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The article discusses the Public Health Education Service for Health Students (SSES) program in France, which aims to promote health behaviors and raise awareness of public health issues among healthcare students. The program is mandatory for all healthcare students and involves interdisciplinary work and workshops on public health topics. The article also highlights the implementation of the program at a university in Valence, detailing the training process, partnerships, and outcomes of the program. Overall, the program has received positive feedback from students and partners, with a focus on improving health behaviors and addressing public health needs. [Extracted from the article]

Abstract Background Although the promise of integrated neighborhood approaches, including the essential roles of communities and collaboration between the medical and social domains, has been widely acknowledged, the realization of such approaches in practice often remains difficult. To gain insight into the development of integrated neighborhood approaches, this case study describes the experiences of stakeholders involved in such an approach for health promotion and prevention in Rotterdam. Methods Interviews with 18 stakeholders (including health and social care professionals, health insurance employees, and policymakers) were conducted, and stakeholders’ statements were analyzed thematically. Results The results reveal a lack of alignment among the professional, organizational, and system levels. Elements needed for collaboration between health and social care professionals are not supported at the organizational and system levels. The lack of integration at the policy and organizational levels encourages competition and self-interest instead of stimulating collaboration. Conclusions Intersectoral collaboration and coordination must take place not only between professionals, but also at the organizational and policy levels. As long as integration at the organizational and system levels is lacking, professionals’ ability to collaborate and provide coordinated support to neighborhood residents will be compromised.

Abstract Background Health inequities exist within and between societies at different hierarchical levels. Despite overall improvements in health status in European Union countries, disparities persist among socially, economically, and societally disadvantaged individuals. This study aims to develop a holistic model of health determinants, examining the complex relationship between various determinants of health inequalities and their association with health condition. Methods Health inequalities and conditions were assessed at the territorial level of Local Administrative Units (LAU1) in the Czech Republic. A dataset of 57 indicators was created, categorized into seven determinants of health and one health condition category. The necessary data were obtained from publicly available databases. Comparisons were made between 2001–2003 and 2016–2019. Various methods were employed, including composite indicator creation, correlation analysis, the Wilcoxon test, aggregate index calculation, cluster analysis, and data visualization using the LISA method. Results The correlation matrix revealed strong relationships between health inequality categories in both periods. The most significant associations were observed between Economic status and social protection and Education in the first period. However, dependencies weakened in the later period, approaching values of approximately 0.50. The Wilcoxon test confirmed variations in determinant values over time, except for three specific determinants. Data visualization identified persistently adverse or worsening health inequalities in specific LAU1, focusing on categories such as Economic status and social protection, Education, Demographic situation, Environmental status, Individual living status, and Road safety and crime. The health condition indices showed no significant change over time, while the aggregate index of health inequalities improved with widened differences. Conclusion Spatial inequalities in health persist in the Czech Republic, influenced by economic, social, demographic, and environmental factors, as well as local healthcare accessibility. Both inner and outer peripheries exhibit poor health outcomes, challenging the assumption that urban areas fare better. The combination of poverty and vulnerabilities exacerbates these inequalities. Despite the low rates of social exclusion and poverty, regional health inequalities persist in the long term. Effectively addressing health inequalities requires interdisciplinary collaboration and evidence-based policy interventions. Efforts should focus on creating supportive social and physical environments, strengthening the healthcare system, and fostering cooperation with non-medical disciplines.

Chronic Kidney Disease (CKD) is considered a public health problem (1) with a high disease burden, affecting 9.1% of the world's population (2017) with 1.2 million deaths annually. (2. 3). In Argentina, the prevalence is estimated at 3.8 million cases (4), representing 12.7% of the population over 18 years of age. It is an asymptomatic disease and affects the population unequally, falling more heavily on the most vulnerable sectors. While premature mortality accounts for most of the disease burden, morbidity is also significant. Late treatment in advanced stages of the disease (dialysis and transplant) generates very high costs for the health system and significantly worsens people's quality of life (5). The marked lack of knowledge of kidney disease in the population and the factors that could cause it contribute to its progression. It is commonly identified in advanced stages due to another ailment, apparently different from kidney disease and other comorbidities, generally cardiovascular conditions, which is why many patients die from associated pathologies without detecting CKD. The leading causes of CKD are modifiable, except age and other biological, genetic, or hereditary conditions. It is necessary to develop public health promotion and disease prevention policies to address risk factors and substantially reduce the disease burden. [ABSTRACT FROM AUTHOR]

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Objective Children and young people with visible differences can experience psychosocial difficulties, such as anxiety and teasing by others. Interventions targeting difficulties have previously been reviewed by Jenkinson et al. This review aimed to identify and critically assess recent studies evaluating the effectiveness of psychosocial interventions for children and young people with visible differences on psychosocial wellbeing, self-esteem, and social experiences and compare the findings with Jenkinson et al. using a replacement review process. Methods Inclusion criteria are as follows: studies with participants aged 0–18 years with visible differences; investigating a psychosocial intervention; including comparison with an alternative intervention, control group, or pre- and post-intervention; and including a quantitative measure assessed pre- and post-intervention. Exclusion criteria are as follows: participants with body dysmorphic disorder or appearance changes due to eating disorders or obesity and studies not written in English. MEDLINE, AMED, and PsycInfo were searched and grey literature was included. Results were reviewed against eligibility criteria, data were extracted, and studies were evaluated using the Cochrane Risk of Bias 2 tool. Results Using Jenkinson et al. as one source of studies, 24 studies were included evaluating a range of interventions such as social interaction skills training, residential social camps, and cognitive behavioral therapy. Risk of bias was high in 20 studies and of some concern in four studies. Conclusion There is some evidence of the effectiveness of hypnotherapy, a relaxation response resiliency program, integrative body-mind-spirit group, and therapeutic patient education, but more rigorous research is needed to confirm their impact on psychosocial outcomes. [ABSTRACT FROM AUTHOR]

