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1.
Am J Orthod Dentofacial Orthop ; 156(2): 169-177.e2, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31375226

RESUMO

INTRODUCTION: A randomized controlled trial was undertaken to compare the efficacy of 3 methods of delivering information on short- and long-term recall of information in orthodontic patients and parents. METHODS: Participants who received an audiovisual presentation on orthodontic treatment were randomly allocated to 1 of 3 written information groups (leaflets, generic mind map, or participant's customized mind map). A questionnaire was used to assess short- and long-term retention of information (maximum score 30). RESULTS: Eighty-eight patients (94.6%) and 77 parents (86.5%) completed the study. The average knowledge scores at baseline for the patient groups were 17.71 95 CI 16.28-19.14), 16.58 (14.67-18.49), and 17.37 (15.92-18.81), respectively. The parents' knowledge scores for the 3 groups were 19.06 (17.51-20.62), 19.39 (17.44-21.35), and 18.76 (17.19-20.33), respectively. The short- and long-term knowledge scores improved over baseline in all 3 groups (P <0.0001). The parents achieved higher scores than the patients (P = 0.002) and their rate of forgetting information was less. The knowledge scores of the mind map groups were higher than that of the leaflet group for all cohorts (P = 0.025). No statistical difference was found between the type of mind map. The correlation between patient and parent knowledge scores was significant (P <0.0001) at all 3 time points. CONCLUSIONS: Provision of an audiovisual presentation supplemented with 1 of 3 written information methods is an effective way of delivering information. There was a significant improvement in the retention of information with the use of mind maps compared with leaflets. The generic mind map is equally as effective, more consistent in information delivered, and less labor intensive than the individual customized mind map and therefore would be our recommendation. Participation of parents is important because they comprehend and retain information better. In this study, 100% of parents shared information with their children, perhaps improving the patients' recall.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Ortodontia Corretiva/psicologia , Ortodontia/educação , Pais/educação , Educação de Pacientes como Assunto , Adolescente , Adulto , Criança , Comunicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto/métodos , Inquéritos e Questionários , Reino Unido , Gravação em Vídeo , Redação
2.
Artigo em Alemão | MEDLINE | ID: mdl-31263914

RESUMO

Too often, diagnosis of maltreatment is missed by healthcare professionals - thus denying children in danger from necessary protection. Insufficient knowledge and insecurities towards professional confidentiality and how to approach child protection services may be the reasons for the failure to protect children effectively.In this article, we present how a comprehensive concept by the competence center of child protection in medicine of the state of Baden-Wurttemberg consisting of peer counseling, peer education, and research can add to the prevention of maltreatment. One component is peer counseling through a telephone helpline that is accessible 24/7, the medical child protection hotline. The requests to the helpline are analyzed and add to the generation of tailored content for the education of doctors, psychotherapists, nurses, and other healthcare professionals. As an example, we present the online course "Child protection in medicine - a basic course for all health professionals" (so far available only in German). One common issue when the child protection hotline is called for counseling is abusive head trauma. Research shows that sometimes a diagnosis of abusive head trauma might be missed. This condition is most prevalent in children under the age of 2 and represents one of the most severe forms of physical abuse with high mortality.Inquiries to the medical child protection hotline are constantly increasing, but making the service known nationwide to all healthcare professionals still poses a challenge. The online course is widely used and being constantly improved. The comprehensive concept of peer counseling, education, and research is an important contribution to the improvement of the prevention of child maltreatment.


Assuntos
Maus-Tratos Infantis/prevenção & controle , Traumatismos Craniocerebrais/prevenção & controle , Educação em Saúde , Pais/educação , Síndrome do Bebê Sacudido/prevenção & controle , Criança , Serviços de Proteção Infantil , Aconselhamento , Alemanha , Humanos
3.
Eur J Oncol Nurs ; 41: 126-134, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31358245

