Showing papers in "Children's Health Care in 2013"
TL;DR: Strategies employed to minimize barriers to recruitment and retention of African American families receiving Women, Infants, and Children services in a longitudinal study examining caregiver feeding and child weight are described.
Abstract: Children from low socioeconomic status (SES) and ethnic minority backgrounds are at heightened risk for overweight, yet are underrepresented in the pediatric obesity literature. This article describes strategies employed to minimize barriers to recruitment and retention of African American families receiving Women, Infants, and Children services in a longitudinal study examining caregiver feeding and child weight. Seventy-six families enrolled in the study over 3½ years, and 50% of the families completed the study. Despite effortful planning, unanticipated barriers likely contributed to lengthy recruitment and a modest retention rate. Future research should incorporate lessons learned to modify and develop effective strategies for increasing engagement of low-SES and ethnic minority families in research.
58 citations
TL;DR: The revised BAMBIC developed with factor analysis had stronger psychometrics than the original scale and produced three subscales of feeding problems: Limited Variety, Food Refusal, and Disruptive Behavior.
Abstract: The present study examined psychometric properties of the Brief Autism Mealtime Behavior Inventory (BAMBI) when applied to a population of children with feeding problems. The new scale was renamed the Brief Assessment of Mealtime Behavior in Children (BAMBIC) for wider clinical usefulness. Parents completed questionnaires with the original BAMBI, the Child Eating Behavior Questionnaire, and the Parent Mealtime Action Scale. The revised BAMBIC developed with factor analysis had stronger psychometrics than the original scale and produced three subscales of feeding problems: Limited Variety, Food Refusal, and Disruptive Behavior. More Limited Variety was reported for boys than girls, and more Food Refusal was reported for younger children and children with special needs.
36 citations
TL;DR: It is indicated that youth participation in chronic illness camps facilitates increased hope and goal-directed behaviors, which contributes to improvements in psychosocial functioning.
Abstract: This study evaluated health-related quality of life (HRQOL) and hope in youth after participation in a summer camping program for children with chronic medical conditions. A total of 102 youth (mean age = 13.10 years, SD = 2.37) with various medical diagnoses (e.g., cancer, 36.9%; kidney disease, 21.4%) participated in the study. Findings from the Children's Hope Scale indicated that from pre- to post-camp, youth were more confident in their ability to identify strategies to accomplish goals. Additionally, findings from this scale suggested that the identification and development of personal goals is associated with enhancement of perceived HRQOL at the post-camp assessment. No significant differences emerged in HRQOL from pre- to post-camp. Overall, the results are consistent with previous studies of positive benefits of the camp experience; this study indicates that youth participation in chronic illness camps facilitates increased hope and goal-directed behaviors, which contributes to improvements in p...
30 citations
TL;DR: In this paper, the authors examined links among organizational-level climate variables, turnover-related attitudes, and emotional labor in the field of child life and found that the need to suppress emotion and sustain outward expressions in pediatric health care facilities can be overwhelming for employees, leading to low job performance and high turnover.
Abstract: The need to suppress emotion and sustain outward expressions in pediatric health care facilities can be overwhelming for employees, leading to low job performance and high turnover. This is particularly true within the field of child life. Notwithstanding, retention and performance of health care professionals have emerged as national agenda items, and hospital administrators are routinely asked to increase performance, reduce turnover, and increase patient-care quality. Although human health care professionals are asked to support these initiatives, few evidence-based models are available to guide intervention. This correlational study (N = 241) examined links among organizational-level climate variables, turnover-related attitudes, and emotional labor in the field of child life. Hypotheses were tested through correlational and hierarchical regression analytic procedures. Contributions to practice and recommendations for future research are discussed.
27 citations
TL;DR: Results suggest that pediatric oncology patients with caregivers of lower educational attainment and financial difficulties are at significantly greater risk for psychosocial problems, and should be offered early psychological intervention.
Abstract: The aim of this study was to investigate demographic and socioeconomic variables associated with risk for patient and family problems over the course of 1 year in a largely low-income and rural pediatric oncology population. Caregivers (n = 163) completed the Psychosocial Assessment Tool 2.0 up to 4 times during regular clinic visits. Multilevel modeling examined change over time, as well as demographic and socioeconomic variables associated with psychosocial risk. Results suggest that pediatric oncology patients with caregivers of lower educational attainment and financial difficulties are at significantly greater risk for psychosocial problems, and should be offered early psychological intervention.
25 citations
TL;DR: Most siblings reported changes to many aspects of their relationships, family processes, and increased responsibilities as a result of the patients' pain experiences, whereas most patients did not report significant changes to their relationships or family processes.
