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This study explores attitudes toward diphtheria-tetanus-acellular pertussis (DTaP), measles-mumps-rubella (MMR), influenza, and coronavirus disease 2019 (COVID-19) vaccines among English-speaking and Spanish-speaking parents of infants in a safety-net setting. Parents aged 18 years or older were recruited from outpatient clinics between December 2020 and December 2021. The interviews were then recorded, transcribed, translated, and qualitatively analyzed using the modified grounded theory. Thirty-two individuals participated (18 English-speaking and 14 Spanish-speaking). Almost all supported receiving routine childhood vaccines, DTaP, influenza, and MMR and believed that vaccines promote health. Vaccine concerns differed by each vaccine. Few participants expressed concerns about DTaP and MMR vaccines. Concerns around influenza vaccines often stemmed from personal experience and perceived increased risk of flu-like illnesses. Participants expressed the most concerns related to COVID-19 vaccinations, including age-based immunity of their infants. Based on these findings, future interventions to improve vaccine uptake may focus on benefits common to all vaccines, while addressing vaccine-specific concerns. [ABSTRACT FROM AUTHOR]

Due to its competitive nature, youth sports may provide an environment that invites the display of negative parenting behavior and exposes children to adults outside of their own household. This study aimed to quantify the frequency of negative parent and spectator behavior at youth sporting events and compare incidences across different sports and age ranges. Investigators attended baseball, basketball, soccer, and football events in Central Oʻahu, Hawaiʻi for children ages 6 to 10 years. Recorded spectator behaviors included alcohol use, smoking, swearing, and negative language (such as threats and violent language). Negative behaviors were reported at a majority (68%) of events. The 95% confidence intervals of the means (95% CIM) for all negative behaviors observed were overlapping, and we were not able to demonstrate statistically significant differences between the 4 sports. The lack of significance between sports may be due to the younger-player-age group, small sample size, and time of events. [ABSTRACT FROM AUTHOR]

Sleep is essential for maintenance and restoration of health, yet studies exploring this in hospitalized children are scarce. In a qualitative study, we assessed the perceived quality of sleep, factors affecting sleep, and the role of health care professionals in the sleep environment for hospitalized children aged 1 to 12 years. Data were obtained from 11 semi-structured, audio-recorded, and verbatim-transcribed interviews with parents, and analyzed using a systematic thematic analysis. The interviews were coded based on iterative assessment of transcripts. Subsequently, categories and interpretative main themes were identified. Four themes emerged: (1) being informed, keeping informed; (2) coordination of care; (3) parents as main advocates for their child's sleep; and (4) environmental disturbers. Parents reported differences in their child's sleep quality during hospital compared with home. Sleep is substantially affected during hospitalization, prompting the need for interventions to improve the quality of sleep of children. Parents provided valuable suggestions for improvements. [ABSTRACT FROM AUTHOR]

The opioid epidemic has heavily affected adults of childbearing age, leading to thousands of children impacted by parental substance use. Few programs provide longitudinal support to these children. This article describes an innovative pediatric medical home model for substance-impacted children and their families, at an urban safety-net hospital. The team-based program directly serves children, and also devotes significant resources to parental health and recovery. In the program's first 3 years, 95% of enrollees were engaged in care, meeting the American Academy of Pediatrics' recommended periodicity schedule for preventive health visits. On-time receipt of childhood vaccines ranged from 95% (pneumococcal conjugate) to 100% (human papilloma virus). The program's high engagement in care shows promise in engaging vulnerable families over time. Future work should explore how to engage children from more diverse backgrounds, and should examine whether the model impacts other indicators of health and well-being for children impacted by parental substance use. [ABSTRACT FROM AUTHOR]

This pilot study assessed the feasibility and potential effectiveness of a single-session workshop in modifying parental beliefs/knowledge about attention-deficit/hyperactivity disorder (ADHD) in children and impact on treatment acceptance/utilization. Concerns raised by school professionals about lack of treatment follow-through after ADHD diagnosis and parental misinformation about medication usage catalyzed this project. A single-group pre-post quasi-experimental design was used. Sixty-eight parents completed ADHD knowledge/belief scales and stress inventories, and pre-ADHD and post-ADHD information workshop. Follow-up calls were made after the workshop to assess treatment utilization. Parents/caregivers experienced significant knowledge and belief changes regarding medication efficacy, willingness to accept physician treatment recommendations, and rejection of non-empirically based treatments. Follow-up data showed that 41% of contacted participants met with physicians to discuss medication utilization and behavioral treatments. Brief, one-session psycho-educational workshops were feasible and impacted parental beliefs and behaviors regarding scientifically supported interventions for ADHD.