RESUMO

PURPOSE: Parents have a desire and need for instructive support from healthcare professionals on how best to communicate a cancer diagnosis with their dependent children. Healthcare professionals lack confidence to initiate and facilitate parent-child communication, reporting the need for training. To address the evident gap, this paper outlines the planning, development and testing phases of an e-learning intervention, using a person-based approach. METHODS: The planning and development phases combined evidence from reviews of qualitative and quantitative literature, an expert group and data generated from primary research of two focus groups with frontline oncology professionals (n = 23) to develop the e-learning intervention prototype. An iterative approach was adopted with 14 'think aloud' interviews for prototype usability testing, resulting in continuous movement between data collection, analysis and modification of the e-learning intervention. RESULTS: Involving end-users throughout all phases of this process, optimised the intervention development. As a result, a communication framework on how healthcare professionals can initiate these conversations with parents was integrated, alongside role-play videos and original artwork by children expressing their views associated with parental cancer. During the testing phase, think-aloud interviews identified key navigational difficulties which were modified and resolved. Minor modifications were made to the content and 'look and feel' of screen pages. CONCLUSIONS: The systematic and iterative, person-based approach, yielded important and complementary insights to enhance acceptability of the e-learning intervention. Providing a detailed description of the foundations that underpinned the development of this e-learning intervention, promotes transparency in the planning and design process, therefore aids methodological rigour.


Assuntos
Instrução por Computador/métodos , Pessoal de Saúde/educação , Neoplasias/psicologia , Relações Pais-Filho , Pais/educação , Pais/psicologia , Educação de Pacientes como Assunto/métodos , Adulto , Comunicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
4.
Accid Anal Prev ; 131: 63-69, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31233996

RESUMO

This randomized controlled trial evaluated the impact of integrating Steering Teens Safe, a parent communication intervention, with feedback from an in-vehicle video recording system. In-vehicle video systems that trigger a recording when the vehicle exceeds a g-force threshold have been used to provide feedback to young drivers. Few of these programs have involved parental engagement. Parent-teen dyads were randomized to three groups and 150 dyads completed the study. All groups received an in-vehicle video system that recorded driving events. The control group received no feedback or intervention. In the first intervention group, teens received real-time feedback, and parent-teen dyads received summary feedback, based on information recorded by the in-vehicle system. The second intervention group received the same feedback, plus parents were taught strategies to improve communication with their teen about safe driving. The primary outcome variable was unsafe driving event rates per 1000 miles driven and the primary independent variable was group assignment. Generalized linear models were used to calculate effect estimates. Compared with the control group, the Event Recorder Feedback group had a rate ratio of 0.35 (95% CI = 0.24 - 0.50) and the combined intervention group (Event Recorder Feedback and parent communication) had a rate ratio of 0.21 (95% CI = 0.15 - 0.30). Furthermore, the combined intervention group had a significantly lower event rate than the Event Recorder Feedback only group (rate ratio = 0.60, 95% CI = 0.41 - 0.87). While in-vehicle feedback systems can help reduce unsafe driving events in early independent driving, teaching parents strategies for effective communication with their young driver may further improve impact.


Assuntos
Condução de Veículo/educação , Pais/educação , Acidentes de Trânsito/prevenção & controle , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Comunicação , Retroalimentação , Feminino , Humanos , Modelos Lineares , Masculino
5.
Public Health ; 173: 50-57, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31254678

RESUMO

OBJECTIVES: The aim of this study was to explore factors which mediated or moderated the effect of the Time2bHealthy online program for parents of preschool-aged children on body mass index (BMI) change. STUDY DESIGN: Mediation and moderation analyses of data from a two-arm parallel randomised controlled trial. METHODS: Randomisation was conducted after baseline measures. The intervention group received an 11-week online program, and the comparison group received emailed links to information from an evidence-based parenting website. Data on the primary outcome (child BMI), potential mediators (energy intake, fruit and vegetable intake, discretionary food intake, physical activity, screen-time, sleep, child feeding, parent self-efficacy or parent role-modelling) and potential moderators (child age, parent age, parent income, parent education or parent living situation) were collected at baseline, 3 months and 6 months. PROCESS macro for SPSS was used to analyse possible mediators and moderators on BMI outcomes. RESULTS: Despite significant food-related outcomes in the main analysis of this trial, no significant mediating or moderating effects were found for any hypothesised mediators or moderators. CONCLUSIONS: This study's null results could be explained by the high proportion of children in the healthy weight range, the study period not being long enough to detect change, the multicomponent nature of the intervention or the relatively small number of outcomes measured. Future childhood obesity interventions should continue to explore the effects of mediators and moderators on BMI and consider collecting data on a wide range of mediating and moderating factors to allow for comparison between studies to develop a better understanding of the factors contributing to successful interventions.