Abstract: This qualitative study presents the experiences of youth with chronic pain and their siblings, and their perspectives on how pain experiences influence family dynamics. Most siblings reported changes to many aspects of their relationships, family processes, and increased responsibilities as a result of the patients' pain experiences, whereas most patients did not report significant changes to their relationships or family processes. Professionals treating adolescents with chronic pain may find siblings to be a valuable, but overlooked, source of information on family dynamics and illness influence on family relationships.
17 citations
TL;DR: Challenges faced during the course of providing family-based weight management interventions as part of the Extension Family Lifestyle Intervention Project (E-FLIP) for kids are reviewed and effective and innovative suggestions for future programs are provided.
Abstract: Rates of obesity are higher for children and adults living in rural areas relative to non-rural settings. As a result, there is an immense need for pediatric weight management programs focused on children and families living in rural areas. However, clinicians and families in rural communities experience numerous barriers when participating in these programs. This article reviews challenges faced during the course of providing family-based weight management interventions as part of the Extension Family Lifestyle Intervention Project (E-FLIP) for kids. Effective and innovative suggestions for future programs are provided for consideration when designing weight management programs for rural pediatric populations. A selected review of the pediatric and adult rural service delivery literature and clinicians' experiences are discussed. Challenges to providing pediatric weight management interventions in rural communities include the lower socioeconomic status of many rural families, unique aspects of rural cul...
16 citations
TL;DR: The relation between parent-rated temperament and behavior and observer-rated child preoperative anxiety was examined in 61 children undergoing a day surgery procedure in this article, where parents completed measures of child temperament and behaviour prior to surgery.
Abstract: The relation between parent-rated temperament and behavior and observer-rated child preoperative anxiety was examined in 61 children undergoing a day surgery procedure. Parents completed measures of child temperament and behavior prior to surgery. Child preoperative anxiety was observer-rated throughout the day surgery process. Results demonstrated that subscales of the child temperament measure had relatively lower internal consistencies. Subscales from measures of temperament and behavior showed the expected convergent validity in the assessment of inhibition and impulsive constructs, respectively. The anxious-shy subscale from the behavior measure was the only subscale that significantly predicted child anxiety at anesthetic induction (r = .24). Parent-rated measures of child behavior may be useful in identifying children at risk of developing preoperative anxiety.
16 citations
TL;DR: The CASSS-HB showed preliminary evidence of reliability and validity as a measure of targeted social support for healthy behaviors in children, with parent support a significant unique predictor.
Abstract: Understanding the relationship among weight status, body dissatisfaction, and social support is essential to addressing childhood obesity. To address the lack of reliable and valid measurement tools to assess social support specifically for healthy behaviors pertaining to childhood obesity, a new measure was developed, the Child and Adolescent Social Support Scale for Healthy Behaviors (CASSS-HB). The study sample included 121 third- through fifth-grade students. Results indicated that the CASSS-HB showed preliminary evidence of reliability and validity as a measure of targeted social support for healthy behaviors in children. Youth who were categorized as obese scored higher on a score of body dissatisfaction than healthy weight or overweight youth. Social support for healthy behaviors was significantly related to body size dissatisfaction for males, with parent support a significant unique predictor. The assessment of targeted social support and body size dissatisfaction at early ages is essential to ch...
16 citations
TL;DR: The authors found that parents who considered themselves a lone parent when caring for their ill child had significantly lower incomes and greater distress (i.e., were more likely to score at or above clinical or "case" cutoffs on the Brief Symptom Inventory).
Abstract: This article reports findings from 2 studies assessing the relation between parental perception of “lone” parenting and socioeconomic factors, including low income, perception of child health, and parental emotional distress among parents of chronically ill children. In both studies, parents who considered themselves a lone parent when caring for their ill child had significantly lower incomes and greater distress (i.e., were more likely to score at or above clinical or “case” cutoffs on the Brief Symptom Inventory) than those who considered themselves to be married or partnered. Longitudinal research is needed to determine the impact of lone parenting and low income on parental and child health outcomes over time.
13 citations
TL;DR: Direct observation data showed that participants successfully acquired the skills during the group, and the skills were maintained 1-month posttreatment, and social validity data revealed the intervention was well-received.
Abstract: Children with autism spectrum disorders (ASD) and disruptive behavior disorders (DBD) have significant difficulties in social interactions. Although social skills training (SST) is often prescribed for children with ASD and DBD, research showing its effectiveness is still emerging. This study examined the effects of SST for children with ASD and DBD. Evaluation measures included the Social Skills Improvement System, direct observation of behaviors during role-play, and social validity ratings. Direct observation data showed that participants successfully acquired the skills during the group, and the skills were maintained 1-month posttreatment. Social validity data revealed the intervention was well-received.
TL;DR: A measure to assess parents' beliefs about sleep that indicated that parents of children with ADHD and ASD held beliefs that children's sleep problems were more intrinsic, less modifiable, and less responsive to treatment.