Caregiver-reported data on children's health are typically provided by mothers. We investigated whether measures of children's health would significantly differ between mother and father respondents to a nationally representative survey. This study used de-identified data on children age 0 to 17 years from the 2016-2019 National Survey of Children's Health (NSCH). The primary exposure was whether the survey was completed by the child's father (cases) or mother (controls). Outcome variables included general health, special health care needs (SHCN), and unmet health care needs. We identified 85 191 children meeting inclusion criteria, of whom 35.1% had a father respondent. After propensity score matching, 27 738 children with a father respondent were matched to an equal size group of children with a mother respondent. On conditional logistic regression analysis of the matched sample, we found that poor health, SHCN, and unmet health care needs were less likely to be reported for children in the sample by father respondents. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has impacted parents' and children's well-being. This study aimed to evaluate the impact of the COVID-19 pandemic and its preventive measures on children's well-being and their parents' anxiety level. Parents/caregivers were invited to respond to a self-administered survey. The primary outcome was to assess the rate and severity of parental anxiety during the pandemic/lockdown. Four hundred and thirty parents completed the survey. Ninety-two (21%) and 10 (2%) parents reported that their children gained or lost weight during the pandemic, respectively. Eighty-one (19%) parents reported a regression in their children's developmental milestones, particularly in toileting, speech, and social interaction. The GAD-7 mean scores increased by 2.9 points (95% CI [2.5, 3.25]; P <.001) in comparison with prepandemic scores. Adjusted multivariable analysis showed that having children with psychological conditions and a maternal education level less than a university degree were significantly associated with higher parental anxiety. [ABSTRACT FROM AUTHOR]

Objective: Tobacco exposure plays an important role in children's health. Little is known about pediatrician's experience with parental e-cigarette use. This pilot study aimed to assess pediatrician's knowledge, attitude, and behaviors regarding parental e-cigarette use. Methods: This cross-sectional survey at an academic clinic assessed residents' and attendings' knowledge, attitudes, and behaviors regarding parental combustible and e-cigarette use and counseling and cessation barriers. Results: Sixty of 69 care providers completed the survey. Participants reported asking about parental use (5% vs 58%, Δ = 53% [95% CI Δ = 40%-67%]), advising about harms (5% vs 52%, Δ = 47% [95% CI Δ = 33%-61%]), and assisting with quitting (2% vs 28%, Δ = 27% [95% CI Δ = 15%-39%]) significantly less for e-cigarettes than for combustible cigarettes. The most common barrier to discussing use was lack of time. Lack of knowledge, unsure of harm, and lack of training were reported significantly more for e-cigarettes than for combustible cigarettes. Conclusion: Parental screening and counseling rates are significantly lower for e-cigarettes than for combustible cigarettes in this pilot study. Increased training could help pediatricians better protect children from tobacco exposure. [ABSTRACT FROM AUTHOR]

Parental participation in shared decision-making in children's cancer therapy is essential because parents advocate for and support their children's wishes. However, little research has focused on this issue. We conducted a longitudinal observational study of 7 parents whose child had received their first cancer treatment. We recorded parents' behaviors, interactions, and narratives in 1 pediatric ward and 2 outpatient clinics. The recordings were systematically conducted and thematically analyzed using variable-oriented and process-oriented modes to assess the causal relationships among phenomena. We found 4 themes describing the processes by which parents developed and participated in shared decision-making. The first 2 themes reflected the development of reciprocal parental relationships and parent-other child relationships. These 2 types of relationship generated mutual trust and a sense of solidarity among parents (the third theme). This, in turn, became the foundation for parents to share decision-making with health care professionals (the fourth theme). [ABSTRACT FROM AUTHOR]

Using qualitative methods, we examine telehealth care quality from the perspective of parents of pediatric patients during a pandemic. We fill a gap in the literature essential for measuring effectiveness of pediatric telehealth. A total of 22 participants (n = 21 female; n = 1 male) enrolled in 1 of 9 interviews and focus groups conducted in 2021. Transcribed data were thematically analyzed and organized based on the 6 domains of quality health care by the Institute of Medicine (IOM). Analyzed data revealed 7 themes and 52 codes. Pediatric telehealth visits were perceived as efficient, timely, safe, and generally effective by parents for their child's health care. Participants experienced equal or greater time with their child's care provider via telehealth than through in-person visits. Qualitative results directly align with IOM domains of quality health care and contribute to the growing literature and evidence that may lead to improved telehealth outcomes and better preparedness for emergent public health events. [ABSTRACT FROM AUTHOR]