Assuntos
Instrução por Computador/métodos , Promoção da Saúde/métodos , Promoção da Saúde/organização & administração , Estilo de Vida Saudável , Pais/educação , Obesidade Pediátrica/prevenção & controle , Obesidade Pediátrica/terapia , Índice de Massa Corporal , Peso Corporal , Pré-Escolar , Dieta , Exercício , Comportamento Alimentar , Feminino , Humanos , Masculino , Poder Familiar , Comportamento Sedentário , Autoeficácia , Sono/fisiologia
6.
Rech Soins Infirm ; (136): 66-79, 2019 03.
Artigo em Francês | MEDLINE | ID: mdl-31210502

RESUMO

INTRODUCTION: An educational group talk on caring for a child is offered to all parents as part of their preparation for being discharged from the maternity unit. A nursey nurse and a childcare assistant lead a group of parents on the following themes: the rhythms of a newborn, sleeping, feeding, and caring for a child. Videos and leaflets are used as teaching aids. METHOD: 100 parents completed a satisfaction questionnaire that also questioned their sense of competence. RESULTS: 80% of parents were totally satisfied with the session but only 52% felt fully competent when it came to taking care of their child. This figure was at 69% for sleeping, 71% for temperature, and 57% for preventing infections and accidents. Mothers' satisfaction with participation was significant (p<0.013) for primiparous women (n=46) if they were listened to about their concerns. The same was true for multiparous women (n=35) if they were able to express themselves freely (p<0.018) by sharing their experiences. DISCUSSION: This educational group talk that prepares families for leaving the maternity unit must evolve into a sharing by the group of knowledge and practices where care-givers remain guarantors of their validity. It helps parents to develop child care skills for a more confident return home. The above-average sense of self-efficacy demonstrates the benefits of this method of family health education.


Assuntos
Unidade Hospitalar de Ginecologia e Obstetrícia , Relações Pais-Filho , Pais/educação , Alta do Paciente , Feminino , Humanos , Recém-Nascido , Masculino , Pais/psicologia , Satisfação do Paciente/estatística & dados numéricos
7.
BMC Health Serv Res ; 19(1): 394, 2019 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-31217007

RESUMO

BACKGROUND: Traditionally, the care of infants in neonatal care units has been professionally centered, paying less attention to family support. In recent years, many interventions have been developed to improve family-centered care and thereby parent and infant outcomes. Understanding the key factors of implementation of these interventions would help improve clinical practice. The aim of this study was to describe the staff's perceptions of the implementation of the Close Collaboration with Parents Training Program and to identify the barriers and facilitators of the implementation. METHODS: A descriptive qualitative interview study was conducted in eight neonatal intensive care units in Finland. Nineteen unit managers and 32 nurses were interviewed after their unit had finished the 1.5-year training program. Data were analyzed using thematic content analysis. RESULTS: Key factors facilitating the implementation of the training program were multidisciplinary commitment and the staff's motivation to change their professional role to work as the parents' facilitator. Observable benefits promoted the implementation, as well as experiential learning as a facilitation method. The role of mentor was remarkable as a facilitator. In addition, contextual elements such as support from leadership and proper timing were important. CONCLUSIONS: Implementation of family-centered care is facilitated by staff who is prepared to accept parents as partners and adopt a new professional role. Enough time for preparation, readiness for the change, solid support from the leadership, and a multidisciplinary approach are needed as well. Mentoring was found to be one of the key factors facilitating the change.