High school and college student-athletes face unique stressors that can negatively impact their mental health, which were exacerbated by the COVID-19 pandemic. Although mental health issues are prevalent in athletic communities, there often remains stigma around mental health and reluctance to seek psychological support. Physical injury can be the cause or the result of the psychological struggles that athletes face—holistic care for the adolescent athlete population must incorporate both elements. Pediatric psychologists, allied healthcare professionals, sports organizations, academic institutions, coaches, caregivers, and student-athletes themselves all play an active role in shaping the mental health of student-athletes and are therefore responsible for creating a culture that prioritizes mental and physical wellness. This paper aims to provide clear recommendations for the various stakeholders on how to address the unique mental health needs of student-athletes. The recommendations presented are based on a review of existing literature in the field and on-the-ground experience working with student-athletes during the COVID-19 pandemic. There are several key interventions highlighted in this paper, including changing the athletic community's culture to prioritize the holistic well-being of athletes, as well as proactively offering mental health education, resources, and programming for student-athletes, with a particular emphasis on health equity to meet the needs of students most at risk. Commitment from pediatric psychologists and allied healthcare professionals, sports organizations, academic institutions, coaches, caregivers, and student-athletes will maximize the likelihood of improving student-athletes' psychological well-being. [ABSTRACT FROM AUTHOR]

Objective Little is known about the symptoms, signs, and management guidelines for children under the age of 6 years after they sustain a concussion. Caregivers of such young children may have unique concerns and encounter different challenges from those of school-age children given the distinctive developmental characteristics of the early childhood period. This study aimed to explore the experience of caregivers through semistructured interviews to inform clinical practice. Methods Fifty caregivers of children aged 6 months to 5.99 years were interviewed 3 months postinjury for this qualitative study to document their experience in relation to their child's accident, recovery, and healthcare provisions. Results Four main themes were identified: (1) visible changes associated with caregiver concerns, (2) a roller-coaster of emotions after the injury, (3) healthcare providers' role in addressing the need for reassurance, and (4) the need for better information after the injury. Conclusion The findings provide critical insight into the unique experiences and information needs of caregivers of young children who sustain concussion. The challenges identified can inform healthcare professionals regarding the needs of caregivers after early concussion and contribute to building a knowledge base for the development of age-appropriate anticipatory guidance for caregiver mental health and child recovery. [ABSTRACT FROM AUTHOR]

Background: Although the promise of integrated neighborhood approaches, including the essential roles of communities and collaboration between the medical and social domains, has been widely acknowledged, the realization of such approaches in practice often remains difficult. To gain insight into the development of integrated neighborhood approaches, this case study describes the experiences of stakeholders involved in such an approach for health promotion and prevention in Rotterdam. Methods: Interviews with 18 stakeholders (including health and social care professionals, health insurance employees, and policymakers) were conducted, and stakeholders' statements were analyzed thematically. Results: The results reveal a lack of alignment among the professional, organizational, and system levels. Elements needed for collaboration between health and social care professionals are not supported at the organizational and system levels. The lack of integration at the policy and organizational levels encourages competition and self-interest instead of stimulating collaboration. Conclusions: Intersectoral collaboration and coordination must take place not only between professionals, but also at the organizational and policy levels. As long as integration at the organizational and system levels is lacking, professionals' ability to collaborate and provide coordinated support to neighborhood residents will be compromised. [ABSTRACT FROM AUTHOR]

ObjectiveTo identify early life adversity (ELA) risk factors for earlier pubertal timing, itself a risk factor for poor cardiometabolic health, and to determine whether such ELA-related risk may be mediated by pre-pubertal body mass index (BMI).MethodsSubjects included 426 female participants in a prospective birth cohort study, the NICHD Study of Early Child Care and Youth Development. Survival analysis models were fit to examine ELA exposures, representing childhood socioeconomic status (SES), maternal sensitivity, mother-child attachment, and negative life events, along with child health indicators and covariates, in relation to pubertal timing outcomes, including age at menarche and ages at Tanner stage II for breast and pubic hair development.ResultsHigher childhood SES emerged as an independent predictor of older age at menarche, showing each one standard deviation increase in childhood SES corresponded to a 1.3% increase in age at menarche (factor change = 1.013; 1.003-1.022; p < .01), but did not predict breast or pubic hair development (ps > .05). In mediation analyses, indirect (mediated) effects of mother-child attachment on the pubertal timing outcomes, via pre-pubertal BMI, were all statistically significant (ps < .05).ConclusionsHigher childhood SES predicted directly, and secure (vs. insecure) mother-child attachment predicted indirectly (via pre-pubertal BMI), later pubertal timing, suggesting these factors may protect girls from earlier pubertal development. By extension, clinical implications are that intervention strategies designed to lessen ELA- and pre-pubertal obesity-related risk may be effective in remediating life course pathways linking ELA, accelerated pubertal development, and cardiometabolic risk.

This randomized controlled trial tested the Vermont Family Based Approach (VFBA) in primary care pediatrics. The VFBA is a model of healthcare delivery that shifts the focus from the individual to the family, emphasizes emotional and behavioral health, and uses evidence-based health promotion/prevention along with the treatment of emotional and behavioral problems. Participants were 81 families of 3–15-year-olds. For children, the VFBA was associated with greater reductions than the Control condition on the Child Behavior Checklist Emotionally Reactive, Withdrawn, Sleep Problems, Aggressive Behavior and Total Problems scales. For parents, the VFBA was associated with greater reductions than the Control condition on the Adult Self-Report Anxious/Depressed, Rule-Breaking Behavior, Internalizing Problems and Total Problems scales. The VFBA was also associated with greater improvement than the Control condition in the parents' health-related quality of life, as indicated by all scales of the Medical Outcomes Study Health Survey. [ABSTRACT FROM AUTHOR]

