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Abstract Background Black very low birth weight (VLBW;

Abstract Background Leading causes of unintentional child injury such as poisoning and falls are preventable, and the majority occur in the home. Numerous home safety interventions have been developed and tested to increase safety behaviors; however, no smart phone-based applications (apps) have been developed and evaluated for this purpose. The objective of this study was to evaluate whether a mobile technology-based health behavior change intervention, the Make Safe Happen® app, was an effective tool to increase safety knowledge and safety actions/behaviors for the prevention of child unintentional injuries in and around the home. Methods Data were collected in pretest and posttest online surveys from an existing nationwide population-based survey panel. Intervention subjects were randomized to organically (participant-driven) use the Make Safe Happen® app for 1 week, which provided home safety information and the ability to purchase safety products, while control participants were assigned to download and use an app about a topic other than home safety. The primary outcomes of safety knowledge and home safety actions were assessed by using linear mixed model regressions with intention-to-treat analyses. Results A total of 5032 participants were randomized to either the intervention (n = 4182) or control (n = 850) group, with 2055 intervention participants downloading and entering their participant IDs into the Make Safe Happen® app. The online posttest survey was completed by 770 intervention and 283 control subjects. Mean knowledge parent safety score increased at a greater rate for intervention than control subjects (p

Abstract Background Chaos has implications for child health that may extend to childhood obesity. Yet, results from studies describing associations between chaos and childhood obesity are mixed. New approaches to studying the environments of young children may help to clarify chaos-obesity relationships. Methods We conducted a concurrent mixed methods analysis of quantitative and qualitative data describing home and neighborhood chaos among a diverse cohort of 283 caregiver-toddlers dyads from Ohio. We examined the underlying structure of environmental and household chaos using exploratory factor analysis then sought to validate the structure using qualitative field notes. We generated total scores for factors of chaos and described their distributions overall and according to cohort characteristics. Additionally, we conducted a thematic content analysis of brief ethnographies to provide preliminary construct validity for our indicators of chaos. Results Dyads varied according to household composition, income, education, and race/ethnicity. We found evidence for a multi-factor structure for chaos, which included disorganization and neighborhood noise. Household disorganization scores ranged from 0 to 7.3 and were on average 2.1 (SD = 1.8). Neighborhood noise scores ranged from 0 to 4 and were on average 1.1 (SD = 1.1). Both disorganization and neighborhood noise were associated with indicators of socioeconomic disadvantage, such as lower educational attainment and household income. Qualitative data from households with high and low scores on the two identified factors were aligned in ways that were supportive of construct validity and further contextualized the social and material environments in which chaos occurred. Conclusions Chaos represents a complex construct with implications spanning various disciplines, including childhood obesity research. Previous studies suggest challenges associated with measuring chaos may limit the conclusions that can be drawn about which aspect of chaos (if any) matter most of early childhood weight development. We advance the literature by demonstrating chaos may be comprised of conceptually distinct subdomains. Future childhood obesity prevention research may benefit from more contemporary measure of chaos, such as those relying on direct observations that account for a multifaceted underlying structure.

Parenting that is sensitive and responsive to children’s needs has been shown to support children’s optimal growth and development in many cultural contexts. Numerous studies suggest that self-compassion is positively related to sensitive parenting. Despite growing research interest linking self-compassion to responsive parenting, there are considerable gaps in the literature. The current study examined the associations between self-compassion, depressive symptoms, socioeconomic status, and sensitive parenting. Data was obtained from a cohort study of 300 families in central Ohio enrolled when children were a mean (SD) calendar age of 18.2 (0.7) months. Children of all gestational ages at birth are included, and 37% were born preterm (p = 0.03), but self-compassion was not a statistically significant predictor (p = 0.35) of sensitivity, and neither self-compassion nor depressive symptoms were statistically significant predictors of sensitive parenting after adjustment for covariates. Considerations for future studies are discussed.

