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Hightshoe K, Gutiérrez-Raghunath S, Tomcho MM, Rosenberg CR, Rosenberg SA, Dooling-Litfin JK, Cordova JM, Colborn K, DiGuiseppi C. Barriers to referral and evaluation and corresponding navigation services for toddlers screening positive for autism spectrum disorder. Fam Syst Health 2023; 41:342-357. [PMID: 37732975 PMCID: PMC10516304 DOI: 10.1037/fsh0000786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
INTRODUCTION Children from disadvantaged populations receive referrals, diagnoses, and services for autism spectrum disorder (ASD) late or not at all. We describe barriers to referral for and receipt of evaluation for ASD among young children from disadvantaged families and activities by autism family navigators (AFNs) to address these barriers. METHOD Trained AFNs offered navigation to families of children aged 16-30 months with positive ASD screens from community health center clinics in 2015-2018. AFNs interviewed families to identify perceived barriers to care and documented system barriers and navigation activities. We coded, categorized, and described barriers and AFN activities. Case studies illustrate barriers and navigation activities. RESULTS Of 22 participating mothers, 82% were Latinx and 64% were native Spanish-speaking; 71% had household incomes <$30,000/year and 57% had no high school diploma. Half of the families experienced five or more barriers to ASD evaluation, most commonly pragmatic barriers. Information barriers/needs were 5 times more common among Spanish-speaking than English-speaking mothers. One-fifth of families identified negative experiences or expectations of care. System barriers included incomplete screening tests, inadequate referrals, and waiting lists. AFNs implemented navigation activities, most frequently categorized as care coordination (95%), education (68%), social/emotional support (36%), family advocacy (27%), and self-advocacy coaching (23%). AFNs also trained providers and staff to improve screening and referral implementation. DISCUSSION In this largely Latinx sample, families experienced numerous barriers to obtaining ASD evaluations for their screen-positive children, likely reflecting the complexity of negotiating both healthcare and educational systems. Trained AFNs can assist parents to overcome barriers to timely diagnosis. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | | | | | | | - Kathryn Colborn
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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2
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Romo ML, McVeigh KH, Jordan P, Stingone JA, Chan PY, Askew GL. Birth characteristics of children who used early intervention and special education services in New York City. J Public Health (Oxf) 2020; 42:e401-e411. [PMID: 31884516 DOI: 10.1093/pubmed/fdz179] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 12/02/2019] [Accepted: 12/04/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Early intervention (EI) and special education (SE) are beneficial for children with developmental disabilities and/or delays and their families, yet there are disparities in service use. We sought to identify the birth characteristics that predict EI/SE service use patterns. METHODS We conducted a retrospective cohort study using linked administrative data from five sources for all children born in 1998 to New York City resident mothers. Multinomial regression was used to identify birth characteristics that predicted predominant patterns of service use. RESULTS Children with service use patterns characterized by late or limited/no EI use were more likely to be first-born children and have Black or Latina mothers. Children born with a gestational age ≤31 weeks were more likely to enter services early. Early term gestational age was associated with patterns of service use common to children with pervasive developmental delay, and maternal obesity was associated with the initiation of speech therapy at the time of entry into school. CONCLUSIONS Maternal racial disparities existed for patterns of EI/SE service use. Specific birth characteristics, such as parity and gestational age, may be useful to better identify children who are at risk for suboptimal EI use.