Few studies have examined the impact of the initial school closures and stay-at-home orders on those vulnerable children and adolescents with preexisting psychiatric conditions. In our study, we explore the impact on this population and identify risk and resilience factors by looking both at those children who were impacted negatively as well as those who were impacted positively by this period. Questionnaires were administered by child and adolescent psychiatrists to 101 parents of child and adolescent outpatients in a mental health clinic as well as 75 of the adolescents, themselves, during the initial stay-at-home orders in Israel. Parents and their children were asked how the situation changed the symptoms for which the children are being treated at our clinic. Information regarding demographic, family, and individual factors was also gathered. The largest group of parents (44%) reported improvement in their child's symptoms during this period, whereas 33% reported no change and 25% reported worsening. Risk factors included parental stress and level of child preoccupation with Covid-19. The major protective factor was parental presence. Although home confinement during the Covid-19 pandemic can lead to worsening mental health status among children, it can also provide an opportunity for those with previous mental health conditions to improve and strive. For these children to improve during such a period, decreased social and academic demands and increased parental presence seem to be key factors. For those who deteriorate, identifying and targeting parental stress can be as important as targeting the child's stress during such times. [ABSTRACT FROM AUTHOR]

The goal of this project was to determine whether screening youth and parents for firearm presence and imbedding those results in the electronic medical record (EMR) increased health care provider (HCP) documentation of firearms and subsequent delivery of a safe storage message. The study took place in a large adolescent medicine practice. Fifty-six dyads (40% of eligible) were randomized to usual care or the intervention, in which screening results for firearms were imbedded in the EMR. Health care providers delivered a safe storage message to 20% of controls and 51.2% in the intervention (P =.04). When HCPs documented the delivery of a safe storage message, 64% of parents recalled hearing it, compared with only 36% when there was no documentation (P =.012). Therefore, we found that incorporating firearm screening into the EMR increases the attention HCPs give to delivering a firearm safe storage message and correlates with parents recalling having heard a safe storage message. [ABSTRACT FROM AUTHOR]

To investigate effects of diaper-free times, elimination communication (EC) and early toilet training, a web-based survey was conducted for caregivers. The more diaper-free times an infant experienced during day, the earlier it was toilet trained (P <.001), which was enhanced by the usage of cloth diapers. The amount of diaper-free times significantly reduced the caregiver's continuous sleep, the occurrence of rashes and balm usage (P <.001) and lead to a more regular defecation frequency. Cloth diaper usage had no effect on rashes or balm usage, but on diaper change rate (P <.001). We could show that, although not as effective as full-time EC, part-time EC is more effective if cloth diapers are used, provided they are changed frequently. Furthermore, EC causes a more regular defecation in infants between 1 and 2 years. [ABSTRACT FROM AUTHOR]

The article discusses research by Alexandra H. Baker et al., reported in the Clinical Pediatrics journal, on the comparison between ibuprofen and acetaminophen for fever reduction in the pediatric emergency department. The study found that children who received oral ibuprofen were more likely to become afebrile within each time interval analyzed compared to those who received acetaminophen, with the effect most pronounced beyond 2 hours after administration.

We aimed to investigate the attention function, which is a parameter of cognitive functions, at different obstruction types (adenoid and tonsil hypertrophy, adenoid hypertrophy only, tonsillar hypertrophy only, and normal) of oral cavity and nasopharynx, and the relationship between obstruction level, type, and attention (N = 80). To evaluate attention function, Stroop test has been performed. Eighteen-item Quality of Life (OSA-18) and Brouillette Symptom Score questionnaires have been completed with each child's parents. Significant and positive relation has been found between Brouillette Symptom Score, OSA-18 score, and each 5 sections of Stroop test's points. It has been shown that children with adenotonsillar hypertrophy (ATH) are negatively affected in terms of obstructive symptoms and quality of life. At the situation of obstructive pathology, the Stroop test durations are affected negatively. Results are supporting that quality of life and attention parameter are affected negatively at children with ATH. [ABSTRACT FROM AUTHOR]

The adherence to follow-up testing instructions post-hospitalization is influenced by a variety of factors. Our aim was to assess the parental adherence to follow-up instructions and identify the factors that influence it. Parents of 200 children were asked about their adherence with these instructions; responses were obtained from 184 of 200. Parents did not adhere in 20 of 194 (10.9%) of cases. Families of infants under 12 months and children older than 10 years had lower adherence rates. Test completion was more frequent for children discharged with a test appointment compared with those discharged without an appointment (96% vs 86.6%; P =.07). The main reasons for non-adherence were disagreement as to the value of the testing (45%) or parental misunderstanding (30%). In conclusion, in order to increase adherence with post-hospitalization follow-up testing, physicians should focus on explaining the need and importance of the test and schedule an appointment prior to discharge. [ABSTRACT FROM AUTHOR]

This study aimed to examine predictors of complete and elevated youth mental health screens. Parents of 4- to 11-year-old children completed the Strengths and Difficulties Questionnaire (SDQ) during a routine, universal mental health screening initiative in primary care. Bivariate logistic regressions were run to examine associations between independent (visit age, sex, race/ethnicity, language, insurance, and guardian) and dependent variables (screening completion and elevated SDQ score). Parents of younger and Spanish-speaking (vs English-speaking) children were less likely to have a complete SDQ screen. Among those with complete SDQ screens, older children, male children, those with public or no insurance, and those who had a mother (vs father) complete the screener were more likely to have an elevated score. Understanding patterns of screening completion rates and predictors of elevated screens provides valuable information to improve resource mapping and planning. Findings can inform mental health screening implementation and optimization within primary care. [ABSTRACT FROM AUTHOR]