Background: Health inequities exist within and between societies at different hierarchical levels. Despite overall improvements in health status in European Union countries, disparities persist among socially, economically, and societally disadvantaged individuals. This study aims to develop a holistic model of health determinants, examining the complex relationship between various determinants of health inequalities and their association with health condition. Methods: Health inequalities and conditions were assessed at the territorial level of Local Administrative Units (LAU1) in the Czech Republic. A dataset of 57 indicators was created, categorized into seven determinants of health and one health condition category. The necessary data were obtained from publicly available databases. Comparisons were made between 2001–2003 and 2016–2019. Various methods were employed, including composite indicator creation, correlation analysis, the Wilcoxon test, aggregate index calculation, cluster analysis, and data visualization using the LISA method. Results: The correlation matrix revealed strong relationships between health inequality categories in both periods. The most significant associations were observed between Economic status and social protection and Education in the first period. However, dependencies weakened in the later period, approaching values of approximately 0.50. The Wilcoxon test confirmed variations in determinant values over time, except for three specific determinants. Data visualization identified persistently adverse or worsening health inequalities in specific LAU1, focusing on categories such as Economic status and social protection, Education, Demographic situation, Environmental status, Individual living status, and Road safety and crime. The health condition indices showed no significant change over time, while the aggregate index of health inequalities improved with widened differences. Conclusion: Spatial inequalities in health persist in the Czech Republic, influenced by economic, social, demographic, and environmental factors, as well as local healthcare accessibility. Both inner and outer peripheries exhibit poor health outcomes, challenging the assumption that urban areas fare better. The combination of poverty and vulnerabilities exacerbates these inequalities. Despite the low rates of social exclusion and poverty, regional health inequalities persist in the long term. Effectively addressing health inequalities requires interdisciplinary collaboration and evidence-based policy interventions. Efforts should focus on creating supportive social and physical environments, strengthening the healthcare system, and fostering cooperation with non-medical disciplines. [ABSTRACT FROM AUTHOR]

Introduction: workplaces constitute special environments in which exposures to occupational risk factors contribute to workers' morbidity and mortality; however, occupational diseases are not always recognized. Objective: to evaluate aspects related to the most frequent occupational diseases in Villa Clara Province so that the family physician can differentiate them from common affections and make the opportune referral of the worker. Methods: a bibliographic review was carried out from March to September 2022. Different search engines were used to access several referential databases (BIREME, Ebsco, SciELO regional, PubMed and others) that offered full texts, indexes and academic periodicals. The main theoretical procedures applied were inductiondeduction, analysis-synthesis, abstraction and integration, which made it possible to perform a systemic assessment of the object of study. Conclusions: the identification by the family physician of diseases of occupational or professional origin and their referral for early diagnosis is important not only for those who suffer from them, but also for the labor group, because the prevention of these ailments through systematic screening helps to detect people going through incipient stages and to take preventive measures to minimize or eliminate the causes. [ABSTRACT FROM AUTHOR]

Urban planning has formed a binomial with health since its origins as a discipline. The demands derived from the welfare society, environmental sustainability and the health circumstances of COVID-19 testify to the need to update this relationship. The aim of the URB_HealthSproject is to study the ways of endorsing health in the contemporary city through the urban design of public space. A knowledge transfer model between the academy and the local society in the field of urban health and public space has been defined , whose theoretical structure and implementation in three European localities is presented.

Background: Compared with the general population, autistic adults experience higher rates of physical and mental health conditions, premature morbidity and mortality, and barriers to health care. A health check for autistic people may improve their health outcomes. Aim: To establish the views of autistic people towards a primary care health check for autistic people. Design & setting: Cross-sectional questionnaire study in England and Wales. Method: A questionnaire was sent to autistic adults with physical health conditions in England and Wales. A total of 458 people (441 autistic adults and 17 proxy responders) completed the questionnaire. Results: Most responders (73.4%, n = 336) thought a health check is needed for all autistic people. Around half of the participants thought a health check should be offered from childhood and the health check appointment should last between 15 and 30 minutes. Autistic people were positive about providing primary care staff with contextual information regarding their health and the reasonable adjustments they would like before their health check appointment. Training about autism and the health check was considered important, alongside adequate time for discussions in the health check appointment (all by over 70% of responders). The clinician's autism knowledge, seeing a familiar clinician, environmental adaptations, appropriate information, and accessible appointments were considered particularly important in making a health check accessible. Conclusion: Autistic people and relatives were supportive of a primary care health check for autistic people. Information gathered was used to support the design of a primary care health check for autistic adults. [ABSTRACT FROM AUTHOR]

Background: Compared with the general population, autistic adults experience higher rates of physical and mental health conditions, premature morbidity and mortality, and barriers to health care. A health check for autistic people may improve their health outcomes. Aim: To establish the views of autistic people towards a primary care health check for autistic people. Design & setting: Cross-sectional questionnaire study in England and Wales. Method: A questionnaire was sent to autistic adults with physical health conditions in England and Wales. A total of 458 people (441 autistic adults and 17 proxy responders) completed the questionnaire. Results: Most responders (73.4%, n = 336) thought a health check is needed for all autistic people. Around half of the participants thought a health check should be offered from childhood and the health check appointment should last between 15 and 30 minutes. Autistic people were positive about providing primary care staff with contextual information regarding their health and the reasonable adjustments they would like before their health check appointment. Training about autism and the health check was considered important, alongside adequate time for discussions in the health check appointment (all by over 70% of responders). The clinician’s autism knowledge, seeing a familiar clinician, environmental adaptations, appropriate information, and accessible appointments were considered particularly important in making a health check accessible. Conclusion: Autistic people and relatives were supportive of a primary care health check for autistic people. Information gathered was used to support the design of a primary care health check for autistic adults.

