Comparing the knowledge, attitudes, and practices of pediatric and family medicine clinicians toward atypical anorexia nervosa versus anorexia nervosa

OBJECTIVE

To investigate the knowledge, attitudes, and current practices of adolescent primary care providers regarding the epidemiology, clinical features, and diagnosis of atypical anorexia nervosa (AN) compared to AN.

METHODS

An online survey was sent to the Pediatric and Family Medicine clinicians who provide medical care to adolescents. Statistical analyses compared differences in responses to questions about atypical AN versus AN.

RESULTS

Relative to AN, participants (n = 67) were significantly less familiar with atypical AN, less likely to consider a diagnosis of atypical AN, less comfortable identifying atypical AN, less likely to counsel patients with atypical AN on health risks, less likely to refer patients with atypical AN to a specialist, and less likely to correctly identify atypical AN. Clinicians with more years in medical practice reported a significantly larger gap in familiarity between AN and atypical AN than clinicians with less than 5 years of practice.

CONCLUSIONS

Providers who care for adolescents appear to be less familiar with and less likely to identify atypical AN compared to AN. This knowledge gap may be more pronounced among clinicians with more years practicing medicine due to the novelty of atypical AN as a diagnosis. Lack of knowledge surrounding atypical AN risk factors may result in delayed diagnosis and associated poor health outcomes. Future research should investigate strategies that improve knowledge and screening of atypical AN in medical and other settings.

PUBLIC SIGNIFICANCE

Pediatric and Family Medicine clinicians are less familiar with atypical anorexia nervosa (AN) and less likely to diagnose a patient with atypical AN relative to AN. Insufficient knowledge about atypical AN may place these individuals at increased risk for worsening restrictive eating and the physical and psychological consequences of malnutrition.

Qualitative Analysis of Video-Based Culinary Training on Pediatric Critical Care Clinician Perceptions of Wellness: A Pilot Study

Video conference software has been increasingly used during the COVID-19 pandemic, but it is unknown if pediatric critical care providers would participate in culinary training via video conference in an effort to improve their wellness. The study aims were to (1) assess the feasibility of implementing a video-based culinary training wellness intervention; and (2) understand the barriers and motivators to attaining wellness from the perspective of pediatric critical care clinicians. We conducted, transcribed, and analyzed pre- and post-intervention semi-structured interviews using a directed content analysis approach. Four participants were included in this study. Pre-intervention qualitative analysis identified 3 themes: (1) Job-specific constraints contributed to poorer eating habits; (2) Poor nutrition was related to anxiety levels and job stress; (3) Meal preparation improved healthy eating. Post-intervention analysis identified 3 themes: (1) Wellness intervention was enhanced by involving loved ones; (2) Course improvement suggestions focused on more participants; (3) Major impacts from the course focused on cooking higher quality meals, obtaining new cooking tools, and applying new techniques. By providing pediatric critical care clinicians an opportunity to participate in virtual interactive culinary training experiences, we found that participants reported increased motivation to prepare quick and nutritious meals to improve their overall wellness.

Factors Associated with Adolescent Pregnancy in Sub-Saharan Africa during the COVID-19 Pandemic: A Review of Socioeconomic Influences and Essential Interventions

Objective: A literature review was conducted to analyze the impact of COVID-19 on documented preexisting determinants of adolescent pregnancy in sub-Saharan Africa such as poverty, inequitable gender norms, low access to education, and reproductive health services. Methods: The terms "sub-Saharan Africa," "Gender Norms," "Poverty," and "Adolescent Pregnancy" were used to search the literature for preexisting determinants of adolescent pregnancy in academic and grey literature. "COVID-19" was added to investigate the potential consequences of the pandemic. The literature revealed similar experiences in adolescent girls during the Ebola outbreak, which lead to the analysis of government and healthcare official responses to previous epidemics. Results: The literature review revealed that the relationship between identified micro (inequitable gender norms, transactional sex, sexual and gender-based violence, early marriage, and menstruation) and macro (poverty, education, and healthcare) factors contributing to adolescent pregnancy were exacerbated by the COVID-19 pandemic. Conclusion: Three realistic targets including, expanding and communicating available reproductive health resources, prioritizing the role of women in the economy, and ensuring return to school should be included as part of current COVID-19 mitigation programs. Additionally, these interventions should be incorporated in future public health preparedness plans to reduce the risk of adolescent pregnancy during public health emergencies.