Limited empirical studies were identified to quantify parenting stress in parents of children with nephrotic syndrome (NS). This cross-sectional study aimed to address this gap by examining the prevalence and factors associated with parenting stress. Two hundred two Chinese parents of children with NS were investigated by using the Parenting Stress Index–Short Form (PSI-SF), the Parenting Sense of Competence Scale (PSCS), the Social Support Rating Scale (SSRS), and a demographic questionnaire. The results showed that parents of children with NS experienced higher parenting stress, and 67.8% of participants reported clinical levels of parenting stress. Fathers, parents with a primary education background, low social support and parenting sense of competence, and children with a prolonged treatment childhood NS reported higher parenting stress. Developing corresponding improvement interventions targeting parenting sense of competence, or providing extra disease-related support and education for parents might lessen parenting stress. [ABSTRACT FROM AUTHOR]

Nationally recommended universal lipid screening (ULS) in children aged 9 to 11 years is low. Little is known about parents' understanding of screening. We conducted a survey exploring parental knowledge and attitudes regarding ULS. Of 91 parent respondents, 81.3% were female, 69.2% were non-Hispanic white, 90.1% had a college/graduate degree, and 63.7% had a family history of abnormal cholesterol. Overall, 45.5% agreed that ULS should be done for all children, 30.8% disagreed, and 23.1% were unsure. Parents' support for ULS was significantly associated with their attitudes toward screening rather than their knowledge about cholesterol, family history of cardiovascular disease or abnormal cholesterol, age, race/ethnicity, or gender. Parents were less likely to agree that ULS should be done if they thought that cholesterol screening should be done based on a child's health or family history rather than for all children (P < .001), or if they thought that cholesterol screening was unnecessary (P < .001).

Early dropout and treatment adherence are main challenges in the treatment of children with obesity. The aim of this study was to identify factors associated with attrition and adherence to weight loss intervention program. We retrospectively reviewed the medical records of all the children who entered the program for pediatric weight loss over 5 years and retrieved demographic and clinical characteristics. Attrition and adherence were documented. Ninety-two of the 248 enrolled children (52% women, mean age 11.1 ± 3.9 years, mean body mass index 31.1 ± 7 kg/m2) dropped out (37%). Dropping out correlated with male sex, low parental education, and self-referral to the clinic (P <.05 for all). Adherence correlated with older age and the mother's healthy lifestyle (P <.05 for all). Sex, parental education, and referral source may predict treatment attrition. Early recognition of children at risk of attrition may help to facilitate better care of those children. [ABSTRACT FROM AUTHOR]

This qualitative study evaluated barriers and facilitators to mobility in the homes of children with medical complexity (CMC) and the subsequent impact on CMC and their families. Eighteen caregivers of CMC were interviewed. Parents described that accessibility barriers impaired delivery of care at home and impacted the child's participation in family life. The most inaccessible areas were stairs and bathrooms. Mobility and transfers became more difficult as children grew larger. Parents and children sustained injuries from performance of activities of daily living (ADLs). When available, durable medical equipment (DME) and home modifications improved home access and typically were funded using insurance and state Title V funds. However, parents reported that larger home modifications, such as bathroom modifications, were cost prohibitive. A pediatrician's inquiry about mobility barriers may reveal crucial information about delivery of home care to CMC. CMC may be referred to rehabilitation specialists to address mobility needs. [ABSTRACT FROM AUTHOR]

As the coronavirus pandemic continues to impact families and children, understanding parental attitudes and likely acceptance of the COVID-19 vaccine is essential. We conducted a statewide survey with a representative sample of parents in Tennessee focused on COVID-19 and influenza vaccine acceptance and perspectives. Data from 1066 parents were analyzed using weighted survey methods to generalize results to the state of Tennessee. About 53% of parents reported a likelihood to vaccinate their children against COVID-19, and 45% were likely to vaccinate their child against COVID-19 and influenza. Female parents were less likely to vaccinate their children against COVID-19, but the strongest predictor of likely COVID-19 vaccine acceptance was influenza vaccine acceptance (adjusted odds ratio = 5.46; 95% confidence interval: 3.20-9.30). Parental acceptance of COVID-19 vaccines for children is closely tied to influenza vaccine acceptance. Public health approaches to maximize vaccine uptake could focus on children who have not been receiving influenza vaccines. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate an educational module for Latino parents about the health effects of sweet beverages. Latino parents were randomized to receive the beverage module or a control module. Child beverage consumption was assessed at baseline, 2 weeks, 2 months, and 3 months via a beverage recall survey. At 2-week follow-up, children of intervention participants had a mean reduction in 7-day total sugar-sweetened beverage and 100% fruit juice consumption of 16 ounces while controls had a mean increase of 4 ounces ( P = .01). At 2-month and 3-month follow-up, there was a reduction in mean total sugar-sweetened beverage and 100% fruit juice consumption among both intervention and control children. An educational module on beverages for Latino parents reduced child consumption of sweet beverages at 2-week follow-up. However, study participation appears to have also reduced controls' beverage consumption suggesting that frequent intensive surveys of beverage intake may be an intervention unto itself.