Abstract: Sleep problems are commonly reported in children, yet often go untreated. Parental beliefs about sleep may be a contributing factor. This study developed a measure to assess these beliefs. The Sleep Attitudes and Beliefs Scale (SABS) was administered to parents of typically developing (TD) children (n = 179) and children with attention deficit hyperactivity disorder (ADHD; n = 84) and autism spectrum disorder (ASD; n = 92). Results indicated that the psychometric properties (i.e., inter-item reliability and Cohen's alpha) of the SABS are good and that, in comparison to the TD sample, parents of children with ADHD and ASD held beliefs that children's sleep problems were more intrinsic, less modifiable, and less responsive to treatment. Further work is required, but it is hoped that the SABS can be used both clinically, to determine factors that may contribute to and maintain children's sleep problems, and in research settings.
TL;DR: Individualized, home-based interventions targeting everyday mealtime and sleep routines hold promise in assisting mothers with developing and sustaining their children's healthy behaviors and decreasing their overweight and obesity risks.
Abstract: This study explored the feasibility and acceptability of an individualized, home-based routines intervention targeting preschool-age children's everyday sleeping and eating routines. Using a one-group, pre–post design (N = 11), single mothers with 3- to 5-year-old children participated in an intervention over 6 weeks. Data (self-report, actigraphy, and family mealtime observations) were collected at baseline and 1-month post intervention. Mothers found the intervention acceptable, and point estimates for the intervention effects were in the expected direction. Individualized, home-based interventions targeting everyday mealtime and sleep routines hold promise in assisting mothers with developing and sustaining their children's healthy behaviors and decreasing their overweight and obesity risks.
TL;DR: Across all weight categorizations the rates of high BMIs among Appalachian children significantly exceeded those of all comparison samples, with the odds of a high BMI ranging from 1.29 to 3.92 times greater for young Appalachian children.
Abstract: This study's objectives were to estimate the prevalence rates of obesity and overweight among young, low-income children (N = 497) living in rural Appalachia and to compare these estimates with various national estimates. Across all weight categorizations (body mass indices [BMIs] ≥ 85th, ≥95th, and ≥97th percentiles for age and gender) the rates of high BMIs among Appalachian children significantly exceeded those of all comparison samples, with the odds of a high BMI (≥85th percentile) ranging from 1.29 to 3.92 times greater for young Appalachian children. Appalachian children's weight was unrelated to their gender or age. Children younger than age 5 years living in rural Appalachia are at risk for higher rates of obesity and potentially for the biopsychosocial consequences of obesity.
TL;DR: An initial validation of a new measure for children with cancer and their siblings, the Children's Assessment of Perceived Social Support, which assesses perceived support from individuals in the home and summer camp settings and about cancer and non–cancer-related issues is provided.
Abstract: Although perceived social support is associated with positive outcomes and chronic illness, summer camps strive to provide social support to children and families, no measures of perceived support across settings and about illness-specific issues exist. The current study provides an initial validation of a new measure for children with cancer and their siblings, the Children's Assessment of Perceived Social Support, which assesses perceived support from individuals in the home and summer camp settings and about cancer and non–cancer-related issues. The results indicate the measure has adequate validity and reliability and that perceived support across settings and individuals may differ.
TL;DR: Children with mental health or cognitive/developmental conditions were significantly less likely to receive medical home services but more likely to present family burden, with similar findings for children from low socioeconomic status, exhibiting moderate to severe symptoms, and/or from non-White backgrounds.
Abstract: Medical home services, family burden, and time coordinating health care may differ across disorder groups. Children ages 3 to 17 years from the 2005–2006 National Survey of Children with Special Health Care Needs were divided into 5 groups: attention deficit hyperactivity disorder, mental health disorder, chronic illness, cognitive/developmental disorder, and healthy children. Children with mental health or cognitive/developmental conditions were significantly less likely to receive medical home services but more likely to present family burden, with similar findings for children from low socioeconomic status, exhibiting moderate to severe symptoms, and/or from non-White backgrounds. Health professionals must screen children for mental disorders and assist parents in obtaining necessary services.
TL;DR: Examination of relations among diabetes-specific family factors, adherence to medical regimen, quality of life (QOL), and glycemic control in youth and adolescents with type 1 diabetes found Ethnic minority status was associated with poorer glycemicControl.
Abstract: This study examined relations among diabetes-specific family factors, adherence to medical regimen, quality of life (QOL), and glycemic control in youth and adolescents with type 1 diabetes. During an endocrinologist visit, patient and parent–caregiver dyads (n = 70) completed family factors and QOL measures and participated in a structured interview to assess medical regimen compliance, and the patient's glycemic control was assessed by a medical professional. Combined measures accounted for 42% of the variance in glycemic control. QOL partially mediated adherence and glycemic control. Ethnic minority status was associated with poorer glycemic control.
