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Thompson HR, Madsen KA, Nguyen C, Argenio K, D'Agostino E, Konty K, Day S. School-level self-reported versus objective measurements of body mass index in public high school students. Prev Med 2023; 174:107616. [PMID: 37451556 PMCID: PMC10529345 DOI: 10.1016/j.ypmed.2023.107616] [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] [Received: 05/02/2023] [Revised: 06/15/2023] [Accepted: 07/09/2023] [Indexed: 07/18/2023]
Abstract
Population-level surveillance of student weight status (particularly monitoring students with a body mass index (BMI) ≥95th percentile) remains of public health interest. However, there is mounting concern about objectively measuring student BMI in schools. Using data from the nation's largest school district, we determined how closely students' self-reported BMI approximates objectively-measured BMI, aggregated at the school level, to inform decision-making related to school BMI measurement practices. Using non-matched data from n = 82,543 students with objective height/weight data and n = 7676 with self-reported height/weight from 84 New York City high schools (88% non-white and 75% free or reduced-price meal-eligible enrollment), we compared school-level mean differences in height, weight, BMI, and proportion of students by weight status, between objective and self-reported measures. At the school-level, the self-reported measurement significantly underestimated weight (-1.38 kg; 95% CI: -1.999, -0.758) and BMI (-0.38 kg/m2; 95% CI: -0.574, -0.183) compared to the objective measurement. Based on the objective measurement, 12.1% of students were classified as having obesity and 6.3% as having severe obesity (per CDC definition); the self-report data yielded 2.5 (95% CI: -1.964, -0.174) and 1.4 (95% CI: -2.176, -0.595) percentage point underestimates in students with obesity and severe obesity, respectively. This translates to 13% of students with obesity and 21% of students with severe obesity being misclassified if using self-reported BMI. School-level high school students' self-reported data underestimate the prevalence of students with obesity and severe obesity and is particularly poor at identifying highest-risk students based on BMI percentile.
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Affiliation(s)
- Hannah R Thompson
- University of California Berkeley, School of Public Health, Community Health Sciences, 2121 Berkeley Way West, Berkeley, CA 94720, United States.
| | - Kristine A Madsen
- University of California Berkeley, School of Public Health, Community Health Sciences, 2121 Berkeley Way West, Berkeley, CA 94720, United States.
| | - Caroline Nguyen
- University of California Berkeley, School of Public Health, Community Health Sciences, 2121 Berkeley Way West, Berkeley, CA 94720, United States.
| | - Kira Argenio
- NYC Department of Health and Mental Hygiene, Office of School Health, 125 Worth St, New York, NY 10013, United States.
| | - Emily D'Agostino
- Duke University School of Medicine, Department of Population Health Sciences, Department of Family Medicine & Community Health, 311 Trent Drive, Durham, NC 27710, United States.
| | - Kevin Konty
- NYC Department of Health and Mental Hygiene, Office of School Health, 125 Worth St, New York, NY 10013, United States.
| | - Sophia Day
- NYC Department of Health and Mental Hygiene, Office of School Health, 125 Worth St, New York, NY 10013, United States.
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Context, importance, and process for creating a body mass index surveillance system to monitor childhood obesity within the New York City public school setting. Prev Med Rep 2022; 26:101704. [PMID: 35141118 PMCID: PMC8814642 DOI: 10.1016/j.pmedr.2022.101704] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/15/2021] [Accepted: 01/15/2022] [Indexed: 12/28/2022] Open
Abstract
The Office of School Health, a joint program of the Departments of Health and Education, administers New York City’s (NYC) body mass index (BMI) surveillance system to monitor childhood obesity. We describe the context, importance, and process for creating a multi-agency, school-based BMI surveillance system using BMI collected from annual FITNESSGRAM® physical fitness assessments conducted as part of a larger physical activity and wellness curriculum in NYC public schools. We also summarize our current system and methodology, highlighting the types of data and data sources that comprise the system and partnership between the Departments of Health and Education that enable data sharing. Strategies for addressing threats to data quality, including missing data, biologically implausible values, and imprecise/subjective weight or height equipment are discussed. We also review current and future surveillance data products, and provide recommendations for collecting, analyzing, interpreting, and reporting BMI data for childhood obesity surveillance. Collaboration between Departments of Health and Education as well as attention to safeguards of BMI reporting and data quality threats have enabled NYC to collect high quality BMI data to accurately monitor childhood obesity trends. These findings have implications for youth BMI surveillance systems in the United States and globally.
