Promoting children's health through community-led street interventions: analyzing sustained voluntarism in Canadian School Streets.

BACKGROUND: Active School Travel (AST) initiatives align with the Ottawa Charter for Health Promotion, which calls for 'creating supportive environments' and 'strengthening community action.' However, their reliance on volunteers poses sustainability challenges. The main objectives of this study were to document the motivations, satisfaction, and experiences of volunteers involved in sustaining two AST initiatives in Ontario for an entire school year. METHODS: Two volunteer-led School Street initiatives in Kingston, Ontario successfully operated during pick-up and drop-off times of each school day. The first initiative operated for the entire 2021-2022 school year, and the second operated for the entire 2022-2023 school year. These initiatives were the first of their kind in the province of Ontario, Canada. Volunteers from both sites (n = 56) participated in online surveys and their motivations, satisfaction, and experiences of their role were compared using the 2-sided Fisher's Exact Test. RESULTS: Over 80% of volunteers were highly motivated to promote safety and over 70% of volunteers were highly motivated to disrupt the status quo of unsupportive, car-centric urban environments by reimagining how streets can be used. By taking collective action to re-shape the environment around these public schools to support healthy, active living, our findings reveal that over 90% of volunteers were highly satisfied. Of the volunteers, 87% felt they contributed to child safety and 85% felt they had developed stronger community connections. They appreciated the short (i.e., 40 minute) time commitment of each shift, weekly email communications by the community organization leading the initiative, and the volunteer schedule. They also appreciated the positive social interactions during volunteer shifts, which they felt outweighed the minimal resistance they experienced. CONCLUSIONS: This research demonstrates the importance of logistical, motivational, and social factors in recruiting and retaining volunteers for community-led School Streets. Our findings support appealing to prospective volunteers' influence in achieving School Street objectives (e.g., improved safety) in recruitment efforts, as well as highlighting School Streets' innovative approach. Communicating with volunteers throughout School Street planning and implementation processes and limiting traffic in the closed street zone (i.e., by excluding the school staff parking lot and private driveways from the scope) are additional recommendations based on the findings of this study.

The impact of indoor air pollution on children's health and well-being: the experts' consensus.

BACKGROUND: Pollution of the indoor environment represents a concern for human health, mainly in case of prolonged exposure such as in the case of women, children, the elderly, and the chronically ill, who spend most of their time in closed environments. MAIN BODY: The aim of the study is to organize a group of experts in order to evaluate the evidence and discuss the main risk factors concerning indoor air and the impact on human health as well as challenging factors regarding preventive strategies to reduce pollution. The experts highlighted the main risk factors concerning indoor air, including poor ventilation, climatic conditions, chemical substances, and socio-economic status. They discussed the impact on human health in terms of mortality and morbidity, as well as challenging factors regarding preventive strategies to reduce pollution. CONCLUSION: The experts identified strategies that can be reinforced to reduce indoor pollution and prevent negative consequences on human health at national and local levels.

[Fernandes Figueira and children's health in Rio de Janeiro, 1880-1930]. / Fernandes Figueira e a higiene infantil no Rio de Janeiro, 1880-1930.

This article discusses the relationship between the physician Antônio Fernandes Figueira and children's health during the time that studies in this area were being institutionalized in Brazil. Children's health resulted from the emergence of the concept of health in contrast with disease; here we focus on how children's health became established, in partnership with or opposition to pediatrics. We emphasize how the circulation of ideas on children's health reached Brazil, and how this physician dialogued with and reinterpreted European discussions. A central theme is children's nutrition. We focused on Livro das mães: consultas práticas de higiene infantil [The mothers' book: practical queries on children's health], published by Fernandes Figueira in 1910.