COVID-19 has adversely affected child wellness, but it is unclear whether the pandemic led to changes in home management of chronic diseases like asthma. We surveyed 93 caregivers of children with persistent asthma from 2 ongoing asthma trials to measure changes in home asthma management, stressors, access to health care, and caregivers' worry about COVID-19 affecting their child's health. We conducted descriptive analyses, and assessed whether caregiver worry about COVID-19 was associated with asthma management, stressors, health care access, or recent symptoms. Most (80%) caregivers worried that COVID-19 would affect their child's health, and >50% restricted their child's physical activity to avoid asthma symptoms. We observed a dose-dependent relationship between increasing worry about COVID-19 and activity restrictions, financial hardship, difficulty obtaining asthma medications, and nocturnal asthma symptoms. These findings raise concern that children with persistent asthma may be at particular risk for weight gain and obesity-associated asthma morbidity due to the pandemic. [ABSTRACT FROM AUTHOR]

UnlabelledObjective To characterize bedtime routines (BR) and associations between reading at bedtime and sleep behaviors in a sample of Latino preschoolers.MethodsA convenience sample of Latino parents of a 4-year-old child completed standardized questionnaires assessing BRs, bedtime reading frequency and other sleep variables. Family demographics and home environment were also assessed. Results Parents of 62 children completed questionnaires. A consistent BR was reported by 48%. Frequent reading at bedtime was reported in 42%. After controlling for key confounders, reading at bedtime was significantly associated with longer total nighttime sleep (P < .01), but not with other sleep behaviors. Conclusion Reading at bedtime was significantly associated with longer total nighttime sleep duration. This, together with the relatively low frequency of reading found in this sample, suggests that interventions aimed at increasing reading at bedtime among Latino preschoolers may improve overall sleep health.

A pretest and posttest study design was used to test a healthy weight management intervention with overweight and/or obese Chinese American children. Children attended 8-weekly small group sessions while parents attended a single 2-hour parent workshop. Children had their weight, height, blood pressure, waist and hip circumference, and fast lipids data assessed and completed several questions questionnaires regarding food choices, self-efficacy, and knowledge at baseline, 2 months, and 6 months. Parents completed questionnaires regarding demographic, acculturation level and family environment. We found significant reduction of body mass index, waist/hip ratio, systolic blood pressure and improvement of child's eating style, physical activity knowledge, self-efficacy, and children's quality of life at 6-month follow-up. In addition, significant improvement of high-density lipoprotein cholesterol and decrease in triglyceride were found at 6-month follow-up. Improvement of nutrition self-efficacy and decreased stimulus environment were associated with decreased body mass index in overweight and obese Chinese American children.

This study examined the frequency and type of complementary and alternative medicine (CAM) therapy, as well as characteristics associated with CAM usage. A survey about parental preferences and beliefs regarding CAM usage was distributed to 5 schools with predominantly low socioeconomic Vietnamese children. For the 360 Vietnamese children previously diagnosed with asthma whose families responded, most preferred conventional therapy as prescribed by the physician. The prevalence of CAM usage was 38.1%. Common CAM therapies were steam inhalation, creams/topical oils, foods, prayer, oil inhalation, massage, herbal medication, coining, and cupping. Significant predictors of CAM usage were older age (11-12 years) (P = .038), English language of survey response (P = .001), environmental tobacco smoke exposure (P = .001), fear of long-term medication usage, and perception of asthma as a condition related to genetics (P = .023). These findings suggest that assessing CAM therapy will provide a more holistic approach to asthma therapy.

Purpose: To examine the effects of the COVID-19 pandemic on the lifestyle, habits, and behavioral differences in children, and their changing internet use habits. Methods: The research was planned as a cross-sectional study involving 4892 children aged 8 to 17 years attending schools in the city center of Trabzon, Turkey. Children's daily living activities, social habits, mood and temperament changes, and internet use were investigated before and during the pandemic. In terms of problematic internet use, internet addiction rates were evaluated using the validated Turkish-language version of the Parent-Child Internet Addiction Scale (PCIAT-20). Results: The children's mean age was 13 ± 2.45 years, and 17.1% (n = 837) exhibited problematic internet use features on the PCIAT-20. Problematic internet use was higher in boys and in children older than 13 years. The presence of COVID-19 infection among members of the household, quarantine measures, attending private schools, the mother's occupation, the time spent by the mother and father on their mobile phones, and high parental education levels were associated with a high level of internet addiction. Families also described significant changes in their children's temperament and character compared with the pre-pandemic period. Conclusion: The prevalence of problematic internet use increased during the COVID-19 pandemic compared with previous studies from Turkey. Children were also more introverted, irritable, and pessimistic during the pandemic. [ABSTRACT FROM AUTHOR]

