The state and future of pediatric research-an introductory overview : The state and future of pediatric research series.

IMPACT: This is an introduction to an article series devoted to the current state and future of pediatric research. The role of public-private partnerships, influencing factors, challenges, and recent trends in pediatric research are described, with emphasis on funding, drug and device development, physician-scientist training, and diversity. Potential solutions and advocacy opportunities are discussed.

Parental enculturation and youth mental health functioning among Filipino American families.

Filipino Americans accounted for 2.9 million (16%) of the total U.S. Asian American population. As one of the fastest growing Asian immigrant groups, it is important to examine factors that could be targeted in interventions to better aid this community. OBJECTIVES: This study provided a unique perspective into the lives of Filipino American youth by utilizing a specific measure developed to assess different areas of enculturation among their Filipino American caregivers. The primary objectives of this study were to examine the associations among parental enculturation with parenting practices and youth internalizing and externalizing behaviors using regression analyses. METHOD: This study focused on 131 Filipino American families who participated in the Filipino Family Health Initiative. RESULTS: Our hypotheses were partially supported. Interpersonal norms was positively associated with harsh/inconsistent discipline, while conservatism was positively associated with appropriate discipline and praise/incentives. Connection with homeland was negatively associated with youth behavioral symptoms, while interpersonal norms was positively associated with youth behavioral symptoms. Inconsistent with hypotheses, connection with homeland was negatively associated with appropriate discipline. CONCLUSIONS: This highlighted the need for better understanding of the cultural experiences and values of Filipino American parents when working with Filipino American children in clinical and research settings. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Short-term outcomes from a pilot randomized controlled trial evaluating a virtual culturally adapted parenting intervention among Filipino parents of school-age children.

BACKGROUND: Filipino youth in the United States have significant behavioral health problems, including high rates of depression and suicidal behavior. Evidence-based parenting groups promote positive parenting practices and improve child behavior, yet few have been implemented online. OBJECTIVES: This study tested the short-term effects of a culturally adapted hybrid version of the Incredible Years School Age Basic and Advance Programs when delivered online among groups of parents of Filipino children and estimated intervention effect sizes. METHOD: Forty-nine parents of children aged 8-12 years recruited from schools, clinics, community organizations, and social media were randomly assigned to intervention or a wait-list control group that received literature from the American Academy of Pediatrics' Bright Futures program. The intervention consisted of 12 weekly 2-hr sessions. Parent perceptions of child behavior, parenting practices, and parenting stress as well as child surveys of anxiety and depression symptoms using validated assessments were obtained at baseline and 3-month postintervention follow-up. RESULTS: Forty parents completed both baseline and follow-up surveys with a mean attendance of 9.35 out of 12 sessions (n = 18). Analysis of covariance comparing 3-month (pre-/postintervention) changes revealed that the program had a statistically significant positive impact on parenting practices (positive verbal discipline, praise and incentives, and clear expectations); parent perceptions of their child's internalizing symptoms; and child-reported anxiety and depression symptoms. CONCLUSIONS: Results support the feasibility and potential effectiveness of offering an online evidence-based parenting program to promote positive parenting and decrease child anxiety and depression. This multigenerational approach to mental health prevention could potentially help address the growing mental health epidemic among youth. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Perspectives from the Society for Pediatric Research: contaminants of water and children's health: Can we do better?

Children are uniquely susceptible to the health consequences of water contamination. In this review, we summarize the existing, robust literature supporting the importance of examining specific water contaminants (i.e., lead, pesticides, nitrates, arsenic, perchlorate) and the routes of contamination in the United States and globally. We also discuss the health effects of exposure to contaminated water and significant disparities related to access to clean water. Lastly, we offer strategies for prevention and intervention-including those focused on the individual patient level-and review the current US policy framework pertaining to regulation of these toxicants. IMPACT: A key message in this article is that exposure to water contaminants have serious and long-lasting consequences on children's health. This review summarizes current existing literature and adds policy recommendations supporting clean water for children. Information from this review has two potential impacts: Guide health professionals in screening and/or treating children's health problems resulting from water contaminant exposure. Guide policy makers in using evidence-based approaches to improve water quality and clean water access.