Abstract Background Up to 50 % of women with gestational diabetes mellitus (GDM) will receive a diagnosis of type 2 diabetes mellitus (T2DM) within a decade after pregnancy. While excess postpartum weight retention exacerbates T2DM risk, lifestyle changes and behavior modifications can promote healthy postpartum weight loss and contribute to T2DM prevention efforts. However, some women have difficulty prioritizing self-care during this life stage. Efficacious interventions that women can balance with motherhood to reduce T2DM risk remain a goal. The objective of the Moms in Motion study is to evaluate the efficacy of a simple, novel, activity-boosting intervention using ankle weights worn with daily activities during a 6-month postpartum intervention among women with GDM. We hypothesize that women randomized to the 6-month intensity-modifying intervention will (1) demonstrate greater weight loss and (2) greater improvement in body composition and biomarker profile versus controls. Methods This study will be a parallel two-arm randomized controlled trial (n = 160). Women will be allocated 1:1 to an ankle weight intervention group or a standard-of-care control group. The intervention uses ankle weights (1.1 kg) worn on each ankle during routine daily activities (e.g., cleaning, childcare). Primary outcomes include pre- and post-assessments of weight from Visit 2 to Visit 3. Secondary outcomes include body composition, glycemia (2-h, 75 g oral glucose tolerance test), and fasting insulin. Exploratory outcomes include energy expenditure, diet, and psychosocial well-being. Discussion Beyond the expected significance of this study in its direct health impacts from weight loss, it will contribute to exploring (1) the mechanism(s) by which the intervention is successful (mediating effects of energy expenditure and diet on weight loss) and (2) the effects of the intervention on body composition and biomarkers associated with insulin resistance and metabolic health. Additionally, we expect the findings to be meaningful regarding the intervention’s effectiveness on engaging women with GDM in the postpartum period to reduce T2DM risk. Trial registration The ClinicalTrials.gov Identifier, is NCT03664089 . The trial registration date is September 10, 2018. The trial sponsor is Dr. Sarah A. Keim.

Breastfeeding benefits infants, but support is often needed to meet breastfeeding goals. Social media may help disseminate infant feeding information to caregivers. The relationship between parents’ health information-seeking behaviors (HISB) on social media and infant feeding practices remains understudied. Based on social cognitive theory (SCT), parents’ self-efficacy and outcome expectations are two potential factors for improving online HISB. We aimed to use SCT to describe associations between outcome expectations, self-efficacy (eHealth literacy), and online HISB across infant feeding groups among a nationally representative sample of U.S. parents. Eligible participants (N = 580) completed a cross-sectional online survey assessing infant feeding practices (never breastfed, only pumped, only fed-at-the-breast, and both pumped and fed-at-the-breast), self-efficacy (using eHealth literacy as a proxy), outcome expectations in online HISB, parents’ online HISB on social media, and demographic information. Survey weighted linear and logistic regression models were constructed. No online activities differed by infant feeding practices. Parents who pumped only had significantly lower eHealth literacy than parents who never breastfed (adjusted β = -2.63, 95% CI: -4.73, -0.53). Parents who used both methods had 1.78 times greater odds of considering online tools useful for making health-related decisions (95% CI: 0.96, 3.28) and 1.49 times greater odds of considering online tools important for accessing health information (95% Cl: 0.70, 3.15) than parents who never breastfed, though neither association was statistically significant. Understanding these associations between infant feeding practices and online HISB, as well as the two potential factors of parents’ self-efficacy and outcome expectations, may offer implications for tailoring online social media resources to promote breastfeeding outcomes.