Children infected with COVID-19 have a critical part in community-based viral transmission. This study aimed to evaluate knowledge, awareness, attitudes, and behaviors of parents of pediatric dental patients on COVID-19 and to present required actions to prevent its spreading. A total of 524 parents took part in this cross-sectional study. A self-administered questionnaire was prepared for determining sociodemographic characteristics and socioeconomic status of parents, along with their COVID-19-related knowledge, awareness, attitudes, and behaviors. In total, 90.6% of parents were unaware that disease may show no symptoms; 61.1% and 32.6% did not know roles of "close contact with asymptomatic patients" and "dentistry practices" in transmission, respectively; 30.2% thought it could be transmitted to their children at dental clinics, and only 16.4% stated their children as carriers. Parents need to be informed on COVID-19 transmission through contact with asymptomatic individuals, risks associated with dentistry practices, and role of children in transmission. [ABSTRACT FROM AUTHOR]

The article describes the development of online assessments of cognitive and language development of infants and children from a neonatal intensive care unit during the COVID-19 pandemic. The importance of communication with parents prior to the online evaluation is emphasized. Results show comparable 18-month evaluations between telehealth visits and in-clinic visits. It cites the limitations in performing online developmental evaluations for children.

In this study, we aimed to create a novel tool to assist providers at 2 Chicago-area Federally Qualified Health Centers in giving guidance on early cognitive and language development during well-child visits. We utilized a human-centered design (HCD) process to address specific barriers to providing this guidance and create a tool shaped by the needs of providers and parents. Phase I involved collaborative prototype design; phase II involved implementation, feedback gathering, and responsive iterations of the tool; and phase III involved a collective review of the HCD process. The final version of the tool was a concise, colorful, and parent-accessible "Brain Building Guide" intended for interactive provider and parent use. It featured personalized information about parental knowledge and suggested areas for guidance. It was both satisfactory to stakeholders and efficacious in improving parental knowledge immediately post-visit and 1 month out. It should be further evaluated in a randomized controlled trial. [ABSTRACT FROM AUTHOR]

Pediatric functional constipation (FC) reportedly affects at least 1 in 10 children worldwide. Parent and family education is a key component for successful treatment, yet there is little research exploring what information families need and how to best support them. The aim of this review is to synthesize current evidence on the experiences and information needs of parents caring for a child with FC. We systematically searched published research and completed screening against a priori inclusion criteria. Thirteen studies (n = 10 quantitative, n = 3 qualitative) were included. We found 2 main themes, precarious footing and profound and pervasive effects. Heavy caregiving burdens fueled doubts, misinformation, relationship breakdown, and treatment deviation. In light of clinical recommendations, our findings reveal a potential mismatch between parents' needs and care provision for FC. It is likely that both parents and health care providers would benefit from resources and interventions to improve care related to pediatric FC. [ABSTRACT FROM AUTHOR]

Childhood obesity is highly prevalent among certain populations of New York. This cross-sectional pilot study examined the associations between parental attitudes about outdoor activities and body mass index (BMI). A questionnaire was distributed among parents of 1 to 13 aged children at ambulatory pediatric clinics. Of 104 children included in the study 57 were of normal weight and 47 were overweight or obese. Most parents of children with BMI <85% reported frequent playground utilization, considered longer hours to spend outside on weekdays, reported a larger total temperature range for outdoor playground utilization and a lower tolerable minimum temperature compared to parents of children with BMI ≥85%, p < .05. Only having a parent born outside of the United States remained a significant predictor of overweight and obesity in the final model. Parents of children with BMI < 85% are more willing to spend time outdoors, regardless of weather. Immigrant parents are protective against overweight., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The authors have no conflicts of interest to declare. They did not get any support for the present manuscript, grants or contracts from any entity, royalties or licenses, consulting fees, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events, payment for expert testimony, and support for attending meetings and/or travel. There are no patents planned, issued, or pending. They did not participate on a Data Safety Monitoring Board or Advisory Board. They do not have leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, stock or stock options, receipt of equipment, materials, drugs, medical writing, gifts or other services, other financial, or nonfinancial interests.