BackgroundDuring the past decades, the mental health of the population has been declining. Mindfulness-based stress reduction (MBSR) has been found effective in enhancing well-being along with reducing perceived stress and symptoms of anxiety and depression. Mindfulness-based interventions (MBIs) in the workplace have shown promising results relating to the mental health of employees and managers. However, the research field of organizational-level MBIs being offered to entire companies is still nascent. Practicing mindfulness may affect skills related to good mental health. Thus, the objective of this study was to investigate the impact of an organizational-level MBI on the mental health skills of employees and managers.MethodsThis qualitative study was part of a quasi-experimental multi-method study. Four small and medium-sized private enterprises with a total of 368 employees and managers were included. The intervention contained: 1. An obligatory introductory session on mental health and mindfulness, 2. Voluntary participation in a 10-week live online workplace-adapted MBSR course, and 3. A workshop for selected employee representatives and managers on further implementation of mindfulness in the organization. A total of 27 focus group interviews including 76 respondents were conducted pre- and post-intervention. Verbatim transcription was performed. Data was analyzed using inductive qualitative content analysis.ResultsThrough analysis, four pre-intervention categories emerged: 1. Bodily sensations and awareness in stressful situations, 2. Reactive and passive behavior during stressful situations, 3. Differences in perception as a stressor, 4. Self-criticism and low ability to practice self-care. Six post-intervention categories were identified: 1. Enhanced ability to be aware in the present moment, 2. Increased acknowledgement of how others may view things differently from oneself, 3. Increased kindness to oneself and being able to practice self-care, 4. Moving from reactive to responsive behavior in stressful situations, 5. Mindfulness as an accelerator for an ongoing personal process and 6. Practicing mindfulness – setting time aside or being mindful in everyday life.ConclusionThis study indicates that it is possible to enhance employees’ and managers’ mental health skills using an organizational-level MBI. Enhanced awareness in the present moment transcended through post-intervention categories, facilitating increased self-kindness and responsive behavior in stressful situations.

Objective: Expand the current Patient-Reported Outcome Measurement Information System (PROMIS®) well-being measures to early childhood (1-5 years) using best practices from PROMIS and developmental science.Methods: Qualitative methods included expert input, literature and measure review, and parent interviews to confirm measure frameworks, item understandability, and developmental appropriateness. Quantitative methods included two waves of field testing and item response theory (IRT)-based psychometric evaluation of reliability and validity, as well as IRT centering and item calibration. Correlational analyses with other PROMIS Early Childhood (EC) Parent Report measures and known-group differences analyses by health status were conducted to evaluate construct validity. All measures were normed to the general U.S. population.Results: Qualitative results suggested three primary early childhood well-being domains: Positive Affect, Engagement, and Self-Regulation. Quantitative results revealed a unidimensional factor structure for Positive Affect and multidimensional factor structures for Engagement and Self-Regulation, both of which had two factors accounting for >10% of modeled variance reflecting unique unidimensional domains. This resulted in five final PROMIS EC well-being measures: Positive Affect, Engagement-Curiosity, Engagement-Persistence, Self-Regulation-Flexibility, and Self-Regulation-Frustration Tolerance. Correlations and known-groups differences analyses showed robust construct validity across a range of chronic health conditions.Conclusions: The new PROMIS EC Parent Report well-being measures offer clinicians and researchers a brief, efficient, and precise way to evaluate young children's well-being. All five measures include only positively valanced item content, which pushes the field to evaluate the presence of children's positive assets rather than the absence of problems. [ABSTRACT FROM AUTHOR]

Objective: Assessing general ("global") health is important to clinicians caring for patients, researchers studying patient subgroups, and epidemiologists tracking population trends. The Patient-Reported Outcomes Measurement Information System® (PROMIS®) introduced an adult self-report Global Health measure (ages 18+) in 2009 and pediatric versions (ages 5-17 years) in 2014. Our aim was to extend global health assessment to 1-5-year olds.Methods: We used the PROMIS mixed-methods approach to develop PROMIS Early Childhood (EC) Global Health, emphasizing qualitative measure development guidance utilizing input from experts and parents. Quantitatively, we conducted two data collection waves with parents of 1-5-year olds and applied state-of-the-science measure development methods, including exploratory, confirmatory, and bi-factor analytics, particularly regarding potentially multi-dimensional Global Health item content. We conducted a series of hypothesis-based across-domain association analyses, which were more exploratory in nature, and known-groups validity analyses.Results: Experts emphasized the physical, mental, and social facets of global health, and parents described the broader, overarching construct. Using Waves 1 (N = 1,400) and 2 (N = 1,057) data, we retained six items directly sourced from the age 5-17 version and two new items. The resulting 8-item PROMIS EC Global Health was sufficiently unidimensional, so we fit item responses to the graded response model for parameter estimation. This produced an 8-item scale with one total score. Across-domain associations and known-groups validity analyses largely supported our hypotheses.Conclusions: We achieved our aim to extend global health assessment to 1-5-year olds and to thereby expand the range of PROMIS life course global health assessment from children aged 1-17 years, to adults of all ages. [ABSTRACT FROM AUTHOR]

Objective: Headaches are common among youth and are associated with significant negative outcomes. Despite advances in interdisciplinary treatments for youth with chronic pain, research suggests disparities in access to these services.Methods: A total of 186 youth (M = 14.19 years old, 70.8% female) presenting to a neurology appointment at a children's hospital system were screened using the Pediatric Pain Screening Tool (PPST), a brief, validated measure to identify youth that may benefit from additional pain management services.Results: Two-thirds of participants (n = 124, 66.7%) screened as medium or high risk on the PPST. Risk categorization did not vary by patient age or sex. A greater proportion of Hispanic/Latino patients were categorized as low-risk relative to non-Hispanic/Latino patients (55.6% vs. 30.1%), and a somewhat lower proportion of patients of color were categorized as medium-risk relative to White patients (14.0% vs. 30.5%). Three-quarters (n = 94, 75.8%) of patients who were screened as medium or high risk were not referred for any additional pain management services. Referrals did not vary by patient age or ethnicity. While not statistically significant, a lower proportion of males received referrals at both medium (8.3% vs. 17.6%) and high levels of risk (15.8% vs. 34.5%), and a greater proportion of youth of color who screened as medium risk received referrals relative to White youth categorized as medium risk (37.5% vs. 10.3%).Conclusion: Future research should continue to explore factors influencing decision-making regarding referral to specialized pain management services for youth with headache. [ABSTRACT FROM AUTHOR]

Objective: To explore the impact of the COVID-19 pandemic on Black adolescent girls' physical, psychological, and sexual development.Methods: Semistructured interviews were conducted with 25 girls (9-18 years old) primarily across the Midwestern United States. Interviews were conducted until theoretical saturation was reached. We conducted a conventional content analysis by reviewing transcripts, coding data, and developing themes.Results: Utilizing the social-ecological model findings revealed themes related to the individual-, interpersonal-, institutional-, and community-level changes that Black girls experienced during the COVID-19 pandemic.Conclusions: Black adolescent girls need opportunities to discuss the changes, receive relevant resources, and have spaces to support their physical, psychological, and sexual development. Systems such as families, schools, and clinics should implement programming to facilitate discussions around the impact of COVID-19 on Black girls. [ABSTRACT FROM AUTHOR]