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Paul DR, Scruggs PW, Goc Karp G, Ransdell LB, Robinson C, Lester MJ, Gao Y, Petranek LJ, Brown H, Shimon JM. Developing a statewide childhood body mass index surveillance program. THE JOURNAL OF SCHOOL HEALTH 2014; 84:661-667. [PMID: 25154530 DOI: 10.1111/josh.12194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 01/07/2014] [Accepted: 02/03/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Several states have implemented childhood obesity surveillance programs supported by legislation. Representatives from Idaho wished to develop a model for childhood obesity surveillance without the support of state legislation, and subsequently report predictors of overweight and obesity in the state. METHODS A coalition comprised of the Idaho State Department of Education and 4 universities identified a randomized cluster sample of schools. After obtaining school administrator consent, measurement teams traveled to each school to measure height and weight of students. Sex and race/ethnicity data were also collected. RESULTS The collaboration between the universities resulted in a sample of 6735 students from 48 schools and 36 communities. Overall, 29.2% of the youth in the sample were classified as overweight or obese, ranging from 24.0% for grade 1 to 33.8% for grade 5. The prevalence of overweight and obesity across schools was highly variable (31.2 ± 7.58%). Hierarchical logistic regression indicated that sex, age, race/ethnicity, socioeconomic status, and region were all significant predictors of overweight and obesity, whereas school was not. CONCLUSIONS This coalition enabled the state of Idaho to successfully estimate the prevalence of overweight and obesity on a representative sample of children from all regions of the state, and subsequently identify populations at greatest risk.
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Affiliation(s)
- David R Paul
- University of Idaho, P.O. Box 442401, Moscow, ID 83844.
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Gerber BS, Rapacki L, Castillo A, Tilton J, Touchette DR, Mihailescu D, Berbaum ML, Sharp LK. Design of a trial to evaluate the impact of clinical pharmacists and community health promoters working with African-Americans and Latinos with diabetes. BMC Public Health 2012; 12:891. [PMID: 23088168 PMCID: PMC3571948 DOI: 10.1186/1471-2458-12-891] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 10/16/2012] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Given the increasing prevalence of diabetes and the lack of patients reaching recommended therapeutic goals, novel models of team-based care are emerging. These teams typically include a combination of physicians, nurses, case managers, pharmacists, and community-based peer health promoters (HPs). Recent evidence supports the role of pharmacists in diabetes management to improve glycemic control, as they offer expertise in medication management with the ability to collaboratively intensify therapy. However, few studies of pharmacy-based models of care have focused on low income, minority populations that are most in need of intervention. Alternatively, HP interventions have focused largely upon low income minority groups, addressing their unique psychosocial and environmental challenges in diabetes self-care. This study will evaluate the impact of HPs as a complement to pharmacist management in a randomized controlled trial. METHODS/DESIGN The primary aim of this randomized trial is to evaluate the effectiveness of clinical pharmacists and HPs on diabetes behaviors (including healthy eating, physical activity, and medication adherence), hemoglobin A1c, blood pressure, and LDL-cholesterol levels. A total of 300 minority patients with uncontrolled diabetes from the University of Illinois Medical Center ambulatory network in Chicago will be randomized to either pharmacist management alone, or pharmacist management plus HP support. After one year, the pharmacist-only group will be intensified by the addition of HP support and maintenance will be assessed by phasing out HP support from the pharmacist plus HP group (crossover design). Outcomes will be evaluated at baseline, 6, 12, and 24 months. In addition, program and healthcare utilization data will be incorporated into cost and cost-effectiveness evaluations of pharmacist management with and without HP support. DISCUSSION The study will evaluate an innovative, integrated approach to chronic disease management in minorities with poorly controlled diabetes. The approach is comprised of clinic-based pharmacists and community-based health promoters collaborating together. They will target patient-level factors (e.g., lack of adherence to lifestyle modification and medications) and provider-level factors (e.g., clinical inertia) that contribute to poor clinical outcomes in diabetes. Importantly, the study design and analytic approach will help determine the differential and combined impact of adherence to lifestyle changes, medication, and intensification on clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01498159.