Correction: Policy threats to maternal and child nutrition: putting the unborn child at a lifelong disadvantage.

Following publication of this article the authors noticed that affiliations were incorrectly assigned. The original article has now been updated so that the author "Joyce R. Javier" is associated with the "Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Department of Pediatrics, Division of General Pediatrics, Los Angeles, CA, USA", and the author "Vivek Balasubramaniam" is associated with the "Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, USA". This has been corrected in both the PDF and HTML versions of the article.

Voices of the Filipino Community Describing the Importance of Family in Understanding Adolescent Behavioral Health Needs.

Filipinos are a large, yet invisible, minority at high risk for adolescent behavioral health problems. Limited research describes the family as offering a source of positive support for some Filipino youths and yet for some it is also a source of stress and isolation, leading to struggles with adolescent depression and suicidal behavior. This article describes a qualitative study that investigates the role of family when understanding behavioral health needs among Filipino adolescents. Findings highlight the importance of addressing family cohesion when designing interventions aimed at improving the well-being of Filipino youth.

Prevention of Filipino Youth Behavioral Health Disparities: Identifying Barriers and Facilitators to Participating in "Incredible Years," an Evidence-Based Parenting Intervention, Los Angeles, California, 2012.

INTRODUCTION: Evidence-based interventions for training parents are proven to prevent onset and escalation of childhood mental health problems. However, participation in such programs is low, especially among hard-to-reach, underserved populations such as Filipino Americans. Filipinos, the largest Asian subgroup in California, have significant behavioral health disparities compared with non-Hispanic whites and other Asian subgroups. The purpose of this study was to learn about Filipinos' barriers and facilitators to participating in "Incredible Years" (IY), a parenting program. METHODS: We conducted 4 focus groups in Los Angeles, California, in 2012; the groups consisted of 20 Filipino parents of children aged 6 to 12 years who recently completed the IY parenting program, which was offered as a prevention workshop. Three reviewers, including two co-authors (A.S., J.J.) and a research assistant used content analysis to independently code the interview transcripts and extract subthemes. Grounded theory analytic methods were used to analyze interview transcripts. RESULTS: Parents' perceived benefits of participation in IY were learning more effective parenting techniques, networking with other parents, improved spousal relationships, and improvements in their children's behavior. Parents' most common motivating factor for enrollment in IY was to improve their parenting skills and their relationships with their children. The most common barriers to participation were being uncomfortable sharing problems with others and the fear of being stigmatized by others judging their parenting skills. Participants said that parent testimonials would be the most effective way to promote IY. Many recommended outreach at schools, pediatricians' offices, and churches. CONCLUSION: Increasing Filipino American parent enrollment in IY in culturally relevant ways will reduce the incidence of mental health disorders among children in this growing population.

Community Advocacy in Pediatric Practice: Perspectives from the Field.

Pediatrics is a specialty that is grounded in advocacy, possibly more than any other field of medicine. Infants, children, and adolescents depend on others to cover their basic needs including food, shelter, and education and rely on proxy voices to speak out on their behalf. In this article, we describe the importance of community advocacy in pediatrics, best practices for training pediatricians in community advocacy, and case studies to highlight trainee experiences and demonstrate how community advocacy and community-based participatory research can be incorporated in the career of a pediatrician.

Health Equity and Enrollment in Preventive Parenting Programs: A Qualitative Study of Filipino Parents.