Assuntos
Unidades de Terapia Intensiva Neonatal , Pais/educação , Assistência Centrada no Paciente/métodos , Adulto , Feminino , Finlândia , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal/normas , Masculino , Pessoa de Meia-Idade , Desenvolvimento de Programas , Pesquisa Qualitativa , Melhoria de Qualidade
9.
J Forensic Nurs ; 15(2): 93-102, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31116177

RESUMO

Commercial sexual exploitation of children (CSEC) is the sexual abuse of children through buying, selling, or trading their sexual services. This may involve engaging a child under the age of 18 years in prostitution, pornography, stripping, exotic dancing, escort services, or other sexual services. CSEC is a problem of epidemic proportions throughout the world including the United States; however, the actual number of CSEC victims in the United States is unknown. Studies indicate that most child victims are seen by a healthcare provider while being trafficked and that many victims receive care at a pediatric hospital within 1 year of their identification as a victim. CSEC is a significant pediatric healthcare problem. It is vital that forensic nurses possess a thorough understanding of the problem and be poised to better identify, intervene, and prevent CSEC. In this article, we focus on risk factors commonly experienced by victims, recruitment strategies used by traffickers, indicators to identify child victims, and intervention and educational strategies of relevance to forensic nurses.


Assuntos
Abuso Sexual na Infância/diagnóstico , Abuso Sexual na Infância/prevenção & controle , Enfermagem Forense , Adolescente , Criança , Literatura Erótica , Pessoal de Saúde/educação , Necessidades e Demandas de Serviços de Saúde , Tráfico de Pessoas/prevenção & controle , Humanos , Anamnese , Papel do Profissional de Enfermagem , Avaliação em Enfermagem , Pais/educação , Exame Físico , Serviços Preventivos de Saúde , Fatores de Risco , Trabalho Sexual
10.
J Autism Dev Disord ; 49(8): 3309-3315, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31093801

RESUMO

Anxiety in children with Autism Spectrum Disorder (ASD) contributes to their functional impairment. We evaluated a cognitive-behavioral program for anxiety and social deficits in children with ASD in two schools in Nairobi City, Kenya. Parents and teachers of 40 children and adolescents with ASD (5-21 years) participated, randomized by school. The two schools were randomly assigned to either intervention (n = 20) or control (n = 20). There was a significant improvement in ASD severity as well as anxiety within the treatment group, which was not seen in the control group. These findings support the expansion of treatments for ASD core deficits and secondary problems in youth with ASD in developing countries.


Assuntos
Ansiedade/terapia , Transtorno do Espectro Autista/terapia , Terapia Comportamental/métodos , Intervenção Precoce (Educação)/métodos , Habilidades Sociais , Adolescente , Criança , Feminino , Humanos , Quênia , Masculino , Pais/educação , Instituições Acadêmicas
12.
J Psychosoc Nurs Ment Health Serv ; 57(5): 15-19, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31042296

RESUMO

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social interactions and communication and repetitive stereotypical behaviors. Early recognition and treatment are critical to the treatment gains and prognosis of this disorder in children and adolescents. However, there can be several limitations to initiating a timely intervention, including financial constraints, limited resources, lack of trained providers, and lack of access to health care. In this context, non-specialist mediated interventions for ASD can provide an alternative approach to address the treatment gaps and lack of resources. The current article provides an overview of such interventions for children and adolescents with ASD. [Journal of Psychosocial Nursing and Mental Health Services, 57(5), 15-19.].


Assuntos
Transtorno do Espectro Autista/terapia , Relações Interpessoais , Pais/educação , Adolescente , Criança , Comunicação , Humanos , Pais/psicologia , Jogos e Brinquedos , Telemedicina/métodos
13.
Prax Kinderpsychol Kinderpsychiatr ; 68(4): 305-315, 2019 May.
Artigo em Alemão | MEDLINE | ID: mdl-31044672

RESUMO

For the Benefit of the Children - Judical Requested Counselling of High Conflict Parents in Educational- and Family-Counselling Educational- and Family Counselling supports families as assistance for parenting for a successful growing up of children. Family Counselling is a voluntary offer, which is provided by a multi professional team. The counselling is confidential and bound to secrecy. According to the regulations of the law concerning the proceedings in family cases and the non-contentious jurisdiction (FamFG) the court has several options for action, such as, for example, to order a counselling in the context of child and youth service. Court related inquiries have led to advancement in Educational- and Family Counselling. In the article basic aspects of specific approaches are described.