O artigo discute a relação entre o médico Antônio Fernandes Figueira e a higiene infantil no período de institucionalização dos estudos acerca da saúde da criança no Brasil. A higiene infantil é fruto da emergência do conceito de saúde em contraposição à doença. Interessa-nos compreender como a higiene infantil se estabeleceu, se em parceria ou oposição à pediatria. Enfatizamos como a circulação das ideias sobre a saúde da criança chegou ao país e como esse médico dialoga com as discussões europeias e as reinterpreta. Nosso fio condutor é a alimentação infantil como pilar da higiene infantil. Para tal, nos baseamos no Livro das mães: consultas práticas de higiene infantil, publicado pelo médico em 1910.

Protecting Child Health From Air Pollution in India.

Recent research has underscored the diverse ways in which air pollution detrimentally affects child health in India. Notably, India shoulders one of the highest burdens of mortality of children under five years of age globally due to exposure to air pollution. Distinct mitigation strategies are vital to reduce air pollution exposure and its resultant health burdens among children in India when compared to strategies applicable in the global West. This necessity arises due to the substantial influence of residential combustion of solid fuels, and considerable disparities prevalent among India's population. Addressing these unique challenges requires widespread awareness, community engagement, and sustainable policies. As India embarked on a mission to reduce air pollution, showcasing health benefits linked to interventions is crucial. Augmenting access to health data is equally essential to bolster evidence-based policymaking aimed at reducing the child health burden stemming from air pollution in India.

Barriers and enablers to accessing child health resources and services: Findings from qualitative interviews with Arabic and Mongolian immigrant mothers in Australia.

BACKGROUND: Over the past two decades, there has been an increase of immigrants in Australia. Despite this, the availability of culturally responsive resources and services that cater to their needs remains insufficient. OBJECTIVE: The aim of this study was to explore the resources used and trusted by Mongolian- and Arabic-speaking migrant mothers in Australia for child health information and examine how they navigate and overcome challenges they encounter accessing this information. DESIGN: Semi-structured telephone interview. METHODS: A theory informed semi-structured 60-min telephone interview was conducted in Arabic and Mongolian with 20 Arabic- and 20 Mongolian-speaking migrant mothers of children younger than 2 years or currently pregnant and living in Australia. Data were analysed thematically using the framework method. RESULTS: The reliance on digital platforms such as google emerged as a common trend among both groups of mothers when seeking child health information. Notably, there were differences in resources selection, with Mongolian mothers showing a preference for Australian-based websites, while Arabic-speaking mothers tended to opt for culturally familiar resources. There were various barriers that hindered their access to health services and resources, including language barriers, cost, and limited knowledge or familiarity with their existence. Negative encounters with healthcare professionals contributed to a perception among many mothers that they were unhelpful. Both groups of mothers employed a cross-checking approach across multiple websites to verify trustworthiness of information. Acculturation was shown only among the Mongolian-speaking mothers who adapted their cultural practices in line with their country of residence. CONCLUSION: The findings of this study highlight the importance of addressing the needs of migrant mothers in accessing child health information. Health professionals, government agencies, and researchers have an opportunity to provide culturally responsive support by fostering a culturally inclusive approach to developing and promoting equitable access to services and resources, ultimately enhancing the wellbeing of migrant families.

Barriers and enablers to accessing child health resources and services: Findings from qualitative interviews with Arabic and Mongolian immigrant mothers in AustraliaMothers may experience barriers accessing resources and services related to child health behaviours after migration to Australia. Studies have found that parents actively seek health information and have a significant impact on their child's health behaviours, which can have long-term effects. Various factors influence parental decision-making regarding child health, including the socio-cultural environment, life experiences, and access to services and resources.This study reveals that both Arabic- and Mongolian-speaking migrant mothers heavily depend on online sources for accessing health information, primarily due to various barriers they face when accessing in person services, such as language constraints, financial limitations, and challenges in accessing healthcare services. This article also provides recommendations for future research and initiatives to be considered addressing the challenges faced by migrant mothers in accessing healthcare resources and services.

The impact of the COVID-19 pandemic on reproductive, maternal, neonatal, and child health care services in Kiambu County, Kenya.