Abstract Background Many unintentional injuries that occur in and around the home can be prevented through the use of safety equipment and by consistently following existing safety recommendations. Unfortunately, uptake of these safety behaviors is unacceptably low. This paper describes the design of the Make Safe Happen® smartphone application evaluation study, which aims to evaluate a mobile technology-based safety behavior change intervention on parents’ safety knowledge and actions. Methods Make Safe Happen® app evaluation study is a randomized controlled trial. Participants will be parents of children aged 0–12 years who are recruited from national consumer online survey panels. Parents will complete a pretest survey, and will be randomized to receive the Make Safe Happen® app or a non-injury-related app, and then complete a posttest follow-up survey after 1 week. Primary outcomes are: (1) safety knowledge; (2) safety behaviors; (3) safety device acquisition and use, and (4) behavioral intention to take safety actions. Results Anticipated study results are presented. Conclusions Wide-reaching interventions, to reach substantial parent and caregiver audiences, to effectively reduce childhood injuries are needed. This study will contribute to the evidence-base about how to increase safety knowledge and actions to prevent home-related injuries in children. Trial registration number NCT02751203; Pre-results.

Background: Congenital heart disease (CHD) survivors have an elevated risk for obesity-related comorbidities, but little is known about racial differences in obesity rates for this population., Objective: The authors aimed to compare rates of obesity in CHD survivors to national estimates using National Health and Nutrition Examination Assessment Survey (NHANES) and to characterize racial disparities in obesity among CHD survivors across age ranges., Methods: Retrospective chart review included 4496 CHD survivors (4050 white and 446 black) with a range of lesion severities from a pediatric and an adult medical center., Results: White children with CHD had a higher prevalence of obesity compared with NHANES estimates. In contrast, white young adults with CHD had a lower prevalence of obesity compared with NHANES. Blacks with CHD had a 58% increased risk of obesity in young adulthood and a 33% increased risk in late adulthood compared with whites with CHD., Conclusions: Obesity interventions are needed among CHD survivors across the lifespan, particularly among adult non-Hispanic blacks.

Context: The location of the more superficial thoracic spinous processes is used to help osteopathic physicians locate the deeper and more difficult-to-palpate thoracic transverse processes. In 1979, Mitchell et al proposed the thoracic rule of threes to describe the relationship of the spinous processes to the transverse processes in the thoracic spine. This rule is currently taught at osteopathic medical schools. The rule of threes separates the thoracic vertebrae into 3 distinct groups, each with a different relationship between transverse processes and spinous processes. In 2006, Geelhoed et al proposed a new relationship between the spinous processes and transverse processes for all thoracic vertebrae (ie, Geelhoed's rule)., Objective: To determine which anatomical relationship-the rule of threes or Geelhoed's rule-is most accurate in locating the transverse processes and to define anatomical relationships between thoracic spinous and transverse processes., Methods: The thoracic spinous and transverse processes of 44 formalin-embalmed human cadavers were dissected, marked, and photographed. Six different measurements per vertebra were made between spinous processes and transverse processes in the thoracic spine. Geelhoed's protocol was used to determine the validity of each rule. The measurements were analyzed for additional relationships between thoracic spinous processes and transverse processes. Group 1 consisted of vertebrae T1 to T3 and T12; group 2 consisted of T4 to T6 and T11; and group 3 consisted of T7 to T10., Results: Of the 528 vertebrae measured, 0% of the first group vertebrae, 10.8% of the second group vertebrae, and 69.3% of the third group vertebrae followed the rule of threes. In total, 26.7% of vertebrae followed the rule of threes, whereas 62.3% of vertebrae followed Geelhoed's rule. Additional relationships worth noting include the distance between the transverse process and the adjacent caudal transverse process on the same side is approximately 25.4 mm (1 inch), and the distance between the transverse processes of the same vertebra is approximately 50.8 mm (2 inches) for male T3-T10 vertebrae and female T1-T12 vertebrae., Conclusion: According to our findings, the rule of threes is not as accurate anatomically as Geelhoed's rule in locating the transverse processes of the thoracic spine. This study suggests osteopathic medical schools should teach Geelhoed's rule rather than the rule of threes.