Search

This study aimed to evaluate the impact of information technology tools on the outcomes of children with asthma in the medical home. A registry was established for children aged 4 to 18 years with an ICD-9 code for asthma. Changes to the electronic health record included modifications to notes, care plans, and orders. A retrospective analysis of emergency department and in-patient utilization for a cohort of patients was conducted from July 2009 through June 2013. Of the study population (n = 1217), 65% had a classification of asthma severity and 63% were risk-stratified. Seventy percent had a control assessment at least once. Care plan use increased from 5% to 22% and enrollment in care coordination increased from 0.1% to 4%. After 3 years, there was a reduction of emergency department and inpatient admissions for asthma (P < .05 and P < .005, respectively). The implementation of information technology tools was associated with improved asthma outcomes. [ABSTRACT FROM AUTHOR]

BackgroundParents exert a significant effect on children's eating behaviors and physical activity levels, so it is imperative to find successful obesity prevention programs that target whole families in underserved communities. PurposeTo investigate the effects of a Coordinated School Health Program (CSHP) on parents in the program over a 2-year period. MethodsParents of kindergarteners (n = 277) in 7 schools participating in a CSHP that served an underserved, predominantly minority community were surveyed at 3 time points regarding their nutrition and physical activity knowledge, attitudes, and behaviors (KABs). Results after years 1 and 2 were compared with pre-intervention results using t tests. Effects of socioeconomic variables were investigated using multivariate linear regression. ResultsReported unhealthy behaviors were lower at the end of both year 1 (P = .03) and year 2 (P = .04). Numerous factors were associated with changes in KABs in the parents, including parental gender. DiscussionA CSHP may have lasting effects on parental behaviors in an underserved, predominantly minority community. Translation to Health Education PracticeFuture studies should assess the effects of CSHPs in other populations and which factors most significantly affect parental attitude and behavioral changes so that program content may be tailored accordingly. [ABSTRACT FROM AUTHOR]

Background:Obesity is a public health concern that disproportionately affects underserved and minority communities.Purpose:To evaluate whether a comprehensive obesity prevention program that targets children and school staff in an underserved Hispanic community affects obesity related knowledge, attitudes, and behaviors among both students and staff.Methods:Using a longitudinal design over 2 years we administered surveys to fourth-grade students (N = 184) and school staff (N = 99) from 7 elementary schools involved in a comprehensive obesity prevention program. In year 2, a control group of students and staff from a neighboring school completed the same surveys for comparison.Results:Over 2 years, students and school staff participating in the program reported improved nutrition knowledge and behavior, and school staff reported improved self-efficacy for physical activity and a trend toward increased physical activity. In year 2 student nutrition behaviors improved preferentially for intervention versus control students.Discussion:Comprehensive programs that target students and school staff may be useful in underserved communities to improve certain knowledge, attitudes, and behaviors related to nutrition and physical activity.Translation to Health Education Practice:Working in concert with public health policy changes, these programs may help to address the disparity in the obesity rate. [ABSTRACT FROM AUTHOR]

Purpose. Investigations were conducted on whether screening for adolescent depression was feasible and acceptable to patients in low-income, urban, predominantly Latino clinics. Further investigations were undertaken for provider acceptance of such screening. Methods. Adolescents aged between 13 and 20 years presenting to 3 pediatric and adolescent primary care practices affiliated with an academic medical center in New York City were screened for depressive symptoms using the Columbia Depression Scale. Providers were surveyed pre- and postimplementation of the screening regarding their attitudes and practices. Results. The vast majority (92%) of those approached accepted the screening. Twelve percent of those screened were referred for mental health treatment. Providers reported satisfaction with the screening tool and a desire to continue to use it. Screening was limited to 24% of eligible participants, and only 10% of screens were at sick visits. Conclusions. The Columbia Depression Scale seems acceptable to adolescent providers and patients in the mostly Latino study population. It may prove to be a helpful tool in evaluating adolescents presenting to primary care for depression. Further study will be required in other Spanish-speaking and minority populations. New methods will also be required to reach a greater proportion of patients, particularly those presenting for sick visits. [ABSTRACT FROM AUTHOR]

This study surveyed pediatric primary care providers at a major academic center regarding their attitudes and practices of obesity screening, prevention, and treatment. The authors compared the care providers’ reported practices to the 2007 American Medical Association and Centers for Disease Control and Prevention Expert Committee Recommendations to evaluate their adherence to the guidelines and differences based on level of training and specialty. Of 96 providers surveyed, less than half used the currently recommended criteria for identifying children who are overweight (24.7%) and obese (34.4%), with attendings more likely to use the correct criteria than residents (P < .05). Although most providers felt comfortable counseling patients and families about the prevention of overweight and obesity, the majority felt their counseling was not effective. There was considerable variability in reported practices of lab screening and referral patterns of overweight and obese children. More efforts are needed to standardize providers’ approach to overweight and obese children. [ABSTRACT FROM PUBLISHER]