Effectiveness of a presentation on infant oral health care for parents.

PURPOSE: The aim of this study was to evaluate an infant oral health education programme, using a pre-post test design, for parents attending a paediatric clinic. METHODS: The subjects were parents attending the well baby appointments at 3, 6, and 9 months of age. The study participants were men and women, all with an infant between 3 and 12 months of age. A 16 question assessment in the form of a questionnaire was completed immediately before and after the introduction of a 30 min educational intervention in the form of a PowerPoint presentation and a video of infant oral hygiene for parents. The parents completed the questionnaire twice (pre-post test design) in the same visit. Recruited parents attended only one presentation. The presentation educated parents about infant oral health and provided anticipatory guidance. RESULTS: Forty-seven parents or caretakers participated in the study. On the pre-test 28% had a score of 70% or less, and on the post-test 87% got a score of 88% or better. On the pre-test, 72% had a score of 70% or higher, and on the post-test 87% got a score of 88% or higher. Most parents (80%) reported that the presentation was helpful and indicated that the information would change the way they care for their baby's teeth at home. CONCLUSION: This study demonstrated the effectiveness of a 30 min PowerPoint and Video presentation in improving the oral health knowledge of parents caring for an infant.

Effectiveness of a basic training presentation on infant oral health care for pediatric medicine residents.

OBJECTIVE: We hypothesize that viewing educational presentation with video will provide pediatric medicine residents with instructive information on infant oral health. Therefore, the aim of this study was to evaluate an infant oral health education program targeting University of Nebraska Medical Center (UNMC) pediatric medicine residents. METHODS: Assessment of 32 pediatric medicine residents in the form of a questionnaire was completed immediately before and after a 60 minute educational intervention. The intervention was in the form of a Power Point presentation and video of infant oral health for health care providers. The 16-questions (True/false/don't know or multiple choice) questionnaire was based on the information presented in the lecture and video. RESULTS: There was a significant difference between the pre-test and post-test scores (p-value < 0.001). The mean score on the pre-test was 10.09 out of 16 (63%) and the mean score on the post-test was 13.3 out of 16 (83%). There was no significant correlation between age, gender, or year of residency training with pre or post-test scores. Twenty-five (78.1%) reported themselves "very likely" to use the information. CONCLUSIONS: A one hour Power Point and video educational intervention was effective in teaching pediatric medicine residents basic information on infant oral health.

Complexity in pediatric primary care.

BACKGROUND: The management of patients in primary care is often complicated by the presence of multiple chronic conditions and psychosocial issues that increase the complexity of the encounter and have important impacts on care. There is a paucity of literature on this subject in the pediatric population. OBJECTIVES: The aim of this study was to quantify the burden of chronic conditions in pediatric primary care. METHODS: The problem lists of 3995 randomly selected patients from a community pediatric clinic and an academic hospital-based pediatric clinic in the same metropolitan area were analyzed for the presence and number of any chronic condition. RESULTS: In total, 53% of patients suffered from at least one chronic problem, 25% had two or more chronic conditions and 5.1% had four or more conditions. Compared with the community clinic, the academic clinic had significantly more children with catastrophic complex conditions (P<0.001). A regression analysis showed a significant positive correlation between the number of chronic medical conditions and mental health diagnoses. CONCLUSIONS: The burden of chronic disease in the pediatric primary care setting may be significantly higher than has been previously suggested. To ensure optimal quality of care, health planners should take into account the high burden of chronic illness, psychosocial issues and multimorbidity among patients in the pediatric primary care setting, as well as the higher complexity profile of patients attending academic clinics.

The "cough trick:" a brief strategy to manage pediatric pain from immunization injections.

OBJECTIVE: The goal was to investigate the effect of a "cough trick" technique on self-reported pain of children receiving routine immunizations. The strategy requires minimal equipment, time, or training for parents, children, and nursing staff members. METHODS: A randomized, controlled, unblinded, within-subject study of 68 children receiving prekindergarten (ages 4-5) or pre-junior high school (ages 11-13) immunizations was performed. Participants were recruited from an outpatient pediatric clinic at a large public hospital in the Midwest. The strategy required a single "warm-up" cough of moderate force, followed by a second cough that coincided with needle puncture. The principle outcome was self-reported pain, although parent and nurse report of pain was used to support the accuracy of self-report. Older participants and all nurses completed a measure of their satisfaction with the procedure. RESULTS: In the initial analysis, the procedure was found not to be effective. However, post hoc tests revealed that the procedure was effective at a statistically and clinically significant level for participants identified as Hispanic white or non-Hispanic white but not for those identified as non-Hispanic black. Participants and clinic nurses found the procedure acceptable and effective. CONCLUSIONS: The results of this study suggest that the cough trick can be an effective strategy for the reduction of pain for some children undergoing routine immunizations. However, additional research is needed to clarify the observed moderation by self-identified race.