Population health includes medical conditions and social determinants of health, and it can be measured through community health needs assessments (CHNAs). A pediatric hospital utilized a survey to ask parents to rank different health topics based on the severity they present to children in the St. Louis Metropolitan for 2 installments of a CHNA (2016 and 2019). Between November 2015 and April 2016, 1156 parents and, between May 2018 and September 2018, 1022 parents responded to the Parent Health Concerns Survey. Respondents were most likely to be 25 to 44 years old, white, educated, have an income of at least $60 000, and work-related insurance. The top needs identified in 2016 and 2018 were lack of exercise and bullying, respectively. Depression saw the largest increase. Emerging topics in 2018 include tobacco/smoking, depression, and health insurance access. Our findings suggests that pediatricians should be prepared to address concerns across a wide variety of topics. [ABSTRACT FROM AUTHOR]

Communication skills are an important part of patient care, but an often neglected part of residency training. Longitudinal active coaching of communication has the potential to effectively improve communication curricula. A novel communication coach curriculum was implemented with approximately half of a pediatric residency class. Residents were coached by both a parent and faculty coach on multiple occasions throughout their intern year. Effectiveness was evaluated through self-assessment, direct observation, chart review, and follow-up phone calls with families. This longitudinal communication coach curriculum was well-received and resulted in increased self-awareness of communication skills. Coachable behaviors improved in intervention residents, and their patients spoke more positively of their experiences with communication. Additionally, these patients were less likely to be readmitted than patients cared for by control residents. A longitudinal communication coaching model is a feasible and effective curriculum for pediatric residents., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

To elucidate the physical and psychosocial health needs of newly arrived Afghan children, we conducted a retrospective chart review of patients 0 to 19 years re-settled to Philadelphia with ≥1 outpatient visit during August 2021 to August 2022. Findings on 121 patients include dental caries (74%), elevated lead (32%), eosinophilia (29%), malnutrition (25%), schistosomiasis (6%), strongyloidiasis (8%), latent tuberculosis (7%), and two cases of cutaneous leishmaniasis. Mental health symptoms include poor sleep in 16%, low energy in 10%, and behavioral concerns in 13%. Families with low English proficiency were more often met with delayed medical care (26.7% vs 11.5% P = .12). Parents with less than a high school education were more likely to experience delayed care (38.5% vs 9.1%; P = .001). We conclude that recently arrived Afghan children have unique physical and mental health needs that need to be addressed., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Verbally rich interactions beginning in early infancy are critical to future vocabulary development. We explored the effectiveness of introducing finger puppets in the primary care setting to support caregiver-infant interactions. The intervention cohort was given a puppet at 2 months, with high dosage defined as using the puppet daily in the first 2 weeks. At 6 months, a usual care cohort was enrolled, and outcome measures were collected for all participants. For the intervention, 92% (n = 70) of those eligible participated, and 80% (n = 56) completed the 6-month visit. For usual care, 78% (n = 60) of those eligible participated. In per-protocol analysis, overall cognitive stimulation (StimQ-I) ( P = .04) and Parental Involvement in Developmental Advance subscale ( P = .03) scores were higher for the high-dosage group (28.68, 5.16) than those for the low-dosage (24.81, 4.48) and usual care (24.15, 3.98) groups. Finger puppets may provide a low-cost and scalable way to support early language and child development., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Children with medical technology dependency (MTD) require a medical device to compensate for a vital body function and substantial nursing care. As such, they require constant high-level supervision. Respite care provides caregivers with a temporary break, and is associated with reduced stress; however, there are often barriers. The study utilizes mixed methodology with the National Survey of Children with Special Health Care Needs (NS-CSHCN) and semistructured interviews with state-wide care coordinators to understand the gap for respite care services. Fifty-nine percent of parents who needed respite care received none. Parents of older children with MTD were more likely to report respite needs. Care coordinators described that home health shortages created barriers to respite care utilization, and the lack of respite care can lead to hospital readmission. Although respite care is a vital resource to support families of children with MTD, it is infrequently available, which can have severe consequences. [ABSTRACT FROM AUTHOR]

The Neonatal Eating Assessment Tool (NeoEAT)–Bottle-feeding is a parent-report assessment of bottle-feeding behavior in infants less than 7 months old with evidence of validity and reliability. The purpose of this study was to establish norm-reference values to guide score interpretation and clinical decision making. Parents of 478 healthy, typically developing infants completed the NeoEAT–Bottle-feeding. Descriptive statistics were calculated for the following age groups: 0 to 2, 2 to 4, 4 to 6, and 6 to 7 months. NeoEAT–Bottle-feeding total scores decreased with increasing infant age. The Infant Regulation subscale contributed the most to the total score and remained high across the first 6 months of life, then decreased dramatically in the 6- to 7-month age group. The 90th and 95th percentile values for the total score and subscale scores can be used to identify infants with problematic feeding, guide referral, tailor treatment, and assess response to treatment. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the impact of access to communication technology on caregiver quality of life, neurodevelopmental, and medical outcomes (eg, rehospitalization, emergency room visits, or surgeries) in preterm infants, and enrollment in public assistance programs. In this cross-sectional study, we surveyed families of preterm infants in a high-risk infant-follow-up clinic. We estimated associations of access to various modes of communication technology with outcomes, adjusting for sociodemographic and infant characteristics using linear and unconditional logistic regression. Access to email, text messaging, and smartphones was associated with higher quality of life scores on the Multicultural Quality of Life Index, and email and smartphone access was significantly associated with increased enrollment in early intervention. Evaluating smartphone and email access on neonatal intensive care unit discharge is important when considering enrollment in community programs and caregiver quality of life. [ABSTRACT FROM AUTHOR]