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Affiliation(s)
- Matthew L Romo
- Division of Family and Child Health, New York City Department of Health and Mental Hygiene, New York, NY, 11101, USA
| | - Katharine H McVeigh
- Division of Family and Child Health, New York City Department of Health and Mental Hygiene, New York, NY, 11101, USA
| | - Phoebe Jordan
- Department of Educational Psychology, University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - Jeanette A Stingone
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Pui Ying Chan
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York, NY, 11101, USA
| | - George L Askew
- Division of Family and Child Health, New York City Department of Health and Mental Hygiene, New York, NY, 11101, USA
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3
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Haine-Schlagel R, Rieth S, Dickson KS, Brookman-Frazee L, Stahmer A. Adapting parent engagement strategies for an evidence-based parent-mediated intervention for young children at risk for autism spectrum disorder. J Community Psychol 2020; 48:1215-1237. [PMID: 32237157 DOI: 10.1002/jcop.22347] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 01/31/2020] [Accepted: 03/11/2020] [Indexed: 06/11/2023]
Abstract
AIMS Aims included (a) characterizing provider feedback on parent engagement strategies integrated into a parent-mediated intervention for toddlers at risk for autism spectrum disorder (ASD) and (b) identifying provider characteristics that predict attitudes about parent engagement strategies. METHODS A mixed method approach was utilized, including gathering quantitative data via survey (breadth) and collecting qualitative data via interview (depth). Acceptability, utility, appropriateness, sustainment, generalizability, and perceived effectiveness were examined. Fourteen agency leaders and 24 therapists provided input. RESULTS Providers perceived the integration of parent engagement strategies as having a positive impact on implementation. Providers considered the strategies to be acceptable, appropriate, and effective, though barriers of time and complexity were noted. Provider characteristics did not consistently predict attitudes about the engagement strategies. CONCLUSIONS Incorporating parent engagement strategies into parent-mediated interventions for ASD is well-received by providers and may improve quality of service delivery for families served in early intervention for ASD.
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Affiliation(s)
- Rachel Haine-Schlagel
- Department of Child and Family Development, San Diego State University, San Diego, California
- Child & Adolescent Services Research Center, San Diego, California
| | - Sarah Rieth
- Department of Child and Family Development, San Diego State University, San Diego, California
- Child & Adolescent Services Research Center, San Diego, California
| | - Kelsey S Dickson
- Department of Child and Family Development, San Diego State University, San Diego, California
- Child & Adolescent Services Research Center, San Diego, California
| | - Lauren Brookman-Frazee
- Child & Adolescent Services Research Center, San Diego, California
- Department of Psychiatry, University of California, San Diego, California
| | - Aubyn Stahmer
- Child & Adolescent Services Research Center, San Diego, California
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, California
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4
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Moll SE, Patten S, Stuart H, MacDermid JC, Kirsh B. Beyond Silence: A Randomized, Parallel-Group Trial Exploring the Impact of Workplace Mental Health Literacy Training with Healthcare Employees. Can J Psychiatry 2018; 63:826-833. [PMID: 29673271 PMCID: PMC6309037 DOI: 10.1177/0706743718766051] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study sought to evaluate whether a contact-based workplace education program was more effective than standard mental health literacy training in promoting early intervention and support for healthcare employees with mental health issues. METHOD A parallel-group, randomised trial was conducted with employees in 2 multi-site Ontario hospitals with the evaluators blinded to the groups. Participants were randomly assigned to 1 of 2 group-based education programs: Beyond Silence (comprising 6 in-person, 2-h sessions plus 5 online sessions co-led by employees who personally experienced mental health issues) or Mental Health First Aid (a standardised 2-day training program led by a trained facilitator). Participants completed baseline, post-group, and 3-mo follow-up surveys to explore perceived changes in mental health knowledge, stigmatized beliefs, and help-seeking/help-outreach behaviours. An intent-to-treat analysis was completed with 192 participants. Differences were assessed using multi-level mixed models accounting for site, group, and repeated measurement. RESULTS Neither program led to significant increases in help-seeking or help-outreach behaviours. Both programs increased mental health literacy, improved attitudes towards seeking treatment, and decreased stigmatized beliefs, with sustained changes in stigmatized beliefs more prominent in the Beyond Silence group. CONCLUSION Beyond Silence, a new contact-based education program customised for healthcare workers was not superior to standard mental health literacy training in improving mental health help-seeking or help-outreach behaviours in the workplace. The only difference was a reduction in stigmatized beliefs over time. Additional research is needed to explore the factors that lead to behaviour change.