Assuntos
Psiquiatria do Adolescente/legislação & jurisprudência , Psiquiatria Infantil/legislação & jurisprudência , Aconselhamento/legislação & jurisprudência , Terapia Familiar , Poder Familiar , Pais/educação , Pais/psicologia , Adolescente , Psiquiatria do Adolescente/métodos , Criança , Psiquiatria Infantil/métodos , Humanos , Poder Familiar/psicologia
14.
J Clin Nurs ; 28(17-18): 3330-3338, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31091340

RESUMO

AIMS AND OBJECTIVES: To explore expectant and new parents' reasons not to participate in parental education (PE) groups in antenatal care or child health care. BACKGROUND: In Sweden, expectant and new parents are offered PE groups in antenatal care and in child health care. Although many parents feel unprepared for parenthood, an urgent task is to attract parents to attend the PE groups. DESIGN: A total of 915 parents with children aged 0 to 21 months answered a web questionnaire with open questions about (a) reasons not to participate; (b) anything that could change their mind; and (c) parenting support instead of PE groups. This was analysed using content analysis. The study follows the SRQR guidelines. RESULTS: Parents expressed private reasons for not attending PE groups. Some parents also asked for more heterogeneity regarding content and methods, as well as accommodation of parents' different interests. Other parents asked for like-minded individuals who were in similar situation to themselves. Lack of information or invitations from antenatal care or child health care, or that PE groups were unavailable, were additional reasons for not participating in groups. CONCLUSIONS: Reasons for not attending PE groups were multifaceted from personal, self-interested and norm-critical reasons, to that the groups were not available or that the parents were not aware of their existence. RELEVANCE TO CLINICAL PRACTICE: Parents of today are a diverse group with different interests and needs. Nevertheless, all parents need to feel included in a way that makes participation in PE groups relevant for them. Thus, it is important for leaders to be aware of structures and norms, and to be able to create a group climate and a pedagogy of acceptance where group members value each other's differences. However, to attract parents to participate in PE groups, it is necessary for clinical practice to work on individual, group and organisational levels.


Assuntos
Poder Familiar/psicologia , Pais/educação , Cuidado Pré-Natal/psicologia , Atitude Frente a Saúde , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pais/psicologia , Gravidez , Cuidado Pré-Natal/organização & administração , Pesquisa Qualitativa , Inquéritos e Questionários , Suécia
15.
Glob Health Action ; 12(1): 1603491, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31062667

RESUMO

During the past decades innovative research has shown that exposure to harmful events during pregnancy and early infancy ('the first 1000 days') has an impact on health at subsequent stages of the life course and even across generations. Recently it has been shown that even the pre-conception period is of outmost importance, and other scholars have made the case that the 1000 days should be extended to a period of 8000 days post-conception. The present contribution aims to bridge further the gap between research evidence and public health policy by applying a holistic 'full-cycle' perspective. Thus, a conceptual framework is suggested for guiding public health prioritization, including the variables of 'impact on the next generation', 'plasticity' and 'available interventions with documented impact'. This framework could guide decision makers in selecting at which stages of the life course to invest (and not), and furthermore it points to some pertinent research priorities.


Assuntos
Promoção da Saúde/métodos , Estilo de Vida Saudável , Cuidado do Lactente/métodos , Pais/educação , Cuidado Pré-Natal/métodos , Saúde Pública/métodos , Política Pública , Adulto , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez
16.
BMC Public Health ; 19(1): 582, 2019 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-31096944