A 21-question survey was conducted among parents attending 4 pediatric outpatient practices to assess their knowledge, perceptions, and attitudes about fever. One hundred and ninety-seven surveys were included. Most commonly the participating parent was the mother. Parents used mainly axillary thermometers to measure child's temperature and mentioned integers for their definition of fever, 100°F being the most frequent answer. Most parents would treat all fevers and would use alternating antipyretics. Parents had a generally negative perception of fever: only one third thought fever may have some benefit, and more than half thought there must be some risk. A positive perception of fever was associated with parental educational level but not with information by the pediatrician. There is much confusion about fever among our parents, a negative perception is prevalent, and parents seem to receive—or recall—little information from the pediatrician. [ABSTRACT FROM AUTHOR]

Attendance at well-child visits (WCVs) is a sine qua non of preventive care. We hypothesized that Reach Out and Read (ROR) would be associated with better WCV attendance. Parents of children 76 to 72 months at 8 clinics who did not yet have ROR reported how many WCVs their child had attended in the previous year; separate samples at the same clinics were interviewed 16 months after the ROR program was instituted. Comparing 267 parents before ROR and 254 after, the percentage who had attended the minimum number of WCVs required by the American Academy of Pediatrics periodicity schedule rose from 67.4% (180/267) to 78.3% (199/254; P < .01). This difference remained significant after controlling for multiple potential confounding factors (estimated odds ratio = 2.1, 95% confidence interval = 1.3-3.5). The largest differences were among Latino children and children of less-educated parents. Programs to enhance early literacy may increase attendance at WCVs among at-risk families. [ABSTRACT FROM AUTHOR]

Background. Prior reports on large congenital melanocytic nevi (LCMN) do not provide a clear management approach to physicians to advise parents or patients. Whether the presence of a halo around the nevus can guide management has not been fully explored. Design. Children born with an LCMN were observed without active intervention. Objectives. (1) To guide physicians, health providers, and parents in the management of CMN. (2) To ascertain the value of the absence or presence of a halo component of the nevi. (3) To reaffirm the diagnostic value of dermoscopy for evaluation of CMN. Materials and Methods. This was a clinical study of 45 children referred to our pediatric dermatology clinics from 1971 to- 2018. Results and Outcome. Of 45 children, 9 were lost to follow-up and 36 were followed for 6 months to 47 years. In follow-up of 17 children with a scalp CMN, spontaneous regression occurred in 6 patients. In follow-up of 5 children with a trunk LCMN, spontaneous regression occurred in 1 patient and excisional surgery was done in 4 patients. Quality of life was excellent in 35 children, but poor in 1 patient during multiple injections and excisions. Conclusions. A conservative approach to management of children with CMN, large and small, is safe, cost-effective, and results in excellent quality of life and cosmetic outcomes. Dermoscopy, a simple in-office procedure, can reassure the examiner that the congenital nevus is benign. A halo rim was present in 12 (80%) of 15 scalp CMN. The presence of a halo rim appears predictive of future regression of a CMN in the scalp or trunk. [ABSTRACT FROM AUTHOR]

The article describes what do during a harried well-child care visit is not evidence-based but just feels like the right thing to do. Topics include the components of well-child care unearths shortcomings in addressing critical topics in preventive care, including developmental or psychosocial surveillance; and extant literature has demonstrated that having longer visit times can improve not only developmental and psychosocial surveillance but also parent satisfaction.

Little is known about parents' perceptions and prevention strategies regarding childhood falls. In this qualitative study using semi-structured interviews, we sought to describe parental reports of child fall experiences, concerns, and prevention strategies in the home. Sixteen parents with at least one child younger than 18 months were asked about their awareness of fall risks, falls experienced by the child, fall concerns, prevention strategies, and where in the home the child spends time throughout the day. Seven themes emerged: (1) "falls are unexpected," (2) "role of the physical environment," (3) "children's temperament and developmental stage," (4) "physical barriers and baby products," (5) "addressing walking surfaces," (6) "modifying the height of a fall," and (7) "supervision." Parents are aware of in-home fall hazards and actively use strategies to lessen fall risk. Anticipatory guidance should promote evidence-based and evidence-informed prevention strategies and augment effective strategies some parents use to lower fall risk., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.