TL;DR: This paper investigated the relation between length of sleep and weight status by analyzing data from 9,321 high school students on the 2007 national Youth Risk Behavior Survey and found that insufficient sleep was associated with higher odds of being categorized as obese in only the most extreme range (5 hr or less of sleep on an average night).
Abstract: The relation between insufficient sleep and weight status among adolescent populations has yielded equivocal findings. This study investigated the relation between length of sleep and weight status by analyzing data from 9,321 high school students on the 2007 national Youth Risk Behavior Survey. Findings indicate that insufficient sleep was associated with higher odds of being categorized as obese in only the most extreme range (5 hr or less of sleep on an average night). Differences in the sleep–weight relation emerged when examined by gender and race/ethnicity. The implications of the results for prevention and intervention programs that address sleep and weight status among adolescents are considered.
TL;DR: In this article, the authors investigate how parenting capacities and child outcomes vary across different indexes of socioeconomic status (SES; e.g., composite vs. single dimension) in a sample of families of children with pediatric cancer.
Abstract: The objective of this article is to investigate how parenting capacities and child outcomes vary across different indexes of socioeconomic status (SES; e.g., composite vs. single dimension) in a sample of families of children with pediatric cancer. Parents provided demographic information for the Hollingshead Index of Social Position, the Parent Protection Scale (PPS), the Child Vulnerability Scale (CVS), the Parenting Stress Index/Short Form (PSI/SF), and the Behavior Assessment System for Children–Second Edition, Parent Rating Scale. Only the PPS differed by composite social status on the Hollingshead Index. Both the PPS and the PSI/SF varied as a function of lower parent education and family income, whereas the CVS was impacted only by lower parent education level. Child externalizing and internalizing problems were influenced only by lower family income. Results highlight the variability in parent and child adjustment outcomes based on the manner in which SES is measured in families of children with c...
TL;DR: It is argued that closer attention to the complex role of poverty in pediatric chronic illness outcomes will allow the field to move beyond an exclusive focus on the detrimental effects of lower SES and into a more holistic approach to health and psychosocial outcomes.
Abstract: Decades of research have documented the robust relation between socioeconomic status (SES) and health outcomes (Schreier & Chen, 2012), with higher SES consistently associated with better health status in both youth and adults (Adler & Stewart, 2010). This relation is evident across a number of pediatric chronic health conditions, including obesity and asthma. It is also increasingly clear that youth with chronic health conditions who live in rural parts of our country may be particularly at risk for untoward health outcomes (Evans & Kim, 2007). To date, pediatric psychology researchers have largely treated SES, income, education, and urban or rural status as control variables. As a result, we know relatively little about the multiple potential ways in which these variables actually exert their influence on health and psychosocial outcomes. A number of authors suggest that this link is most likely a complex interplay of multiple systems of influence, including individual psychological factors, cultural and family dynamics, neighborhood context, medical setting, as well as physical and social domains specific to an individual’s environment (Evans, Gonnella, Marcynyszyn, Gentile, & Salpekar, 2005; Fuller-Rowell, Evans, & Ong, 2012; Yoshikawa, Aber, & Beardslee, 2012). We contend that closer attention to the complex role of poverty in pediatric chronic illness outcomes will allow the field to move beyond an exclusive focus on the detrimental effects of lower SES and
TL;DR: Maternal asthma knowledge increased during the intervention period, and certain changes in medication beliefs were moderated by poverty level, maternal educational level, acculturative stress, and depressive symptoms.
Abstract: The objective of this article is to examine the effectiveness of a culturally tailored asthma intervention in a sample of Latina mothers of children with asthma. Mothers (n = 115) participated in a community-based intervention designed to improve asthma outcomes in their children. Participants provided asthma knowledge and beliefs about asthma medications data pre- and post intervention. Maternal asthma knowledge increased during the intervention period, and certain changes in medication beliefs were moderated by poverty level, maternal educational level, acculturative stress, and depressive symptoms. Culturally tailored interventions can be effective, but participants with fewer resources may require more intensive intervention.
TL;DR: A decrease was seen in maternal variables, including body mass index, calories per day, and percentage of calories from fat, during a brief, novel, visual cue dietary intervention with low-income urban families.
Abstract: Pediatric obesity is highly prevalent, especially among low-literacy populations, and novel interventions are needed to combat the problem in this unique population. The objective of this study was to evaluate the effectiveness of a brief, novel, visual cue dietary intervention with low-income urban families. Eleven families completed the small, in-home pilot study. A decrease was seen in maternal variables, including body mass index, calories per day, and percentage of calories from fat. Regarding foods in the home, the percentage of (green) healthy foods increased, but only slightly, and green foods remained the least prevalent food type in the home.