RESUMO

BACKGROUND: Obesity and overweight have increased dramatically in the United States over the last decades. The complexity of interrelated causal factors that result in obesity needs to be addressed within the cultural dynamic of sub-populations. In this study, we sought to estimate the effects of a multifaceted, community-based intervention on body mass index (BMI) among Mexican-heritage children. METHODS: Niños Sanos, Familia Sana (Healthy Children, Healthy Family) was a quasi-experimental intervention study designed to reduce the rate of BMI growth among Mexican-heritage children in California's Central Valley. Two rural communities were matched based on demographic and environmental characteristics and were assigned as the intervention or comparison community. The three-year intervention included parent workshops on nutrition and physical activity; school-based nutrition lessons and enhanced physical education program for children; and a monthly voucher for fruits and vegetables. Eligible children were between 3 and 8 years old at baseline. Intent-to-treat analyses were estimated using linear mixed-effect models with random intercepts. We ran a series of models for each gender where predictors were fixed except interactions between age groups and obesity status at baseline with intervention to determine the magnitude of impact on BMI. RESULTS: At baseline, mean (SD) BMI z-score (zBMI) was 0.97 (0.98) in the intervention group (n = 387) and 0.98 (1.02) in the comparison group (n = 313) (NS). The intervention was significantly associated with log-transformed BMI (ß = 0.04 (0.02), P = 0.03) and zBMI (ß = 0.25 (0.12), P = 0.04) among boys and log-transformed BMI among obese girls (ß = - 0.04 (0.02), P = 0.04). The intervention was significantly and inversely associated with BMI in obese boys and girls across all age groups and normal weight boys in the oldest group (over 6 years) relative to their counterparts in the comparison community. CONCLUSIONS: A community-based, multifaceted intervention was effective at slowing the rate of BMI growth among Mexican-heritage children. Our findings suggest that practitioners should consider strategies that address gender disparities and work with a variety of stakeholders to target childhood obesity. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01900613 . Registered 16th July 2013.


Assuntos
Índice de Massa Corporal , Promoção da Saúde/métodos , Americanos Mexicanos , Obesidade Pediátrica/etnologia , Obesidade Pediátrica/prevenção & controle , California , Criança , Pré-Escolar , Exercício , Feminino , Humanos , Masculino , México/etnologia , Pais/educação , Avaliação de Programas e Projetos de Saúde , População Rural
17.
J Autism Dev Disord ; 49(9): 3477-3493, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31127486

RESUMO

In two studies, we investigated the effectiveness of parent education in Pivotal Response Treatment (PRT) on parent-created opportunities and spontaneous child initiations in two community-based treatment facilities for children with autism spectrum disorder (ASD). Changes in parental stress and self-efficacy were explored. Participants were 26 parents and their children who participated in group (Study 1) or individual (Study 2) parent education in PRT. Results indicated that group-based parent education resulted in moderate increases in opportunities, functional initiations, and empathic social initiations. Furthermore, parental stress reduced and self-efficacy increased. Individual parent education resulted in large increases in opportunities and functional initiations, but parental stress and self-efficacy did not change. Implications for clinical practice and directions for future research are discussed.


Assuntos
Transtorno do Espectro Autista/terapia , Pais/educação , Educação de Pacientes como Assunto/normas , Transtorno do Espectro Autista/reabilitação , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Autoeficácia
18.
BMC Public Health ; 19(1): 419, 2019 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-30999881

RESUMO

BACKGROUND: Early childhood is a crucial time to foster healthy eating and physical activity (PA) habits, which are critical for optimal child health, growth and development. Child care facilities are important settings to promote healthy eating and PA and prevent childhood obesity; however, almost all prior intervention studies have focused on child care centers and not family child care homes (FCCH), which care for over 1.6 million U.S. children. METHODS: This paper describes Healthy Start/Comienzos Sanos, a cluster-randomized trial evaluating the efficacy of a multicomponent intervention to improve nutrition and PA environments in English and Spanish-speaking FCCH. Eligible child care providers complete baseline surveys and receive a two-day FCCH observation of the home environment and provider practices. Parent-consented 2-5 year-old children are measured (height, weight, waist circumference), wear accelerometers and have their dietary intake observed during child care using validated protocols. FCCH providers are then randomly assigned to receive an 8-month intervention including written materials tailored to the FCCH providers' need and interest, videos, peer support coaching using brief motivational interviewing, and periodic group meetings focused on either nutrition and PA (Intervention) or reading readiness (Comparison). Intervention materials focus on evidence-based nutrition and physical activity best practices. The initial measures (surveys, two-day observation of the FCCH and provider practices, child diet observation, physical measures, and accelerometer) are assessed again 8 and 12 months after the intervention starts. Primary outcomes are children's diet quality (Healthy Eating Index), time in moderate and vigorous PA and sedentary PA during child care. Secondary outcomes include FCCH provider practices and foods served, and PA environments and practices. Possible mediators (provider attitudes, self-efficacy, barriers and facilitators) are also being explored. Process evaluation measures to assess reach, fidelity and dose, and their relationship with dietary and PA outcomes are included. DISCUSSION: Healthy Start/Comienzos Sanos fills an important gap in the field of childhood obesity prevention by rigorously evaluating an innovative multicomponent intervention to improve the nutrition and physical activity environments of FCCH. TRIAL REGISTRATION: (# NCT02452645 ) ClinicalTrials.gov Trial registered on May 22, 2015.