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Affiliation(s)
- Sandra E Moll
- School of Rehabilitation Science, McMaster University, ON, Canada
| | - Scott Patten
- Departments of Community Health Sciences and Psychiatry, University of Calgary, Calgary, AB, Canada.,Mathison Centre for Research & Education in Mental Health, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Heather Stuart
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Joy C MacDermid
- School of Rehabilitation Science, McMaster University, ON, Canada.,Physical Therapy and Surgery, Western University, London, ON, Canada.,Hand and Upper Limb Centre, St. Joseph's Health Centre, London, ON, Canada
| | - Bonnie Kirsh
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.,Department of Rehabilitation Sciences, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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5
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Lee C, Phillips C, Vanstone JR. Educational intervention to reduce treatment of asymptomatic bacteriuria in long-term care. BMJ Open Qual 2018; 7:e000483. [PMID: 30588518 PMCID: PMC6280905 DOI: 10.1136/bmjoq-2018-000483] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 10/12/2018] [Accepted: 11/10/2018] [Indexed: 12/05/2022] Open
Abstract
Objective To determine if an educational intervention can decrease the inappropriate antibiotic treatment of long-term care (LTC) residents with asymptomatic bacteriuria (ASB). Design Prospective chart audit between May and July 2017. Setting Seven LTC facilities in Regina, Saskatchewan, Canada. Participants Chart audits were performed on all LTC residents over 18 years of age with a positive urine culture. Educational sessions and tools were available to all clinical staff at participating LTC facilities. Intervention Fifteen-minute educational sessions were provided to LTC facility staff outlining the harms of unnecessary antibiotic use, antibiotic resistance and the diagnostic criteria of a urinary tract infection (UTI). Educational sessions were complimented with posters and pocket cards that summarised UTI diagnostic criteria. Main outcome measure The primary outcome measure was the number of residents who received inappropriate antibiotic treatment for ASB. Secondary outcome measures included the appropriateness of urine culture tests, number of tests and cost associated with inappropriate treatments. Results In the preintervention period, 172 urine culture and sensitivity (UC&S) tests were performed, 62 (36.0%) were positive and 50/62 (80.6%) residents had ASB based on chart review. In the postintervention period, 151 UC&S tests were performed, 50 (33.1%) were positive and 35/50 (70.0%) residents had ASB. There was a statistically significant decrease in the number of residents treated with antibiotics for ASB, from 45/50 (90%) preintervention to 22/35 (62.9%) postintervention (χ2=9.087, p=0.003). Conclusions An educational intervention was associated with a statistically significant decrease in inappropriate antibiotic treatment of LTC residents with ASB.
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Affiliation(s)
- Christine Lee
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Casey Phillips
- Antimicrobial Stewardship Program, Saskatchewan Health Authority, Regina, Saskatchewan, Canada
| | - Jason Robert Vanstone
- Antimicrobial Stewardship Program, Saskatchewan Health Authority, Regina, Saskatchewan, Canada.,Research and Performance Support, Saskatchewan Health Authority, Regina, Saskatchewan, Canada
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6
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Abstract
Objective. To evaluate the effectiveness of a population-based, public education campaign designed to increase awareness of the Canadian Low-Risk Alcohol Drinking Guidelines (LRDG). Method. A province-wide mass media campaign was introduced. To measure campaign effectiveness, we completed a cross-sectional study using pre- and postcampaign surveys. Measurements included awareness of the LRDG, specific knowledge of the LRDG, and beliefs toward drinking and behavior change. Results. Postsurvey respondents were more likely to be aware of the LRDG (19.2% vs. 25.8%). However, increased awareness was largely driven by females being significantly more aware of the guidelines after the campaign (odds ratio = 1.74; 95% confidence interval = [1.38, 2.19]). Men were not found to be more aware postcampaign. The results did not show a significant increase in specific knowledge of the LRDG or change in beliefs toward drinking and behavior change after the campaign. Independent of the survey cycle, males and those aged 19 to 25 years were less likely to be aware of the LRDG, select the correct drink limit or less, and believe that consuming alcohol in excess has short- and long-term health consequences when compared to females and those aged 56 to 70 years. Conclusions. A provincial public health education campaign was effective at increasing awareness of the LRDG, though uptake was lowest among those at highest risk for heavy drinking.