This qualitative study identified the parent health beliefs and normative beliefs related to child behavioral and mental health problems and examined the benefits and barriers of enrolling in an evidence-based parenting intervention among Filipino parents of school-aged children. A secondary aim was to also use the results to inform the development of a theory-based video intervention to increase enrollment in parenting interventions. Semi-structured interviews were conducted with fifteen parents who had or had not participated in the Incredible Years® parenting program, an evidence-based parenting intervention. Interviews were recorded and transcribed verbatim. Using a "Coding Consensus, Co-occurrence, and Comparison" methodology, emergent themes were mapped into a matrix against a priori-coded health belief model (HBM) and Theory of Planned Behavior (TPB) constructs. Parents believed that perceived susceptibility could be influenced by including knowledge of health disparities affecting Filipino youth in the U.S. Perceived severity was related to behavioral and mental health concerns about school, family dynamics, bullying and parent coping strategies. Perceived benefits included strengthening parent-child relationships, creating support systems, and learning positive parenting skills. Perceived barriers included logistics, stigma, and the perception of the relevance of the program, cultural factors such as generational differences about parenting, and family issues. Social norms and subjective norms related to parent participation were also discussed. Applying the HBM and TPB to enrollment in parenting interventions may explain low enrollment rates. Future interventions need to target perceived susceptibility to future behavioral health problems, barriers, and benefits to enrollment, and influence subjective and social norms.

Developmental Changes in Food Perception and Preference.

Food choices are a key determinant of dietary intake, with brain regions, such as the mesolimbic and prefrontal cortex maturing at differential rates into adulthood. More needs to be understood about developmental changes in healthy and unhealthy food perceptions and preference. We investigated how food perceptions and preference vary as a function of age and how food attributes (taste and health) impact age-related changes. One hundred thirty-nine participants (8-23 years, 60 females) completed computerized tasks to rate high-calorie and low-calorie food cues for taste, health, and liking (preference), followed by 100 binary food choices based on each participant's ratings. Dietary self-control was considered successful when the healthier (vs. tastier) food was chosen. Self-control success ratio was the proportion of success trials over total number of choices. Beta-weights for health (ß-health) and taste (ß-taste) were calculated as each attribute's influence on food preference. Adiposity measurements included BMI z-score and waist-to-height ratio (WHtR). High-calorie foods were rated more tasty and less healthy with increasing age. Older participants liked high-calorie foods more (vs. younger participants), and ß-taste was associated with age. Significant age-by-WHtR interactions were observed for health and taste ratings of high-calorie foods, ß-taste, and marginally for preference of high-calorie foods. Stratifying by WHtR (high, low), we found age-related increases in taste and preference ratings of high-calorie foods in the high WHtR group alone. In contrast, age-related decreases in health ratings of high-calorie foods were significant in the low WHtR group alone. Age and ß-taste were significantly associated in the high WHtR group and only marginally significant with low WHtR. Although participants rated low-calorie foods as less tasty and less healthy with increasing age, there was no association between age and preference for low-calorie foods. Participants made faster food choices with increasing age regardless of WHtR, with a significant age-by-WHtR interaction on reaction time (RT). There were no age-related effects in self-control success ratio and ß-health. These results suggest that individual differences in age and central adiposity play an important role in preference for high-calorie foods, and a higher importance of food tastiness in food choice may contribute to greater preference for high-calorie foods with increasing age.

Children with special health care needs: how immigrant status is related to health care access, health care utilization, and health status.

To compare health care access, utilization, and perceived health status for children with SHCN in immigrant and nonimmigrant families. This cross-sectional study used data from the 2003 California Health Interview Survey to identify 1404 children (ages 0-11) with a special health care need. Chi-square and logistic regression analyses were used to examine relations between immigrant status and health access, utilization, and health status variables. Compared to children with special health care needs (CSHCN) in nonimmigrant families, CSHCN in immigrant families are more likely to be uninsured (10.4 vs. 4.8%), lack a usual source of care (5.9 vs. 1.9%), report a delay in medical care (13.0 vs. 8.1%), and report no visit to the doctor in the past year (6.8 vs. 2.6%). They are less likely to report an emergency room visit in the past year (30.0 vs. 44.0%), yet more likely to report fair or poor perceived health status (33.0 vs. 16.0%). Multivariate analyses suggested that the bivariate findings for children with SHCN in immigrant families largely reflected differences in family socioeconomic status, parent's language, parental education, ethnicity, and children's insurance status. Limited resources, non-English language, and limited health-care use are some of the barriers to staying healthy for CSHCN in immigrant families. Public policies that improve access to existing insurance programs and provide culturally and linguistically appropriate care will likely decrease health and health care disparities for this population.