The global response to COVID-19 undermined established public health goals. This study investigated the impact of COVID-19 on reproductive, maternal, neonatal, and child health (RMNCH) services in Kiambu County, Kenya. It was a retrospective cross-sectional study, where data on antenatal care (ANC), delivery, postnatal care (PNC), and family planning (FP) before and after COVID-19 was retrieved and compared. New ANC clients and 4th ANC visits decreased by 2.9% and 17% respectively. New clients attending PNC increased by 13.3% (p = 0.007). Skilled deliveries reduced by 0.3%, maternal, neonatal deaths, and fresh stillbirths reduced by 0.7%, 23.9%, and 15.8% respectively. Caesarean sections rose by 12.7% (p=0.001). New clients and revisits for family planning reduced by 15.4% and 6.6% respectively. The pandemic adversely affected most of the RMNCH services. There is a need for health departments to institute robust strategies to recover the gains lost during COVID-19.

La réponse mondiale à la COVID-19 a sapé les objectifs de santé publique établis. Cette étude a examiné l'impact du COVID-19 sur les services de santé reproductive, maternelle, néonatale et infantile (SRMNI) dans le comté de Kiambu, au Kenya. Il s'agissait d'une étude transversale rétrospective, dans laquelle les données sur les soins prénatals (ANC), l'accouchement, les soins postnatals (PNC) et la planification familiale (PF) avant et après la COVID-19 ont été récupérées et comparées. Les nouvelles clientes de CPN et les 4èmes visites de CPN ont diminué respectivement de 2,9 % et 17 %. Les nouveaux clients fréquentant la PNC ont augmenté de 13,3 % (p = 0,007). Les accouchements qualifiés ont diminué de 0,3 %, les décès maternels et néonatals et les nouvelles mortinaissances ont diminué respectivement de 0,7 %, 23,9 % et 15,8 %. Les césariennes ont augmenté de 12,7 % (p=0,001). Les nouveaux clients et les nouvelles visites pour la planification familiale ont diminué respectivement de 15,4% et 6,6%. La pandémie a eu des conséquences néfastes sur la plupart des services de RMNCH. Il est nécessaire que les services de santé mettent en place des stratégies solides pour récupérer les gains perdus pendant la COVID-19.

Exploring Gene-Diet Interactions for Mother-Child Health: A Systematic Review of Epidemiological Studies.

BACKGROUND: Maternal-child health suggests the critical impact of maternal nutrition during the pre-conception and gestational periods, with some genetic variants also playing a significant role. Our systematic review provides an overview of epidemiological studies exploring the interactions between genetic variants, maternal dietary habits, and neonatal and/or maternal pregnancy outcomes. METHODS: From its inception until June 2023, we conducted a comprehensive literature search on PubMed, Embase, and Web of Science databases. RESULTS: On a total of 29 epidemiological studies, 11 studies were conducted to explore the interplay between genetic variants and dietary factors, focusing on the risks associated with gestational diabetes mellitus, hypertensive disorders of pregnancy, recurrent spontaneous abortion, recurrent pregnancy loss, iron deficiency anemia, and gestational weight gain. Concerning neonatal outcomes, six studies investigated the interplay between genetic variants, dietary factors, and anthropometric measures, while eight studies delved into abnormal embryonic development, two studies focused on preterm birth, and two studies explored other neonatal outcomes. CONCLUSIONS: Deeply understanding gene-diet interactions could be useful in developing highly personalized approaches to maternal and child nutrition, as well as in exploring the potential implications in disease prevention and the promotion of the long-term well-being of both mothers and their offspring.

Quality of routine health facility data for monitoring maternal, newborn and child health indicators: A desk review of DHIS2 data in Lumbini Province, Nepal.