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Affiliation(s)
| | - Laura Lee Noonan
- Chief Public Health Office, Charlottetown, Prince Edward Island, Canada
| | | | - Karen Phillips
- Chief Public Health Office, Charlottetown, Prince Edward Island, Canada
| | | | - David Sabapathy
- Dalhousie University, Halifax, Nova Scotia, Canada.,Chief Public Health Office, Charlottetown, Prince Edward Island, Canada
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7
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Vilchis-Gil J, Klünder-Klünder M, Flores-Huerta S. Effect on the Metabolic Biomarkers in Schoolchildren After a Comprehensive Intervention Using Electronic Media and In-Person Sessions to Change Lifestyles: Community Trial. J Med Internet Res 2018; 20:e44. [PMID: 29402762 PMCID: PMC5818679 DOI: 10.2196/jmir.9052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 11/07/2017] [Accepted: 12/01/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Obesity is a chronic low-intensity state of inflammation with metabolic alterations that, when acquired during childhood, lead to severe illness in adults. Encouraging healthy eating habits and physical activity is the basis for preventing and treating obesity and its complications. OBJECTIVE To evaluate how a comprehensive intervention promoting healthy eating habits and physical activities in schools affects children's metabolic biomarkers. METHODS Of four Mexico City primary schools in this study, two groups of children that were recruited at their schools were assigned to a 12-month intervention group (IG) and the other two were assigned to control groups (CGs). The intervention had two components: (1) parents/schoolchildren attended in-person educational sessions promoting healthy eating and physical activity habits, and were provided printed information; and (2) parents were able to seek information through a website, and also received brief weekly mobile phone text messages. Anthropometric measurements and fasting blood samples were taken from both groups of children at baseline and again after 12 months. RESULTS The study involved 187 children in the IG and 128 in the CG. Regardless of each child's nutritional status at the beginning of the study, the intervention improved metabolic parameters; the IG showed a negative effect on glucose concentrations (-1.83; CI 95% -3.06 to -0.60), low-density lipoprotein-cholesterol (-2.59; CI 95% -5.12 to -0.06), insulin (-0.84; CI 95% -1.31 to -0.37), and homeostasis model to assess the insulin resistance index (HOMA-IR; -0.21; CI 95% -0.32 to -0.09) in comparison to the CG. HOMA-IR improved in children who had higher than baseline body mass index z-scores. CONCLUSIONS Intervention through multiple components that promoted healthier eating and physical activity habits improved the metabolic parameters of the children in the study after one year, regardless of their nutritional status.
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Affiliation(s)
- Jenny Vilchis-Gil
- Community Health Research Department, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico
| | - Miguel Klünder-Klünder
- Community Health Research Department, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico
- Research Committee, Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition, Ciudad de México, Mexico
| | - Samuel Flores-Huerta
- Community Health Research Department, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico
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8
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Mills IS, Doyle LW, Cheong JL, Roberts G. Rates of early intervention services in children born extremely preterm/extremely low birthweight. J Paediatr Child Health 2018; 54:74-79. [PMID: 28800210 DOI: 10.1111/jpc.13668] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 06/22/2017] [Accepted: 06/28/2017] [Indexed: 11/28/2022]
Abstract
AIM To determine the rates of early intervention (EI) service use in extremely preterm (EP, <28 weeks' gestation) or extremely low birthweight (ELBW, <1000 g) infants between 1991 and 2013, and identify biological or socio-economic factors associated with receiving EI. METHODS Participants comprised consecutive EP or ELBW survivors born in 1991-1992, 1997 or 2005 in Victoria, Australia, and randomly selected, matched term-born controls. The main outcome measure was parent-reported EI participation up to 8 years of age. Neurodevelopmental outcomes and socio-economic risk factors were compared with EI participation to identify associations among the preterm groups. RESULTS The rates of EI were higher in the preterm groups than the control groups overall (odds ratio 4.29, 95% confidence interval 3.28, 5.59, P < 0.001), and the rates of EI rose significantly over time - from 42% in the 1991-1992 preterm cohort to 64% in the 2005 preterm cohort. Among the preterm groups, post-natal corticosteroid therapy, cystic periventricular leukomalacia and surgery in the newborn period were all independently associated with increased odds of receiving EI. Increased severity of disability was associated with higher rates of EI. The majority (95%) of preterm children with a physical impairment received EI, compared with only 73% of children with a cognitive impairment alone. EI participation rates were independent of social risk. CONCLUSION EI participation is high in the EP population, and rates of EI use have increased over time. Contrary to previous reports, social risk factors were not found to be associated with EI use.