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Affiliation(s)
- Ben S Gerber
- Institute for Health Research and Policy, 1747 West Roosevelt Rd. M/C 275, Chicago, IL, 60608, USA
- Jesse Brown VA Medical Center, 820 South Damen Ave., Chicago, IL, 60612, USA
| | - Lauren Rapacki
- Institute for Health Research and Policy, 1747 West Roosevelt Rd. M/C 275, Chicago, IL, 60608, USA
| | - Amparo Castillo
- Midwest Latino Health Research, Training and Policy Center, 1640 West Roosevelt Road- Suite 636, Chicago, IL, 60608, USA
| | - Jessica Tilton
- Department of Pharmacy Practice, 833 S. Wood St. M/C 886, Chicago, IL, 60612, USA
| | - Daniel R Touchette
- Department of Pharmacy Practice, 833 S. Wood St. M/C 886, Chicago, IL, 60612, USA
| | - Dan Mihailescu
- Section of Endocrinology, Diabetes and Metabolism, 1819 West Polk Street, M/C 640, Chicago, IL, 60612, USA
| | - Michael L Berbaum
- Institute for Health Research and Policy, 1747 West Roosevelt Rd. M/C 275, Chicago, IL, 60608, USA
| | - Lisa K Sharp
- Institute for Health Research and Policy, 1747 West Roosevelt Rd. M/C 275, Chicago, IL, 60608, USA
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Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, Maryniuk M, Peyrot M, Piette JD, Reader D, Siminerio LM, Weinger K, Weiss MA. National standards for diabetes self-management education. Diabetes Care 2012; 35 Suppl 1:S101-8. [PMID: 22187467 PMCID: PMC3632167 DOI: 10.2337/dc12-s101] [Citation(s) in RCA: 158] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, Maryniuk M, Peyrot M, Piette JD, Reader D, Siminerio LM, Weinger K, Weiss MA. National Standards for diabetes self-management education. Diabetes Care 2011; 34 Suppl 1:S89-96. [PMID: 21193633 PMCID: PMC3006053 DOI: 10.2337/dc11-s089] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Martha M Funnell
- Department of Medical Education, Diabetes Research and Training Center, University of Michigan, Ann Arbor, Michigan, USA.
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Gerber BS, Cano AI, Caceres ML, Smith DE, Wilken LA, Michaud JB, Ruggiero LA, Sharp LK. A pharmacist and health promoter team to improve medication adherence among Latinos with diabetes. Ann Pharmacother 2009; 44:70-9. [PMID: 20028957 DOI: 10.1345/aph.1m389] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND There is a need to improve blood glucose levels of underserved Latino patients with uncontrolled diabetes. OBJECTIVE To determine the feasibility of a pharmacist and health promoter team designed to address the barriers to medication adherence and adjustment and improve self-care among Latinos with type 2 diabetes. METHODS Clinical staff at the University of Illinois at Chicago Medical Center referred Latino patients with uncontrolled diabetes (hemoglobin A(1c) [A1C] > or =8.0%) to the study. A research assistant assessed patients on diabetes and medical history, medication list, medication adherence and related habits, health literacy, diabetes knowledge and numeracy, beliefs in benefits of diabetes therapy, depression, social support, and access to care. A bilingual, bicultural health promoter reviewed these assessments and worked with patients through home and clinic visits and telephone calls. The health promoter communicated with a pharmacist to receive assistance in medication management (reconciliation and adjustment). Participants received case management for 6 months. RESULTS Nine patients were successfully recruited. The mean age was 58 years and mean duration of diabetes was 21 years. Successful collaboration between pharmacists and the health promoter required frequent communication and intense effort to address complex patient barriers. Health promoter contact time, in person, per participant ranged from 0 minutes to 640 minutes, and telephone call time ranged from 27 minutes to 111 minutes during the study period. Eight participants had medication adjustments during the study period, with a maximum of 7 adjustments per participant. Mean hemoglobin A1C declined from an average of 9.6% to 9.0%. Two patients are presented as case studies to describe how the pharmacist-health promoter team functioned. Information was obtained from health promoter records, survey results, and chart reviews. CONCLUSIONS The pharmacist and health promoter team management of uncontrolled diabetes among Latinos appears to be a feasible approach to improving medication management.
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Affiliation(s)
- Ben S Gerber
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL 60608, USA.
