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Objectives: This study sought to determine the impact of Healthy Families Healthy Futures (HFHF) enhanced with Steps to Success (STS). HFHF is a structured home visiting program for teen parents in Houston that focuses on improving parenting skills and preventing child abuse. HFHF enhanced with STS includes content and activities aimed to reduce repeat pregnancies within 24 months after the first child's birth. Methods: The study team recruited 248 young mothers for the study, primarily through local health clinics and schools, and then randomly assigned them to either a treatment group that was eligible to participate in HFHF enhanced with STS or to a control group. The control group was not offered any other program through the study. Outcomes were measured by a survey administered 12 months after program intake, in five domains aligned with the program's logic model: (1) exposure to information related to program content, (2) contraception knowledge, (3) contraception use, (4) enhanced family functioning, and (5) child health and development. To estimate program impacts, we used ordinary least squares regression, controlling for demographics and baseline measures of the outcome variables, if available. We use both frequentist approaches (calculations of statistical significance) and Bayesian posterior probabilities to interpret the findings. Results: HFHF enhanced with STS significantly (p <.05) impacted exposure to information on parenting and birth control, with effects of 20.8 and 15.4 percentage points, respectively. Using Bayesian posterior probabilities, there is an 85% chance that the program had a favorable effect on these outcomes. We also calculate a probability of 77% that the program had a favorable impact on long-acting reversible contraceptive (LARC) use, but a probability of 89% that the program reduced knowledge of birth control pills; these two results were not statistically significant (p =.17 and.10, respectively). Conclusions for Practice: These findings are primarily favorable and consistent with the program content and goals. Smaller than anticipated sample sizes due to recruitment challenges increased the chances for random error to affect the ability to detect statistically significant differences on many of our other outcomes; Bayesian posterior probabilities can therefore aid in interpreting the impact estimates. More research of this promising model is warranted. [ABSTRACT FROM AUTHOR]

Limiting ultraviolet radiation exposure during early childhood can significantly reduce the risk of developing skin cancer, making early childhood a critical time for sun protection strategies. This study aimed to measure sun protection practices utilized in Australian early-childhood services over the past decade and evaluate the impact of Cancer Council Australia's SunSmart Early-Childhood Program. Results are presented from cross-sectional and repeated-measures survey data, completed by directors or other staff at randomly sampled early-childhood services in 2008, 2013 and 2018 (N  =   3243). Most sun protection practices were used by a significantly greater proportion of services in 2018 relative to earlier years, such as requiring the use of sunscreen (98.4%), and sun-protective hats (99.7%) and clothing (88.8%). However, only a small and declining proportion of services (16.3%–22.4%) required the use of specific items of sun-protective clothing. SunSmart program members reported enacting significantly more sun protection practices compared to non-members, while new members showed an increase in the use of those practices relative to services whose status did not change (d  =   0.48). The results demonstrate improvements in sun protection in Australian early-childhood settings, and highlight the benefits and limitations of the SunSmart program. [ABSTRACT FROM AUTHOR]

Objective  There is no systematic report on pathway to care in autism from tertiary care medical centers of India. The present study was aimed to evaluate the pathways to care among parents of children with autism-seeking treatment at a tertiary care medical center. Methods  Cross-sectional, observational study involving parents of 38 children with autism spectrum disorder diagnosed with INCLEN diagnostic tool. Pathway to care was assessed using World Health Organization Encounter Form. Statistical Analysis   IBM Statistical Package for Social Sciences (SPSS) 20.0 was used for analysis; categorical variables were assessed using Chi-square test keeping statistical significance at 0.05%. Results  A total of 74% parents reported going to a general practitioner and 13% reported going to a child psychiatrist as point of first contact. Among them, 71% parents reported seeking care with a child psychiatrist in a tertiary medical center at the fourth point of contact. Also, 84% parents believed in biomedical explanation of autism. Majority of parents sought for speech therapy and medicines for their child with autism which is in tune with their biomedical explanation. Parents were the first to identify developmental concerns, average age of symptom recognition being 2.2 years. Average age of intervention initiation was 40 months, 8 months prior to diagnosis of autism. Conclusions  Early symptom recognition and initiation of interventions is encouraging. Despite having a biomedical explanation of autism and ability to recognize developmental concerns, there is a lag of 4 years in diagnosis and reaching a specialized child psychiatry setup. This lag is a cause of concern owing to the impact on access to evidence-based interventions. [ABSTRACT FROM AUTHOR]