Objective: To assess whether integrated behavioral health (IBH) prevention encounters provided during well-child visits (WCVs) is associated with increased adherence to WCVs and timely immunizations in the first year.Methods: Data were collected in an urban pediatric primary care clinic serving a low-income population and using the HealthySteps model. Subjects were 813 children who attended a newborn well-child visit between January 13, 2016 and August 8, 2017. Data from the electronic health record was extracted on attendance at six well-child visits in the first year of life, IBH prevention encounters by the HealthySteps specialist, completion of immunizations at 5 and 14 months, and demographics and social and clinical risk factors.Results: After controlling for covariates, odds of attendance at 6, 9, and 12-month WCVs were significantly higher for those who had IBH prevention encounters at previous WCVs. Odds of immunization completion by 5 months was associated with number of IBH prevention encounters in the first 4 months (OR = 1.52, p = .001) but not immunization completion at 14 months (OR = 1.18, p = .059).Conclusions: IBH prevention encounters were associated with increased adherence to WCVs in the first year and vaccine completion at 5 months of age. These findings are consistent with IBH having a broad positive effect on child health and health care through strong relational connections with families and providing value in addressing emotional and behavioral concerns in the context of WCVs. [ABSTRACT FROM AUTHOR]

Abstract Background People with severe mental illness experience physical health significantly worse than the general population. Physical health monitoring is shared between primary care and secondary mental healthcare services, though there is debate whether mental health teams should provide more physical healthcare. The views of mental health clinicians and patients with mental illness towards physical healthcare provision are unclear. Aims To explore the attitudes of Community Mental Health Team (CMHT) clinicians and patients experiencing severe mental illness towards physical healthcare and its provision. Design and setting Qualitative study in a CMHT setting. Methods Interviews were carried out with CMHT clinicians and patients with severe mental illness. Data were collected using semi-structured interviews and analysed using thematic analysis. Results There were 14 patients and 15 clinicians recruited. Patients varied in their awareness of the association between physical and mental health, but were engaged in physical health monitoring. Clinicians were aware of the importance of physical healthcare but reported barriers to provision, including lack of training, resource constraints and uncertainty in their role. There was no consensus in either group regarding how physical healthcare should be provided, with diverse attitudes expressed for why CMHTs should and shouldn’t provide more physical healthcare. Conclusions Increasing physical healthcare provision from mental health teams requires healthcare-related barriers be addressed, but it remains unclear whether CMHT clinicians or patients believe this to be a solution.

Abstract Background Willingness to Pay (WTP) is an alternative to measure quality-adjusted life years for cost-effectiveness analyses. The aim was to evaluate longitudinal changes and determinants of parental WTP for the prevention of childhood overweight and obesity. Methods Longitudinal data from post- (T2) and follow-up (T3) measurements of a school-based health promotion program in Germany. Parental questionnaires included general WTP and the corresponding amount to reduce incidental childhood overweight and obesity by half. Longitudinal differences were examined with the McNemar test for general WTP and the Wilcoxon signed-rank test for the amount of WTP. Regression analyses were conducted to detect determinants. Results General parental WTP significantly decreased from 48.9% to 35.8% (p

Background: COVID-19 pandemic and confinement measures had a major impact on the health and well-being of the population. Health promotion and prevention (HP&P) professionals had to rethink their practices to respond to the challenges raised by the pandemic context. This study aimed to build a professional consensus on the HP&P priorities (apart from the COVID-19 fight) in the early times of the pandemic in Switzerland and to identify the most relevant interventions to respond to these issues., Methods: HP&P experts from the three main linguistic regions of Switzerland reached a consensus through a two-round Delphi methodology with online questionnaires in June-July and October-November, 2020. Out of 282 experts contacted, 121 (43%) contributed in the first round and 99 (35%) in the second., Results: A strong consensus emerged about the importance of tackling mental health problems, non-communicable diseases and their main risk factors, as well as multiple social determinants of health. Although they believed that HP&P priorities changed in this context, experts reported that professional practices had only partially adapted to this new context due to multiple constraints (political, strategic, financial). The experts noted the need to adapt the means of communication to reach the different target groups. They underlined the potential of communication via digital technologies, but also drew attention to the risk of widening social inequalities due to the unequal access to these resources., Conclusions: This study generated new insights and confirmed pre-established knowledge regarding the orientations the field of HP&P should follow. While stressing the need to consolidate the traditional missions of the field (i.e. the fight against non-communicable diseases and the actions on social determinants of health), experts surveyed in this study also revaluated health priorities and rethought the way of developing HP&P actions in this specific context of the early pandemic of COVID-19., Competing Interests: Declaration of conflicting interestsThe authors have no conflicts of interest to declare.

