"Teddy Bear Hospital Project" school visits improve pre-clerkship students' comfort explaining medical concepts to children.

The "Teddy Bear Hospital Project" (TBHP) is a low cost, international initiative aimed at reducing children's fears associated with healthcare visits by modelling these interactions using teddy bears. The University of Ottawa program had the additional objective of assessing whether TBHP increased pre-clerkship medical students' comfort communicating medical concepts to children. Our student volunteers reported a statistically significant increase in their comfort communicating medical topics to young children and all volunteers would recommend TBHP to a colleague interested in pursuing family medicine or pediatrics. Our program could also be easily replicated by Pediatric Interest Groups at other Canadian medical schools.

Le «Teddy Bear Hospital Project¼ (TBHP) est une initiative internationale à faible coût visant à apaiser les craintes des enfants liées aux visites médicales en modélisant ces interactions à l'aide d'ourson en peluche. Le programme de l'Université d'Ottawa avait pour objectif supplémentaire de déterminer si le TBHP permettait aux étudiants du pré-externat de communiquer plus facilement des concepts médicaux aux enfants. Nos étudiants bénévoles ont signalé une augmentation statistiquement significative de leur aisance à communiquer des notions médicales à de jeunes enfants et tous les bénévoles recommanderaient le TBHP à des collègues intéressés par la médecine familiale ou la pédiatrie. Notre programme peut être facilement reproduit par les groupes d'intérêt en pédiatrie d'autres facultés de médecine au Canada.

Impacting child health outcomes in congenital heart disease: Cluster randomized controlled trial protocol of in-clinic physical activity counselling.

BACKGROUND: Most (>90%) children with congenital health defects are not active enough for optimal health. Proactively promoting physical activity during every clinic visit is recommended, but rarely implemented due to a lack of appropriate resources. METHODS: This cluster randomized controlled trial will implement an evidence-based, multi-faceted physical activity intervention. All eligible patients at small (London, ON), medium (Ottawa, ON) and large (Edmonton, AB) pediatric cardiac clinics will be approached, with randomization to intervention/control by clinic and week. Intervention patients will be counselled with 5 key physical activity messages, have questions about physical activity answered, and have access to a custom web site with personalized activity suggestions and support from a Registered Kinesiologist. The primary outcome is daily physical activity (number of steps, minutes of moderate-to-vigorous activity) assessed via pedometer one week per month for 6-months. Standardized questionnaires assess activity motivation and quality of life at baseline and end of study. Healthcare outcomes will be clinic visit time and contacts for physical activity concerns. Repeated measures ANCOVA will compare control/intervention pedometer outcomes, adjusting for covariates (alpha=0.05). CONCLUSIONS: This trial aims to determine whether providing resources and protocols enables clinicians to counsel about physical activity as part of every pediatric cardiology appointment. Evaluations of healthcare system impact and intervention delivery in small, medium and large clinics will assess applicability for implementation in all pediatric cardiac clinics. The impact on physical activity motivation and participation will evaluate the effectiveness of this standardized approach for increasing physical activity in children with congenital heart defects.