of pediatric fractures and demonstrate a baseline need for musculoskeletal care among young children even in the setting of a national shutdown. LEVEL OF EVIDENCE Level II-retrospective prognostic study.
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Affiliation(s)
| | | | | | | | - Apurva S. Shah
- Department of Orthopaedics, The Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Brendan A. Williams
- Department of Orthopaedics, The Children’s Hospital of Philadelphia, Philadelphia, PA
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Feasibility, Acceptability, and Barriers to Implementing Select Non-Pharmaceutical Interventions to Reduce the Transmission of Pandemic Influenza - United States, 2019. Disaster Med Public Health Prep 2022; 17:e209. [PMID: 35912682 PMCID: PMC9464508 DOI: 10.1017/dmp.2022.174] [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] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This study aimed to assess the feasibility and acceptability of implementing non-pharmaceutical interventions (NPIs) reserved for influenza pandemics (voluntary home quarantine, use of face masks by ill persons, childcare facility closures, school closures, and social distancing at schools, workplaces, and mass gatherings). METHODS Public health officials in all 50 states (including Washington, DC) and 8 territories, and a random sample of 822 local health departments (LHDs), were surveyed in 2019. RESULTS The response rates for the states/ territories and LHDs were 75% (44/ 59) and 25% (206/ 822), respectively. Most of the state/ territorial respondents stated that the feasibility and acceptability of implementing NPIs were high, except for K-12 school closures lasting up to 6 weeks or 6 months. The LHD respondents also indicated that feasibility and acceptability were lowest for prolonged school closures. Compared to LHD respondents in suburban or urban areas, those in rural areas expressed lower feasibility and acceptability. Barriers to implementing NPIs included financial impact, compliance and difficulty in enforcement, perceived level of disease threat, and concerns regarding political implications. CONCLUSION Proactive strategies to systematically address perceived barriers and promote disease prevention ahead of a new pandemic are needed to increase receptivity and consistent adoption of NPIs and other evidence-based countermeasures.
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Hayes AR, Lee D. Women, work, and families during the COVID-19 pandemic: Examining the effects of COVID policies and looking to the future. THE JOURNAL OF SOCIAL ISSUES 2022; 79:JOSI12510. [PMID: 35942489 PMCID: PMC9349536 DOI: 10.1111/josi.12510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/16/2022] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
The far-reaching, negative effects of the COVID-19 pandemic have impacted healthcare, economic, public safety, and social systems globally. The public safety measures put in place in the United States during the COVID-19 pandemic, including sheltering in places orders and shutdowns of schools and places of work, negatively impacted the employment status and increased time spent in domestic work and childcare for women. In this paper, we review and analyze the impacts, both direct and indirect, of COVID-related policies on the lives of women. Specifically, we outline how the progression of policies aimed at addressing both public safety and economic recovery during the COVID-19 pandemic affected women's health, paid and unpaid work, and wellbeing. We will focus on the impacts of policies implemented in the United States in comparison to policies that were implemented globally to address similar issues during the first two years of the COVID-19 pandemic. Finally, we conclude with recommendations for policies that could prevent similar disparate impacts on women in future crises.
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Affiliation(s)
| | - Diamond Lee
- The University of Texas at TylerTylerTexasUSA
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22
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Mayra ST, Kandiah J, McIntosh CE. COVID-19 and health in children and adolescents in the US: A narrative systematic review. PSYCHOLOGY IN THE SCHOOLS 2022; 60:PITS22723. [PMID: 35572171 PMCID: PMC9088696 DOI: 10.1002/pits.22723] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/05/2022] [Accepted: 04/11/2022] [Indexed: 12/11/2022]
Abstract
In the United States, the Coronavirus Disease 2019 (COVID-19) pandemic necessitated nationwide closures of kindergarten through twelfth grade (K-12) schools. Stay-at-home orders and social distancing mandates were also implemented to mitigate the spread of COVID-19. The purpose of this systematic review was to synthesize the existing literature on how COVID-19 impacted K-12 students' eating patterns, physical activity, and sleep in the United States. Utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search was conducted between October and December 2021. Inclusion criteria were studies focused on COVID-19 and eating patterns, physical activity, and sleep in students enrolled in K-12 schools since March 2020. International studies were excluded. Mixed findings were observed for eating patterns whereby the consumption of unhealthful savory and sweet items and healthful snacks (e.g., fruit and vegetables) increased. Reductions in physical activity and disrupted sleep routines were also observed. Heterogeneity in methodological procedures may limit the generalizability of these findings. In the United States, preliminary data suggest that select health-promoting behaviors were negatively impacted by the COVID-19 pandemic. Given that prolonged unhealthful eating patterns, physical inactivity, and poor sleep contribute to chronic disease risk, initiatives that increase health-promoting behaviors are warranted.
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Affiliation(s)
- Selicia T. Mayra
- Department of Nutrition and Health ScienceBall State UniversityMuncieIndianaUSA
| | - Jayanthi Kandiah
- Department of Nutrition and Health ScienceBall State UniversityMuncieIndianaUSA
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Hoelscher DM, Brann LS, O’Brien S, Handu D, Rozga M. Prevention of Pediatric Overweight and Obesity: Position of the Academy of Nutrition and Dietetics Based on an Umbrella Review of Systematic Reviews. J Acad Nutr Diet 2022; 122:410-423.e6. [DOI: 10.1016/j.jand.2021.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/27/2021] [Accepted: 11/03/2021] [Indexed: 01/08/2023]
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Impact of the COVID-19 pandemic on therapy service delivery and functioning for school-aged children with disabilities in the United States. Disabil Health J 2022; 15:101266. [PMID: 35115260 PMCID: PMC8730530 DOI: 10.1016/j.dhjo.2021.101266] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 12/21/2021] [Accepted: 12/30/2021] [Indexed: 01/23/2023]
Abstract
Background Objective/Hypothesis Methods Results Conclusions
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Parks SE, Zviedrite N, Budzyn SE, Panaggio MJ, Raible E, Papazian M, Magid J, Ahmed F, Uzicanin A, Barrios LC. COVID-19-Related School Closures and Learning Modality Changes - United States, August 1-September 17, 2021. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2021; 70:1374-1376. [PMID: 34591828 PMCID: PMC8486392 DOI: 10.15585/mmwr.mm7039e2] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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