Objective: Mobile health (mHealth) interventions may be an efficacious strategy for promoting health behaviors among pediatric populations, but their success at the implementation stage has proven challenging. The purpose of this article is to provide a blueprint for using human-centered design (HCD) methods to maximize the potential for implementation, by sharing the example of a youth-, family-, and clinician-engaged process of creating an mHealth intervention aimed at promoting healthcare transition readiness., Method: Following HCD methods in partnership with three advisory councils, we conducted semistructured interviews with 13- to 15-year-old patients and their caregivers in two phases. In Phase 1, participants described challenges during the transition journey, and generated ideas regarding the format, content, and other qualities of the mHealth tool. For Phase 2, early adolescents and caregivers provided iterative feedback on two sequential intervention prototypes. Data were analyzed using thematic analysis in Phase 1 and the rapid assessment process for Phase 2., Results: We interviewed 11 youth and 8 caregivers. The sample included adolescents with a range of chronic health conditions. In Phase 1, participants supported the idea of developing an autonomy-building tool, delivering transition readiness education via social media style videos. In Phase 2, participants responded positively to the successive prototypes and provided suggestions to make information accessible, relatable, and engaging., Conclusions: The procedures shared in this article could inform other researchers' plans to apply HCD in collaboration with implementation partners to develop mHealth interventions. Our future directions include iteratively developing more videos to promote transition readiness and implementing the intervention in clinical care., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Scorpionic accidents have high morbidity and mortality in children under 5 years old, a condition that has increased in Presidente Prudente in the last two decades. The study aimed to analyze the spatial distribution of scorpionism in Presidente Prudente and build hypothesis of correlation between the pattern found and socioeconomic and environmental variables. This is an ecological study carried out by analyzing the medical records of children and adolescents up to 18 years old, treated at the Regional Hospital between 2015 and 2020, and victims of scorpion accidents. For the elaboration of maps, geographic coordinates of the addresses where accidents occurred were obtained. To evaluate the maps and determine the pattern of spatial distribution, statistical analysis tools were used. The spatial distribution was configured in an agglomerated and non-random pattern, with three foci of greater incidence in the urban perimeter of the municipality. The identification of foci allows the implementation of specific and localized preventive actions, enabling greater effectiveness in the use of public resources. [ABSTRACT FROM AUTHOR]

Objective: To describe child adherence to four preventative-health guidelines during the COVID-19 pandemic and investigate caregiver-level correlates of adherence. Method: Two hundred thirty-six caregivers (75% female) of children ages 6–12 years (Mage = 8 years; 53% male) living in the United States rated child adherence to four preventative-health guidelines between 10/16/2020 and 11/14/2020. Caregivers also rated perceived importance of each guideline in limiting virus spread and perceived difficulty in obtaining child compliance. Results: Child adherence was highest for mask-wearing (median [Mdn] = 96%) and hand hygiene (Mdn = 95%). Adherence to social distancing guidelines was lower. Mdn adherence for social distancing with family outside the household was 80%, and Mdn adherence for social distancing with friends was 72%. Furthermore, for each of the four guidelines, fewer than half the sample reported 100% adherence (range = 20%–43%). Adherence was positively associated with caregiver perceptions of importance of a given behavior in limiting virus spread (rs =.38–.62) and negatively associated with perceived difficulty in gaining child compliance (rs = –.37––.25). Discussion: Current results indicated parents perceive child adherence to social distancing more challenging than child adherence to mask wearing or hand hygiene. Lower caregiver perceptions of importance of the behavior and greater perceived difficulty in gaining child compliance were associated with lower adherence to all tasks. Brief targeted interventions (e.g., motivational interviewing, parent behavior management training) may be well suited to enhance caregivers' perceptions of value of the behavior, while also addressing behavioral challenges that interfere with child adherence. Public Significance Statement: Caregivers play a critical role in facilitating child adherence to COVID-19 preventative health guidelines. Public health interventions that help caregivers to see the value of preventative health guidelines and support parents around managing difficulties that arise in implementation may facilitate child adherence behaviors. [ABSTRACT FROM AUTHOR]

Objective: This study examines prevalence rates of elevated depression symptoms utilizing the Patient Health Questionnaire-9 Item Modified for Adolescents (PHQ-9A), characterizes recommendations and interventions by primary care providers (PCPs) and behavioral health clinicians (BHCs) in response to elevated PHQ-9As, and identifies factors associated with improved PHQ-9A scores at follow-up pediatric primary care visits.Methods: A mixed methods approach was taken. Visit data, demographics, and PHQ-9A scores for 2,107 adolescents aged 11-18 were extracted using clinical informatics between January 3, 2017 and August 31, 2018. Descriptive statistics and chi-square analyses were conducted, followed by conventional content analysis of electronic medical records to examine qualitative results. Qualitative analyses were transformed into quantitative results and analyzed using point biserial correlations.Results: Of the 2,107 adolescents, 277 (13%) had an elevated PHQ-9A. Content analysis resulted in 40 actions (17 PCP codes, 23 BHC codes) in response to an elevated PHQ-9A. Significant correlations were found between an improved PHQ-9A at a follow-up visit and the PCP referring to integrated behavioral health (r = .20, p < .01), and BHCs recommending and checking in at a follow-up visit (r = .20, p < .05), conducting a risk assessment (r = .15, p < .05), and providing psychoeducation about mood symptoms (r = .15, p < .05).Conclusions: Primary care is an ideal setting to address the public health crisis of untreated adolescent depression. Implications for screening processes, practice implications for PCPs and BHCs, future directions, and limitations are discussed. [ABSTRACT FROM AUTHOR]

Objective: Unintentional injuries, the leading cause of death for American children, are caused by a range of psychosocial factors, including risk behavior. One factor that may impact child risk-taking is modeling of superhuman risk-taking from superhero media, both immediately following superhero exposure and based on lifetime exposure and engagement.Methods: Fifty-nine 5-year-olds were randomly assigned to view either a 13-min age-appropriate superhero television show or a comparable nonsuperhero show. After the viewing, children engaged in three risk-taking measures: (a) activity room, unsupervised play for 5 min with assortment of apparently dangerous items that might encourage child risk-taking; (b) picture sort, 10 illustrations of children in risk situations, with participant response concerning intended risk-taking in that situation; and (c) vignettes, 10 stories presenting situations with varying degrees of risk, with participant response on intended choice. Parents completed questionnaires concerning children's long-term superhero media exposure and individual superhero engagement (e.g., if child's most recent Halloween costume was of a superhero). Correlations and regressions evaluated effects of immediate superhero exposure, lifetime superhero exposure, and lifetime superhero engagement on children's risk-taking.Results: Mixed results emerged. Lifetime superhero exposure was significantly related to children's risk-taking outcomes in two bivariate (vignettes and picture sort) and one multivariate (picture sort) model. Neither immediate superhero exposure nor lifetime superhero engagement was strongly related to risk-taking.Conclusions: Children's lifetime superhero exposure may influence children's risk-taking. Given American children's substantial media exposure, research should continue to unpack the role of superhero media on children's unintentional injury and other health risk behaviors. [ABSTRACT FROM AUTHOR]