INTRODUCTION: Health-facility data serves as a primary source for monitoring service provision and guiding the attainment of health targets. District Health Information Software (DHIS2) is a free open software predominantly used in low and middle-income countries to manage the facility-based data and monitor program wise service delivery. Evidence suggests the lack of quality in the routine maternal and child health information, however there is no robust analysis to evaluate the extent of its inaccuracy. We aim to bridge this gap by accessing the quality of DHIS2 data reported by health facilities to monitor priority maternal, newborn and child health indicators in Lumbini Province, Nepal. METHODS: A facility-based descriptive study design involving desk review of Maternal, Neonatal and Child Health (MNCH) data was used. In 2021/22, DHIS2 contained a total of 12873 reports in safe motherhood, 12182 reports in immunization, 12673 reports in nutrition and 12568 reports in IMNCI program in Lumbini Province. Of those, monthly aggregated DHIS2 data were downloaded at one time and included 23 priority maternal and child health related data items. Of these 23 items, nine were chosen to assess consistency over time and identify outliers in reference years. Twelve items were selected to examine consistency between related data, while five items were chosen to assess the external consistency of coverage rates. We reviewed the completeness, timeliness and consistency of these data items and considered the prospects for improvement. RESULTS: The overall completeness of facility reporting was found within 98% to 100% while timeliness of facility reporting ranged from 94% to 96% in each Maternal, Newborn and Child Health (MNCH) datasets. DHIS2 reported data for all 9 MNCH data items are consistent over time in 4 of 12 districts as all the selected data items are within ±33% difference from the provincial ratio. Of the eight MNCH data items assessed, four districts reported ≥5% monthly values that were moderate outliers in a reference year with no extreme outliers in any districts. Consistency between six-pairs of data items that are expected to show similar patterns are compared and found that three pairs are within ±10% of each other in all 12 districts. Comparison between the coverage rates of selected tracer indicators fall within ±33% of the DHS survey result. CONCLUSION: Given the WHO data quality guidance and national benchmark, facilities in the Lumbini province well maintained the completeness and timeliness of MNCH datasets. Nevertheless, there is room for improvement in maintaining consistency over time, plausibility and predicted relationship of reported data. Encouraging the promotion of data review through the data management committee, strengthening the system inbuilt data validation mechanism in DHIS2, and promoting routine data quality assessment systems should be greatly encouraged.

Effects of household vectors on child health and its determinants in southwest, Ethiopia correspondence analysis.

Background: Household vectors transmit pathogens from one child to another. This study aimed to investigate the prevalence and determinants of household vectors on child health. Methods: A community-based cross-sectional study design was conducted, during which a total of 846 household data were collected using a pretested questionnaire and simple random sampling technique. The data was entered into EpiData3.4 and then exported to Stata 14 software for analysis. A multivariable logistic regression analysis was conducted to identify significant factors associated with household vectors that contribute child health problems. The correspondence analysis was used to determine statistically significant effects or associations between household vectors and child health problems, that was explained by the percentage of variance. Results: This study revealed that the prevalence of household vector effects among children was 35.5% suchas itching, allergies, nuisances and aesthetically displeasing factors. Households with no formal education were significantly 36% less likely to be affected compared to their counterparts (AOR 0.64, 95% CI 0.41, 0.99). Housewives are significantly 2.21 times more likely to be bexposed to household vectors compared to government workers (AOR 2.21, 95% CI 1.23, 3.70). Caregivers who had limited awareness of household vectors were 98.6% less likely to be affected compared to their counterparts (AOR 0.014; 95% CI 0.01-0.04). Similarly, children from households that consumed less than 20 liters of water per individual were 1.45 times more likely to be at risk compared to children from households that consumed more water (AOR 1.45, 95% CI 1.02, 2.07). The infestations of household vectors were found to be statistically significant and were associated with the occurrence of child health problems. This significant association accounted for 86.8 percent of the explained variance. Conclusion: Addressing the high burden of household vectors on child health requires interventions that target informal education, limited access to information, and inadequate access to safe water. Implementing effective vector control measures is crucial to reduce the incidence of vector-borne diseases among children.