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Affiliation(s)
- Ianthe S Mills
- Department of Paediatrics and Neonatology, Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia
| | - Lex W Doyle
- Neonatal Services, Royal Women's Hospital, Melbourne, Victoria, Australia.,Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia.,Premature Infant Follow-Up Program, Royal Women's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Jeanie Ly Cheong
- Neonatal Services, Royal Women's Hospital, Melbourne, Victoria, Australia.,Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia.,Premature Infant Follow-Up Program, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Gehan Roberts
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Community and Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia.,Population Health, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
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9
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Palmer CJ, Connor C, Newton BJ, Patterson P, Birchwood M. Early intervention and identification strategies for young people at risk of developing mental health issues: working in partnership with schools in Birmingham, UK. Early Interv Psychiatry 2017; 11:471-479. [PMID: 26293410 DOI: 10.1111/eip.12264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 07/12/2015] [Indexed: 11/28/2022]
Abstract
AIM This study explores the mental health needs of teachers and how these might impact on their capacity to provide early identification and intervention strategies to support their student's emotional well-being. METHOD The present study surveyed a sample of UK teachers (N = 320) to explore the impact of work-related stress on their mental health and their ability to provide early intervention support for their students. RESULTS Our survey showed high levels of work-related stress due to time pressures and excessive workloads; many teachers failed to seek help for their stress often due to stigmatic attitudes and fear of negative response by senior management. Such factors led some to withdraw from taking on extra responsibilities with regard to student support and to consider leaving the teaching profession altogether. Coping mechanisms included the use of alcohol and tobacco, with only a small minority receiving access to psychological therapies. CONCLUSION High levels of work-related stress in teachers can have serious consequences for their mental health and impede their ability to provide effective early intervention support for their student's emotional well-being. Improvements in mental health training for teachers and greater assistance for their own mental health needs are necessary.
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Affiliation(s)
- Colin J Palmer
- Department of Research and Innovation, Birmingham & Solihull Mental Health Foundation Trust, Edgbaston, Birmingham, UK
| | - Charlotte Connor
- Department of Research and Innovation, Birmingham & Solihull Mental Health Foundation Trust, Edgbaston, Birmingham, UK
| | - Benjamin John Newton
- Department of Research and Innovation, Birmingham & Solihull Mental Health Foundation Trust, Edgbaston, Birmingham, UK
| | - Paul Patterson
- School of Psychology, University of Birmingham, Birmingham, UK
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10
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Wright R, Casamassimo PS. Assessing attitudes and actions of pediatric dentists toward childhood obesity and sugar-sweetened beverages. J Public Health Dent 2017; 77 Suppl 1:S79-S87. [PMID: 28712110 DOI: 10.1111/jphd.12240] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 06/23/2017] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Childhood obesity is a major US health concern, and oral health professionals have opportunities to participate in an interprofessional effort to intervene owing to their access to young patients and their abilities in addressing obesity-related dietary habits like consumption of sugar-sweetened beverages (SSBs). This study determined attitudes, behaviors, future intentions, and perceived barriers of pediatric dentists regarding efforts to prevent childhood obesity and reduce children's consumption of SSBs. METHODS The American Academy of Pediatric Dentistry conducted an online electronic survey with a convenience sample of approximately 7,450 pediatric dentists and pediatric dental residents during spring 2016. RESULTS Over 17 percent of pediatric dentists offer childhood obesity interventions. Of those not providing interventions, 67 percent were interested in offering obesity-prevention services. Nearly 94 percent of pediatric dentists offer information or other interventions on consumption of SSBs. Statistically significant barriers to providing healthy weight interventions were fear of offending parents, appearing judgmental, or creating parent dissatisfaction and a lack of parental acceptance of guidance about weight management from a dentist. Significant barriers to SSB interventions were sufficient time and health professional education. CONCLUSIONS More pediatric dentists stated they offer childhood obesity interventions than in previous surveys reporting 6 percent, but respondents suggested that a child's weight is seen as a medical rather than dental issue. Most pediatric dentists provide interventions related to consumption of SSBs, perceiving the issue as integral to their care of children.