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Nihiser AJ, Lee SM, Wechsler H, McKenna M, Odom E, Reinold C, Thompson D, Grummer-Strawn L. BMI measurement in schools. Pediatrics 2009; 124 Suppl 1:S89-97. [PMID: 19720672 DOI: 10.1542/peds.2008-3586l] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE School-based BMI measurement has attracted attention across the nation as a potential approach to address obesity among youth. However, little is known about its impact or effectiveness in changing obesity rates or related physical activity and dietary behaviors that influence obesity. This article describes current BMI-measurement programs and practices, research, and expert recommendations and provides guidance on implementing such an approach. METHODS An extensive search for scientific articles, position statements, and current state legislation related to BMI-measurement programs was conducted. A literature and policy review was written and presented to a panel of experts. This panel, comprising experts in public health, education, school counseling, school medical care, and parenting, reviewed and provided expertise on this article. RESULTS School-based BMI-measurement programs are conducted for surveillance or screening purposes. Thirteen states are implementing school-based BMI-measurement programs as required by legislation. Few studies exist that assess the utility of these programs in preventing increases in obesity or the effects these programs may have on weight-related knowledge, attitudes, and behaviors of youth and their families. Typically, expert organizations support school-based BMI surveillance; however, controversy exists over screening. BMI screening does not currently meet all of the American Academy of Pediatrics' criteria for determining whether screening for specific health conditions should be implemented in schools. CONCLUSION Schools initiating BMI-measurement programs should adhere to safeguards to minimize potential harms and maximize benefits, establish a safe and supportive environment for students of all body sizes, and implement science-based strategies to promote physical activity and healthy eating.
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Affiliation(s)
- Allison J Nihiser
- Centers for Disease Control and Prevention, Division of Adolescent and School Health, 4770 Buford Hwy NE, Mailstop K-12, Atlanta, GA 30341, USA.
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Babamoto KS, Sey KA, Camilleri AJ, Karlan VJ, Catalasan J, Morisky DE. Improving diabetes care and health measures among hispanics using community health workers: results from a randomized controlled trial. HEALTH EDUCATION & BEHAVIOR 2009; 36:113-26. [PMID: 19188371 DOI: 10.1177/1090198108325911] [Citation(s) in RCA: 130] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The increasing prevalence of diabetes and obesity, growing health disparities, and shortage of bilingual and culturally trained health care professionals underscore the role of trained community health workers (CHWs) to provide economically sustainable and culturally relevant services. This prospective randomized design evaluated the relative effectiveness of a CHW intervention among Hispanic persons with newly diagnosed type 2 diabetes, as compared with usual clinic practice in three inner-city health centers. In sum, 189 Hispanic patients newly diagnosed with type 2 diabetes were randomly assigned to one of three 6-month diabetes management approaches--CHW, case management, and standard provider care--and assessed for diabetes-related health measures and clinical indicators at baseline and postintervention. Participants in the CHW group achieved greater improvements than did the controls in program measures: health status, emergency department utilization, dietary habits, physical activity, and medication adherence. They also had 2.9 times greater odds of decreasing body mass index.
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Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, Maryniuk M, Peyrot M, Piette JD, Reader D, Siminerio LM, Weinger K, Weiss MA. National standards for diabetes self-management education. Diabetes Care 2009; 32 Suppl 1:S87-94. [PMID: 19118294 PMCID: PMC2613581 DOI: 10.2337/dc09-s087] [Citation(s) in RCA: 191] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Martha M Funnell
- 1Department of Medical Education, Diabetes Research and Training Center, University of Michigan, Ann Arbor, Michigan, USA.
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Cherrington A, Ayala GX, Amick H, Allison J, Corbie-Smith G, Scarinci I. Implementing the community health worker model within diabetes management: challenges and lessons learned from programs across the United States. DIABETES EDUCATOR 2008; 34:824-33. [PMID: 18832287 DOI: 10.1177/0145721708323643] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this qualitative study was to examine methods of implementation of the community health worker (CHW) model within diabetes programs, as well as related challenges and lessons learned. METHODS Semi-structured interviews were conducted with program managers. Four databases (PubMed, CINAHL, ISI Web of Knowledge, PsycInfo), the CDC's 1998 directory of CHW programs, and Google Search Engine were used to identify CHW programs. Criteria for inclusion were: DM program; used CHW strategy; occurred in United States. Two independent reviewers performed content analyses to identify major themes and findings. Sixteen programs were assessed, all but 3 focused on minority populations. Most CHWs were recruited informally; 6 programs required CHWs to have diabetes. RESULTS CHW roles and responsibilities varied across programs; educator was the most commonly identified role. Training also varied in terms of both content and intensity. All programs gave CHWs remuneration for their work. Common challenges included difficulties with CHW retention, intervention fidelity and issues related to sustainability. Cultural and gender issues also emerged. Examples of lessons learned included the need for community buy-in and the need to anticipate nondiabetes related issues. CONCLUSIONS Lessons learned from these programs may be useful to others as they apply the CHW model to diabetes management within their own communities. Further research is needed to elucidate the specific features of this model necessary to positively impact health outcomes.