Regional determinants of quality of care for sick children: A multilevel analysis in four countries.

Background: The limited impact of increased access to care on improvements in health outcomes during the Millennium Development Goal era has been attributed, in part, to inadequate quality of care. We identified regional factors associated with health service quality for sick child care in low-income countries and examined whether provider factors interact with regional factors to affect the quality of care. Methods: We conducted cross-sectional random intercept four-level linear regression using the most recent Service Provision Assessment and Demographic Health Survey data from four countries (467 from the Democratic Republic of Congo 2018, 2425 from Afghanistan 2018, 2072 from Nepal 2015, and 813 from Senegal 2017). The outcome variable was the service quality score for sick child care, which was measured as the percentage of clinically recommended tasks completed in the integrated management of childhood illness (ranging from 0 to 100). Regional factors were selected based on the High-Quality Health System Framework. Results: The service quality score was found to be positively associated with the proportion of large facilities (ß = 8.61; P = 0.004) and the proportion of providers ranked in the top fifth for service quality score (ß = 30.15; P < 0.001) in the region. We identified significant cross-level interactions between provider qualifications (ß = -16.6; P < 0.001) or job descriptions (ß = 12.01; P = 0.002) and the proportion of providers in the top fifth for service quality scores within the region. As the proportion of top-performing providers in a region increased, the increase in the service quality score was more pronounced among providers who were nonmedical doctors or did not have job descriptions than among their counterparts. Conclusions: Our findings indicate that the quality of care for sick children in a region improves with a greater proportion of high-performing providers or larger facilities. Providers who are not medical doctors, or those who have specific job descriptions, tend to benefit more from the presence of these top-performing providers.

How do household living conditions and gender-related decision-making influence child stunting in Rwanda? A population-based study.

Child stunting (chronic undernutrition) is a major public health concern in low- and middle-income countries. In Rwanda, an estimated 33% of children are affected. This study investigated the household living conditions and the impact of gender-related decision-making on child stunting. The findings contribute to ongoing discussion on this critical public health issue. In December 2021, a population-based cross-sectional study was conducted in Rwanda's Northern Province; 601 women with children aged 1-36 months were included. Stunting was assessed using low height-for-age criteria. The Multidimensional Poverty Index (MPI) was used to determine household socioeconomic status. Researcher-designed questionnaires evaluated gender-related factors such as social support and household decision-making. Multivariable logistic regression analysis identified risk factor patterns. Six hundred and one children were included in the study; 27.1% (n = 163) were diagnosed as stunted; there was a higher prevalence of stunting in boys (60.1%) than girls (39.9%; p<0.001). The MPI was 0.265 with no significant difference between households with stunted children (MPI, 0.263; 95% confidence interval [CI], 0.216-0.310) and non-stunted children (MPI, 0.265; 95% CI, 0.237-0.293). Most households reported a lack of adequate housing (78.9%), electricity (63.0%), good water sources (58.7%), and proper toilets (57.1%). Male-headed households dominated (92% vs. 8.0%; p = 0.018), and women often shared decision-making with their partners. However, 26.4% of women reported forced sexual intercourse within marriage (Odds Ratio [OR] 1.81; 95% CI, 1.15-2.85). Lack of support during illness ([OR], 1.93; 95% CI, 1.13-3.28) and absence of personal guidance (OR, 2.44; 95% CI, 1.41-4.26) were significantly associated with child stunting. Poverty contributes to child stunting in the Northern Province of Rwanda. Limited social support and women's lack of decision-making power in the household increase stunting rates. Interventions should empower women and address the broader social and economic context to promote both women's and children's health.

Empowering child health: Harnessing machine learning to predict acute respiratory infections in Ethiopian under-fives using demographic and health survey insights.