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Affiliation(s)
- Robin Wright
- Pediatric Oral Health Research and Policy Center, American Academy of Pediatric Dentistry, Chicago, Illinois, United States
| | - Paul S Casamassimo
- Pediatric Oral Health Research and Policy Center, American Academy of Pediatric Dentistry, Chicago, Illinois, United States
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11
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Burgette JM, Preisser JS, Weinberger M, King RS, Rozier RG. Early Head Start, Pediatric Dental Use, and Oral Health-Related Quality of Life. JDR Clin Trans Res 2017; 2:353-362. [PMID: 28944292 DOI: 10.1177/2380084417709758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The objective of the study was to examine the mediating effect of child dental use on the effectiveness of North Carolina Early Head Start (EHS) in improving oral health-related quality of life (OHRQoL). In total, 479 parents of children enrolled in EHS and 699 parents of Medicaid-matched children were interviewed at baseline when children were approximately 10 mo old and 24 mo later. In this quasi-experimental study, mediation analysis was performed using the counterfactual framework analysis, which employed 2 logit models with random effects: 1) for the mediator as a function of the treatment and covariates and 2) for the outcome as a function of the treatment, mediator, and covariates. The covariates were baseline dental OHRQoL, dental need, survey language, and a propensity score. We used in-person computer-assisted, structured interviews to collect information on demographic characteristics and dental use and to administer the Early Childhood Oral Health Impact Scale, a measure of OHRQoL. Dental use had a mediation effect in the undesired direction with a 2-percentage point increase in the probability of any negative impact to OHRQoL (95% confidence interval [CI], 0.3%-3.9%). Even with higher dental use by EHS participants, the probability of any negative impact to OHRQoL was approximately 8 percentage points lower if an individual were moved from the non-EHS group to the EHS group (95% CI, -13.9% to -1.2%). EHS increases child dental use, which worsens family OHRQoL. However, EHS is associated with improved OHRQoL overall. Knowledge Transfer Statement: Study results can inform policy makers that comprehensive early childhood education programs improve oral health-related quality of life (OHRQoL) for disadvantaged families with young children in pathways outside of clinical dental care. This awareness and its promotion can lead to greater resource investments in early childhood education programs. Information about the negative impacts of dental use on OHRQoL should lead to the development and testing of strategies in dentistry and Early Head Start to improve dental care experiences.
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Affiliation(s)
- J M Burgette
- Department of Pediatric Dentistry, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - J S Preisser
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - M Weinberger
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - R S King
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - R G Rozier
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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12
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Jimenez ME, DuRivage NE, Bezpalko O, Suh A, Wade R, Blum NJ, Fiks AG. A Pilot Randomized Trial of a Video Patient Decision Aid to Facilitate Early Intervention Referrals From Primary Care. Clin Pediatr (Phila) 2017; 56:268-277. [PMID: 27834191 DOI: 10.1177/0009922816677038] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Many young children identified with developmental concerns in pediatric settings do not receive early intervention (EI). We assessed the impact of a video decision aid and text message reminder on knowledge and attitudes regarding developmental delay and EI as well as referral completion. We conducted a pilot randomized controlled trial in an urban setting and enrolled 64 parent-child dyads referred to EI. Compared with controls, participants who received the intervention demonstrated increased knowledge regarding developmental delay and EI as well as more favorable attitudes in certain topics. Although we did not find a significant difference between arms in EI intake and evaluation, we found a pattern suggestive of increased intake and evaluation among participants with low health literacy in the intervention arm. Additional study is needed to identify strategies that improve the EI referral process for families and to understand the potential targeted role for decision aids and text messages.