Objective: To test breastfeeding duration and responsive parenting as independent predictors of infant weight change from birth to 12 months, and to test the moderating effect of a tiered parenting intervention on relations between breastfeeding and responsive parenting in relation to infant weight change.Methods: Mother-infant dyads (N = 403) were participants in the ongoing Smart Beginnings (SB) randomized controlled trial testing the impact of the tiered SB parenting model that incorporates two evidence-based interventions: Video Interaction Project (VIP) and Family Check-Up (FCU). The sample was low income and predominantly Black and Latinx. Responsive parenting variables (maternal sensitivity and intrusiveness) came from coded observations of mother-infant interactions when infants were 6 months. Continuous weight-for-age (WFA) z-score change and infant rapid weight gain (RWG) from 0 to 12 months were both assessed.Results: Longer breastfeeding duration was significantly associated with less WFA z-score change. The relationship between breastfeeding duration and WFA z-score change was significant only for infants in the intervention group. Intrusive parenting behaviors were also associated with greater WFA z-score change after accounting for breastfeeding duration.Conclusions: This study is one of the first to test both breastfeeding and parenting in relation to infant weight gain in the first year. Findings may have implications for family-focused child obesity prevention programs. [ABSTRACT FROM AUTHOR]

Objective: The present nonrandomized controlled trial aimed to evaluate feasibility, acceptability, and preliminary efficacy of a tailored text message intervention for increasing adolescent physical activity, as compared with passive monitoring.Methods: Forty adolescents (13-18 years old) received either a tailored text messaging intervention (Network Underwritten Dynamic Goals Engine [NUDGE]; N = 20), or participated in an attention-control condition (N = 20), for 20 days. Physical activity was measured for all participants via continuous accelerometry. Frequency analyses were conducted on program usage and satisfaction ratings to evaluate feasibility and acceptability, and multilevel models were used to evaluate the efficacy hypotheses.Results: The vast majority of participants (90%) reported being very or mostly satisfied with the NUDGE program and rated their enjoyment as above average. The intervention group was estimated to spend an average of 20.84 more minutes per day in moderate-to-vigorous physical activity relative to the attention-control group (β = 20.84, SE = 8.19). Exploratory analyses revealed that the intervention group also engaged in 82 fewer minutes of sedentary time per day on average, although this effect was not significant due to the large variability in sedentary time (β = -81.98, SE = 46.86).Conclusions: The NUDGE tailored text messaging intervention was feasible, acceptable, and efficacious in increasing physical activity in this sample. Findings warrant additional evaluation of NUDGE as both a standalone physical activity intervention or as part of a multicomponent package. [ABSTRACT FROM AUTHOR]

Pediatric obesity confers increased risk for a host of negative psychological and physical health consequences and is reliably linked to low levels of physical activity. Affective antecedents and consequences of physical activity are thought to be important for the development and maintenance of such behavior, though research examining these associations in youth across the weight spectrum remains limited.Objective: This study examined bi-directional associations between affect and physical activity (i.e., moderate-to-vigorous physical activity [MVPA] and total activity counts), and the extent to which weight (body mass index z-score [z-BMI]) moderated these associations.Methods: Participants were drawn from a prior study of siblings (N = 77; mean age = 15.4 ± 1.4 years) discordant for weight status (39 nonoverweight siblings, 38 siblings with overweight/obesity) who completed ecological momentary assessment (EMA) with accelerometer-assessed physical activity.Results: Generalized linear mixed models indicated z-BMI moderated trait-level and momentary associations. When adolescents with higher z-BMI reported momentary negative affect, they evidenced less MVPA within the next hour. Across the sample, greater overall activity was associated with lower negative affect. However, at the momentary level, when adolescents with higher (but not lower) z-BMI evidenced greater activity, they reported decreases in negative affect.Conclusions: Findings indicate affective experiences surrounding physical activity differ according to z-BMI. Specifically, momentary negative affect may impede momentary MVPA among youth with higher z-BMI. Further research is warranted to elucidate factors influencing these momentary associations and the extent to which these momentary associations prospectively predict weight change. [ABSTRACT FROM AUTHOR]

Objective: Several factors are known to impact response to the intensive interdisciplinary pain treatment (IIPT) program described in this study, yet no research has explored the role of perfectionism. This secondary data analysis explored direct and indirect relations between perfectionism and functional disability (primary outcome) and pain severity (secondary outcome) after IIPT, with pain catastrophizing and fear of pain as mediators.Methods: Youth (N = 253) aged 8-21 with chronic pain and associated disability completed pre- and post-IIPT measures of self-oriented perfectionism (SOP), socially prescribed perfectionism (SPP), pain catastrophizing, fear of pain, functional disability, and pain characteristics for routine clinical care and this nonrandomized trial. Eight mediated models were run for the two predictors, two mediators, and two outcomes.Results: Pretreatment perfectionism (SOP and SPP) led to greater reductions in pain catastrophizing over the course of IIPT, which resulted in lower pain severity (β = -.02 [CI = -0.07, -0.01] for SOP and β = -.02 [CI = -0.06, -0.003] for SPP) and less functional disability (β = -.06 [CI = -0.13, -0.01] for SOP and β = -.06 [CI = -0.14, -0.01] for SPP). Independent of pain catastrophizing, pretreatment SPP was directly associated with more posttreatment functional disability (β = .16 [CI = 0.05, 0.27]). Fear of pain was not a mediator.Conclusions: Findings suggest perfectionism has the potential to negatively impact IIPT outcomes. However, when perfectionistic youth with chronic pain learn to manage pain-related distress, they benefit. Results highlight the importance of assessing for and treating perfectionism and pain-related distress in youth with chronic pain. [ABSTRACT FROM AUTHOR]