BACKGROUND: A dearth of studies showed that infectious diseases cause the majority of deaths among under-five children. Worldwide, Acute Respiratory Infection (ARI) continues to be the second most frequent cause of illness and mortality among children under the age of five. The paramount disease burden in developing nations, including Ethiopia, is still ARI. OBJECTIVE: This study aims to determine the magnitude and predictors of ARI among under-five children in Ethiopia using used state of the art machine learning algorithms. METHODS: Data for this study were derived from the 2016 Ethiopian Demographic and Health Survey. To predict the determinants of acute respiratory infections, we performed several experiments on ten machine learning algorithms (random forests, decision trees, support vector machines, Naïve Bayes, and K-nearest neighbors, Lasso regression, GBoost, XGboost), including one classic logistic regression model and an ensemble of the best performing models. The prediction ability of each machine-learning model was assessed using receiver operating characteristic curves, precision-recall curves, and classification metrics. RESULTS: The total ARI prevalence rate among 9501 under-five children in Ethiopia was 7.2%, according to the findings of the study. The overall performance of the ensemble model of SVM, GBoost, and XGBoost showed an improved performance in classifying ARI cases with an accuracy of 86%, a sensitivity of 84.6%, and an AUC-ROC of 0.87. The highest performing predictive model (the ensemble model) showed that the child's age, history of diarrhea, wealth index, type of toilet, mother's educational level, number of living children, mother's occupation, and type of fuel they used were an important predicting factor for acute respiratory infection among under-five children. CONCLUSION: The intricate web of factors contributing to ARI among under-five children was identified using an advanced machine learning algorithm. The child's age, history of diarrhea, wealth index, and type of toilet were among the top factors identified using the ensemble model that registered a performance of 86% accuracy. This study stands as a testament to the potential of advanced data-driven methodologies in unraveling the complexities of ARI in low-income settings.

[Maternal and Child Health Exhibition in the early days of the People's Republic of China].

In the early days of the People's Republic of China, Maternal and Child Health Exhibitions were widely held in urban and rural areas across the country. The vivid image and wide coverage of the Exhibition have directly promoted the popularization of a new and more progressive delivery methods in urban and rural areas across the country. While effectively protecting the health of mothers and children, the people's political power is closely linked to "progress".The purpose, organizer and content of the Maternal and Child Health Exhibition are related to the policies of new methods of midwifery, painless delivery, and birth control in the early days of People's Republic of China.It also partly carried the mission of learning from the Soviet Union to "learn from the advanced medical experience", therefore the content in the first ten years was slightly different.

Study protocol for a systems evaluation of an infant mental health service: Integration of 'Little Minds Matter' into the early years system.

Infant Mental Health relates to how well a child develops socially and emotionally from birth to age three. There is a well-established link between parent-infant relationship quality, Infant Mental Health, and longer-term social and emotional development there is a lack of evidence-based interventions that support the parent-infant relationship and/or protect against poor Infant Mental Health. Little Minds Matter is a specialist Infant Mental Health service developed in Bradford (UK) to support parent-infant relationships by providing training and consultation for professionals and direct clinical work to families. The successful implementation of this intervention depends upon how well it becomes embedded within, or integrated into, the early years system. For the purposes of this study, the early years system includes health, social and education services that support child health and development from conception to primary school entry at age five. This study protocol aims to apply a systems approach to evaluate this service and provide a perspective on the process of embedding a complex service within a healthcare system. Multiple methods will be used to investigate embeddedness within the wider early years system. Routinely collected quantitative data about the service will be used to develop a system map showing interaction with related services. Qualitative data will be collected at two time points through interviews with individuals involved in the design and provision of the service, and professionals working within the early years system. Framework analysis will be used to analyse the data inductively and deductively within a systems approach. The findings from this study will provide evidence to inform the ongoing implementation of the service for providers and commissioning bodies. Exploring the application of a systems approach in this clinical context will have application more broadly for researchers evaluating complex interventions and services within a wider system.

Impact of inconsistent ethnicity recordings on estimates of inequality in child health and education data: a data linkage study of Child and Adolescent Mental Health Services in South London.