The primary aim of this study was to assess the efficacy of a childcare-based intervention in increasing child physical activity by allowing children unrestricted access to outdoor areas for free-play when structured activity is not taking place. A randomized controlled trial was conducted in six childcare services. Intervention services provided children unrestricted access outdoors for active free-play, while control services provided their usual scheduled periods of outdoor play. Consent was obtained from 231 children. Child moderate to vigorous activity (MVPA), the primary trial outcome, was assessed via accelerometer at baseline and 3 months post baseline. Intervention effects were examined using Generalised Linear Mixed Models. Controlling for child age, gender and baseline outcome measure, at follow-up there were no significant differences between groups in minutes of MVPA in-care (mean difference: 4.85; 95% CI: −3.96, 13.66; P = 0.28), proportion of wear time in-care spent in MVPA (mean difference: 1.52%; 95% CI: −0.50, 3.53; P = 0.14) or total physical activity in-care (mean difference in counts per minute: 23.18; 95% CI: −4.26, 50.61; P = 0.10), nor on measures of child cognition (P = 0.45–0.91). It was concluded that interventions addressing multiple aspects of the childcare and home environment might provide the greatest potential to improve child physical activity. [ABSTRACT FROM AUTHOR]

An extensive body of research demonstrates a higher prevalence of obesity among children with developmental delays (DD) versus children without delays. This analysis examined the effectiveness of a randomized controlled trial to promote healthy weight in a subsample of preschool-age children with DD (n = 71) on the adoption of quality nutrition and increased physical activity habits versus controls. Child care centers (N = 28) randomized to the intervention group received a multilevel (parent, teacher, child) role modeling program and curriculum on obesity prevention. Results showed that children in the intervention group slightly decreased their junk food consumption while the control group increased their junk food consumption. In addition, among preschool-age children with DD, change in parent fruit and vegetable consumption significantly influenced change in their child’s consumption. Conversely, the greater the consumption of junk food by parents, the greater consumption by their children. Results imply that preschool-age children with DD may benefit from child care center–based healthy weight programs. [ABSTRACT FROM AUTHOR]

Little is known regarding the prevalence and context of missingness (i.e., being reported as a missing person) among children in out-of-home (OOH) care. The present research examines the relationship between missingness and OOH care placements as well as predictors and case contexts of children missing from OOH care. Point-in-time count data of reported missing persons in Nebraska and administrative records on children's OOH placements are used. Bivariate significance tests examine group differences; case contexts are explored through content analysis of OOH case reviews. About 30 % of Nebraska's missing children are in OOH care. Bivariate tests show that children missing from OOH care are older and are more likely to be Black and less likely to have their race listed as "unknown" than children missing from their families of origin. Children in OOH who are missing are also more likely to be in group care, on probation, and have greater placement instability compared to children in OOH care who are not missing. Case contexts of missingness include unmet substance use and mental health challenges, experiences with violence and victimization, and few bonds to school. Screening and interventions for high-need children in OOH care and their caregivers are necessary to prevent children from going missing from placements. [ABSTRACT FROM AUTHOR]

ABSTRACT We examine the relationship between individual commuting behavior and household responsibilities, with a focus on gender differences in that relationship. Using the Dutch Time Use Survey for the years 2000 and 2005, we analyze the relationship between commuting time, home production, and childcare. To deal with reverse causality, we use Propenstity Score Matching techniques to obtain imputed data for individuals. We find that the effect of home production on commuting time for women is more than double that for men, while childcare time has an effect on women's commuting behavior only. Our results shedding light on the Household Responsibility Hypothesis. [ABSTRACT FROM AUTHOR]