Assuntos
Cuidado da Criança/organização & administração , Promoção da Saúde/organização & administração , Dieta Saudável/estatística & dados numéricos , Hispano-Americanos/educação , Estado Nutricional , Obesidade Pediátrica/prevenção & controle , Criança , Cuidado da Criança/métodos , Creches , Pré-Escolar , Exercício , Feminino , Humanos , Pais/educação , Projetos de Pesquisa , Autoeficácia
19.
Pediatr Dent ; 41(2): 112-118, 2019 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-30992108

RESUMO

Purpose: The purpose of this pilot study was to determine whether an audiovisual intervention was more effective than verbal instructions at reducing preoperative anxiety levels for parents whose children were having their first experience of dental treatment with the use of oral sedation. Methods: A prospective clinical trial was conducted. Parents were systematically assigned to either view an animated video (intervention group) or receive standardized verbal instructions (control group). Questionnaires modified from the Amsterdam Preoperative Anxiety and Information Scale were distributed to parents at the assessment appointment before the preoperative information was given (T0) and again at the subsequent sedation appointment (T1). The change in parental anxiety levels between T0 and T1 was measured (Δ equals T0-T1). Results: A total of 40 subjects comprised of 20 individuals each in the control and intervention group were included in the final analytical data set. There were no significant differences in the effectiveness of reducing preoperative parental anxiety between the audiovisual intervention and the verbal instructions. Conclusions: The audiovisual intervention was effective at reducing preoperative parental anxiety, but the reduction was not significantly different from using verbal instructions. Dentists may wish to incorporate audiovisual aids to supplement verbal instructions during the sedation preoperative consultation.


Assuntos
Anestesia Dentária , Sedação Consciente , Ansiedade ao Tratamento Odontológico/prevenção & controle , Pais/educação , Pais/psicologia , Agendamento de Consultas , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Projetos Piloto , Estudos Prospectivos , Inquéritos e Questionários , Gravação de Videoteipe
20.
Int J Pediatr Otorhinolaryngol ; 122: 99-104, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30991208

RESUMO

AIM: The study assessed the outcome of a low-intensity parent training program for improving parent's language input to children with language delay. METHOD: Nine parents and their children aged between 12 months to 24 months, exhibiting delay in language development, participated in a brief training program over three sessions. Training comprised of inputs on speech-language development, play development and speech-language stimulation strategies, supported by a manual. Effect of the training program on parent's language behaviour was evaluated through observations of parent-child interaction recorded before training and six-weeks and 10-weeks post training. Measures including, different functions served by verbalizations of parents and their nonverbal affective behaviours, were analysed. RESULTS AND DISCUSSION: Parents' verbalizations increased significantly from baseline to the two follow-up sessions. Proportion of comments, suggestions and reflections on the child's productions increased with a concurrent decrease in the use of direct commands and questions, from baseline to post training at 10-weeks. Parents reported regular use of the manual during and after the training sessions. Post training, they identified play-based activities and provided opportunities for interactions in daily routines. Changes in the child's communication skills were also reported. CONCLUSION: A low-intensity training program for parents, supported by a manual focusing on developmentally appropriate play and speech-language stimulation, resulted in increased verbal interaction and changes in language input to children.


Assuntos
Educação não Profissionalizante/métodos , Transtornos do Desenvolvimento da Linguagem/terapia , Pais/educação , Comportamento Verbal , Feminino , Humanos , Lactente , Desenvolvimento da Linguagem , Masculino , Relações Pais-Filho , Fala
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