OBJECTIVES: Ethnicity data are critical for identifying inequalities, but previous studies suggest that ethnicity is not consistently recorded between different administrative datasets. With researchers increasingly leveraging cross-domain data linkages, we investigated the completeness and consistency of ethnicity data in two linked health and education datasets. DESIGN: Cohort study. SETTING: South London and Maudsley NHS Foundation Trust deidentified electronic health records, accessed via Clinical Record Interactive Search (CRIS) and the National Pupil Database (NPD) (2007-2013). PARTICIPANTS: N=30 426 children and adolescents referred to local Child and Adolescent Mental Health Services. PRIMARY AND SECONDARY OUTCOME MEASURES: Ethnicity data were compared between CRIS and the NPD. Associations between ethnicity as recorded from each source and key educational and clinical outcomes were explored with risk ratios. RESULTS: Ethnicity data were available for 79.3% from the NPD, 87.0% from CRIS, 97.3% from either source and 69.0% from both sources. Among those who had ethnicity data from both, the two data sources agreed on 87.0% of aggregate ethnicity categorisations overall, but with high levels of disagreement in Mixed and Other ethnic groups. Strengths of associations between ethnicity, educational attainment and neurodevelopmental disorder varied according to which data source was used to code ethnicity. For example, as compared with White pupils, a significantly higher proportion of Asian pupils achieved expected educational attainment thresholds only if ethnicity was coded from the NPD (RR=1.46, 95% CI 1.29 to 1.64), not if ethnicity was coded from CRIS (RR=1.11, 0.98 to 1.26). CONCLUSIONS: Data linkage has the potential to minimise missing ethnicity data, and overlap in ethnicity categorisations between CRIS and the NPD was generally high. However, choosing which data source to primarily code ethnicity from can have implications for analyses of ethnicity, mental health and educational outcomes. Users of linked data should exercise caution in combining and comparing ethnicity between different data sources.

The Role of an Early Childhood Community Health Worker in Addressing Psycho-Social Needs in the Perinatal and Early Childhood Period.

OBJECTIVE: Addressing family psychosocial and mental health needs in the perinatal and early childhood period has a significant impact on long-term maternal and child health and is key to achieving health equity. We aimed to (1) describe and evaluate the role of an Early Childhood Community Health Worker (EC-CHW) to address psychosocial needs and improve psychosocial well-being for families in the perinatal period, and (2) examine factors associated with completion of goals. METHODS: An EC-CHW program was modeled after an existing hospital CHW program for children with special healthcare needs and chronic disease. An evaluation was conducted using repeated measures to assess improvements in psychosocial outcomes such as family stress and protective factors after participating in the EC-CHW program. Linear regression was also used to assess factors associated with completion of goals. RESULTS: Over a 21-month period (January 2019-September 2020), 161 families were referred to the EC-CHW. The most common reasons for referral included social needs and navigating systems for child developmental and behavioral concerns. There were high rates of family engagement in services (87%). After 6 months, families demonstrated statistically significant improvements in protective factors including positive parenting knowledge and social support. Only 1 key predictor variable, maternal depression, showed significant associations with completion of goals in the multivariable analysis. CONCLUSIONS: This study demonstrated the need for, and potential impact of an EC-CHW in addressing psychosocial and mental health needs in the perinatal period, and in a primary care setting. Impacts on protective factors are promising.

Franz Alfred (1880-1962) and Georg Frederich (1921-2010) Kantorowicz.

George Kantorowicz was a senior lecturer/consultant in conservative dentistry at the Royal Dental Hospital who provided ground-breaking treatment for cleft palate children at Great Ormond Street Hospital. His father, Alfred, was a Jewish professor, dean at Bonn Dental School and a world-famous advocate of mobile dental surgeries and prevention for children's dental health, until the Nazis put him in a concentration camp. After important interventions, he became director of Istanbul Dental Institute.