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Affiliation(s)
- Manuel E Jimenez
- 1 Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.,2 Children's Specialized Hospital, New Brunswick, NJ, USA
| | | | - Orysia Bezpalko
- 3 Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Andrew Suh
- 3 Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Roy Wade
- 3 Children's Hospital of Philadelphia, Philadelphia, PA, USA.,4 Perelman School of Medicine, University of Pennsylvania Philadelphia, PA, USA
| | - Nathan J Blum
- 3 Children's Hospital of Philadelphia, Philadelphia, PA, USA.,4 Perelman School of Medicine, University of Pennsylvania Philadelphia, PA, USA
| | - Alexander G Fiks
- 3 Children's Hospital of Philadelphia, Philadelphia, PA, USA.,4 Perelman School of Medicine, University of Pennsylvania Philadelphia, PA, USA
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Vilchis-Gil J, Klünder-Klünder M, Duque X, Flores-Huerta S. Decreased Body Mass Index in Schoolchildren After Yearlong Information Sessions With Parents Reinforced With Web and Mobile Phone Resources: Community Trial. J Med Internet Res 2016; 18:e174. [PMID: 27342650 PMCID: PMC4963027 DOI: 10.2196/jmir.5584] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 05/10/2016] [Accepted: 05/27/2016] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The obesity pandemic has now reached children, and households should change their lifestyles to prevent it. OBJECTIVE The objective was to assess the effect of a comprehensive intervention on body mass index z-score (BMIZ) in schoolchildren. METHODS A yearlong study was conducted at 4 elementary schools in Mexico City. Intervention group (IG) and control group (CG) were split equally between governmental and private schools. Three educational in-person parents and children sessions were held at 2-month intervals to promote healthy eating habits and exercise. To reinforce the information, a website provided extensive discussion on a new topic every 2 weeks, including school snack menus and tools to calculate body mass index in children and adults. Text messages were sent to parents' mobile phones reinforcing the information provided. The IG contained 226 children and CG 181 children. We measured their weight and height and calculated BMIZ at 0, 6, and 12 months. RESULTS The CG children showed a change of +0.06 (95% CI 0.01, 0.11) and +0.05 (95% CI 0.01, 0.10) in their BMIZ at 6 and 12 months, respectively. The BMIZ of IG children decreased by -0.13 (95% CI -0.19 to -0.06) and -0.10 (95% CI -0.16 to -0.03), respectively, and the effect was greater in children with obesity. CONCLUSIONS The comprehensive intervention tested had beneficial effects, preserved the BMIZ of normal weight children, and reduced the BMIZ of children with obesity.
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Affiliation(s)
- Jenny Vilchis-Gil
- Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Community Health Research Department, Mexico City, Mexico
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Resegue R, Puccini RF, Silva EMKD. Risk factors associated with developmental abnormalities among high-risk children attended at a multidisciplinary clinic. SAO PAULO MED J 2008; 126:4-10. [PMID: 18425280 PMCID: PMC11020518 DOI: 10.1590/s1516-31802008000100002] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2006] [Revised: 06/15/2006] [Accepted: 01/08/2008] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVE Knowledge of risk factors associated with child development disorders is essential for delivering high-quality childcare. The objective here was to evaluate the relationships between risk factors and occurrences of developmental abnormalities among children attended at a reference clinic for children at risk of developmental abnormalities. DESIGN AND SETTING Retrospective study at a multidisciplinary reference center, Embu, São Paulo. METHODS All cases followed up for more than three months between 1995 and 2003 were reviewed. The risk factors assessed were low birth weight, gestational age, length of stay in neonatal ward, perinatal asphyxia, mothers age < 18 years, congenital infections, malformations and low mothers education level. Developmental abnormalities were defined according to developmental tests and assessments by the clinics professionals. The statistical analysis consisted of the chi-squared test for comparing categorical variables and a logistic regression model for multivariate analysis. RESULTS 211 children were followed up for more than three months. Developmental abnormalities occurred in 111 (52.6%). Univariate analysis showed significant relationships between developmental abnormality and low birth weight, perinatal asphyxia, length of stay > 5 days, prematurity and mothers age 18 years and older. Low birth weight, history of perinatal asphyxia and mothers age continued to be significant in multivariate analysis. CONCLUSIONS Special attention must be paid to the development of low birth weight infants and/or infants with histories of neonatal complications. Low birth weight is easily assessed and should be considered to be an important marker when defining guidelines for following up child development.
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Affiliation(s)
- Rosa Resegue
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Embu, São Paulo, Brazil.
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