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Affiliation(s)
- Andrea Cherrington
- The School of Medicine, University of Alabama at Birmingham (Dr Cherrington, Dr Allison, Dr Scarinci)
| | - Guadalupe X Ayala
- Graduate School of Public Health, San Diego State University, California (Dr Ayala)
| | - Halle Amick
- Graduate School of Public Health, University of North Carolina at Chapel Hill (Dr Amick)
| | - Jeroan Allison
- The School of Medicine, University of Alabama at Birmingham (Dr Cherrington, Dr Allison, Dr Scarinci)
| | - Giselle Corbie-Smith
- School of Medicine, University of North Carolina at Chapel Hill (Dr Corbie-Smith)
| | - Isabel Scarinci
- The School of Medicine, University of Alabama at Birmingham (Dr Cherrington, Dr Allison, Dr Scarinci)
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Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, Maryniuk M, Peyrot M, Piette JD, Reader D, Siminerio LM, Weinger K, Weiss MA. National standards for diabetes self-management education. Diabetes Care 2008; 31 Suppl 1:S97-104. [PMID: 18165344 PMCID: PMC2797381 DOI: 10.2337/dc08-s097] [Citation(s) in RCA: 125] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Martha M Funnell
- Department of Medical Education, Diabetes Research and Training Center, University of Michigan, Ann Arbor, Michigan 48109-0489, USA.
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Thompson JR, Horton C, Flores C. Advancing diabetes self-management in the Mexican American population: a community health worker model in a primary care setting. DIABETES EDUCATOR 2007; 33 Suppl 6:159S-165S. [PMID: 17620396 DOI: 10.1177/0145721707304077] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this study was to pilot test the effectiveness of health promoters trained in the transtheoretical model of change to provide diabetes management education and support to Mexican Americans in a primary care setting. METHODS The study site was an urban community health center in Oakland, California. This study reports on 142 patients who were enrolled for at least 1 year in the program. Community health workers acted as extenders of the medical staff to facilitate behavior change, using patient-centered counseling. This was a 1-group pretest/posttest pilot study. Descriptive statistics and the paired-sample t test were used to compare the change in clinical outcome measures from baseline to 6 months and 1 year. Statistically significant changes were correlated with frequency of community health worker contact. RESULTS The paired-sample t test showed significant reduction in glycosylated hemoglobin (HbA1c) from baseline to 1 year (P < .004). Reductions were also seen in low-density lipoprotein cholesterol and blood pressure, but they were not statistically significant. When stratified by gender, women showed a greater reduction in HbA1c than men at 1 year. Patients with a higher frequency of community health worker contact showed a greater decline in HbA1c level. CONCLUSIONS The pilot study demonstrates that community health workers, as an integral part of the health care team, are effective agents in providing self-management support to persons with diabetes.
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Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, Maryniuk M, Peyrot M, Piette JD, Reader D, Siminerio LM, Weinger K, Weiss MA. National standards for diabetes self-management education. DIABETES EDUCATOR 2007; 33:599-600, 602-4, 606 passim. [PMID: 17684162 DOI: 10.1177/0145721707305880] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Funnell MM, Brown TL, Childs BP, Haas LB, Hosey GM, Jensen B, Maryniuk M, Peyrot M, Piette JD, Reader D, Siminerio LM, Weinger K, Weiss MA. National standards for diabetes self-management education. Diabetes Care 2007; 30:1630-7. [PMID: 17526822 DOI: 10.2337/dc07-9923] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Martha M Funnell
- Department of Medical Education, Diabetes Research and Training Center, University of Michigan, Ann Arbor, Michigan 48109-0489, USA.
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Backman H. Children at risk of developing amblyopia: When to refer for an eye examination. Paediatr Child Health 2004; 9:635-637. [PMID: 19675853 PMCID: PMC2724129 DOI: 10.1093/pch/9.9.635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Amblyopia is a sensory vision deficit that may be detected, diagnosed and treated best during the early stages of visual development. Only a small percentage of the paediatric population receive oculovisual examinations during this critical period of development even though such care is often free and easily accessible. Vision screening programs exist in certain states in the United States and in several European countries. Unfortunately, these programs are rarely implemented in Canada because of limited resources.Alternatively, screening at-risk infants may be more efficient and cost-effective in the early detection of amblyopia. Educating and training health care professionals, such as paediatricians, to recognize certain risk factors for amblyopia and encouraging early referral of the at-risk child to an eye care professional may prevent the development of amblyopia. The at-risk child has been defined to guide paediatricians and other primary health care professionals as to when to refer these children, the appropriate frequency of follow-up evaluations and the comanagement of compliance and treatment.
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