Objective: Upwards of 14% of late adolescents and young adults (AYAs) experience chronic pain; however, limited research has focused on factors specifically influencing late AYAs as they transition to adulthood. In this topical review, we propose a conceptual model of multidomain pain resilience (MDPR) in late AYAs with chronic pain that extends existing pain resilience literature, including the Ecological Resilience-Risk Model for Pediatric Chronic Pain.Method: A conceptual framework for MDPR in late AYAs was developed from the existing literature on resilience in young people with chronic pain. Gaps in knowledge specific to late AYAs are identified, and relevant research examining MDPR in adults with pain are summarized to inform applications of this concept to youth as they transition to adulthood.Results: Few studies have explored resilience factors in pediatric pain. Of note, these endeavors have largely neglected late adolescence and young adulthood, despite unique considerations germane to this crucial developmental period. Existing research has also focused exclusively on assessing resilience as a unitary, rather than a multidimensional construct. Although limited, MDPR has been examined in midlife and older adults with chronic pain, highlighting the need to expand prior models of pain resilience and extend these principles to emerging adulthood.Conclusions: Understanding MDPR in late AYAs with chronic pain may provide insights regarding measurable and modifiable resilience factors (e.g., adaptive and personal resources) that promote healthy pain-related outcomes (e.g., reduced pain and enhanced physical functioning) and optimize prevention and/or treatment strategies for this group. [ABSTRACT FROM AUTHOR]

Objectives To highlight the role of implicit bias in contributing to existing health disparities among pediatric populations during the coronavirus disease 2019 (COVID-19) pandemic and recommend strategies to reduce its impact. Methods A topical review of the recent literature on implicit bias describing its potential impact in key areas of pediatric health care within the context of COVID-19 was conducted. Results Pediatric provider implicit bias has been found to be similar to the general population and can negatively influence clinical decision-making and outcomes for marginalized youth and families, particularly under stressful conditions such as the COVID-19 pandemic. Implicit bias can be mitigated through strategies proposed at the individual, institutional/organizational, educational, and scientific/research levels. Conclusions The additional strain on provider resources, staff, and supplies created by COVID-19 may exacerbate providers' susceptibility to implicit bias and contribute to health disparities. Pediatric psychologists are encouraged to recognize implicit biases in themselves and colleagues and promote identified strategies to reduce the impact of implicit bias on perpetuating health disparities in marginalized youth and families. [ABSTRACT FROM AUTHOR]

Tools of empirical epidemiology have been and are indispensable to focus political power on blocking the spreading of coronavirus disease 2019 (COVID-19) by stopping transmission. The present paper is a comment on E. Gibney's article 'Whose coronavirus strategy worked best?' (Nature 2020;581:15–6). The strategy for phase 2 should be more complex and interdisciplinary than described in the paper in Nature, especially in the period before a vaccine and specific treatments are available. The focus on reducing the mortality of COVID-19 will have side effects, including excess mortality from other causes. A part of this excess mortality will be based on the reduction of health-care offers as a consequence of the pandemic, and on structural limitations of the health-care system. A special challenge is to understand the relationship between death from and death with COVID-19, and therefore the relevance of severe acute respiratory syndrome coronavirus 2 infection in people with pre-existing burdens, for example coronary heart disease, cancer or older age. There is a need to extend the recently used tools to all available instruments, including physiological principles of prevention and promotion. The way to integrate global solidarity into the strategies of the different countries is critical not only for global health but also for the peace and long-term success for each individual country. The consequences of efforts against COVID-19 and the impact on reduced air pollution and climate change are also important to analyse from a global health perspective. [ABSTRACT FROM AUTHOR]

Objective: This mixed-methods study examined perceived acceptability and appropriateness of a novel digital mental health program targeting anxiety risk (i.e., perfectionism or error sensitivity) in 5-to-7-year-old children and their parents., Methods: Parent-child dyads participated in a modular, web-based cognitive-behavioral program targeting negative overreactions to making mistakes. The program, "Making Mistakes", consisted of a 6-month series of short video clips, journaling activities, and weekly reminders, and modules were delivered to caregivers and children separately. 86 dyads completed self-report measures, 18 of whom participated in semi-structured interviews, following completion of the primary program module. A standard thematic analysis was used to elucidate themes from the parent and child interview content., Results: Our quantitative and qualitative results were generally aligned. Children and parents viewed the novel digital mental health program as acceptable and appropriate, favoring the cognitive behavioral strategies such as modeling positive reactions to mistakes, responding positively to child mistakes, and emphasizing effort over outcome. Participants also provided helpful feedback related to program content, delivery, and engagement, as well as suggestions to enhance the program., Conclusions: Findings have implications for design and content features of parent-based and dyad-based programs, as well as digital mental health programs focused on reducing anxiety risk., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Physical distancing behavior (PDB) is a key disease prevention strategy for limiting the spread of COVID-19. In order to effectively encourage it among adolescents, it is necessary to understand the associated mental mechanisms. Health behavior theories suggest that emotions, personality, motivation, and moral disengagement could all play a role. On the basis of a longitudinal study, we investigated the importance of these factors in predicting PDB.Methods: The participants were 347 adolescents residing in Italy. Data were collected in four waves starting from 1 year before the pandemic. A structural equation model based on health behavior theory was tested.Results: After the COVID-19 national lockdown, adolescents experienced fewer positive emotions and more negative emotions compared with 1 year earlier. Nevertheless, these emotional changes, and adolescents' personality (except for openness to experiences), were not related to the adoption of PDB. Instead, the autonomous motivation of adolescents significantly predicted a higher likelihood to adopt PDB by increasing the intention to engage in this behavior and, more indirectly, by substantially decreasing moral disengagement, which was negatively related to PDB. In contrast, controlled motivation corresponded to significantly higher levels of moral disengagement and predicted less likelihood of adopting PDB.Conclusions: Messages and interventions targeted at adolescents should be oriented towards supporting autonomy, emphasizing the personal and social value of PDB. Communications should avoid the use of coercive strategies based on eliciting emotions such as shame and guilt in adolescents who do not adopt PDB, which appear to trigger off mechanisms of moral disengagement. [ABSTRACT FROM AUTHOR]

Background: People with severe mental illness experience physical health significantly worse than the general population. Physical health monitoring is shared between primary care and secondary mental healthcare services, though there is debate whether mental health teams should provide more physical healthcare. The views of mental health clinicians and patients with mental illness towards physical healthcare provision are unclear. Aims: To explore the attitudes of Community Mental Health Team (CMHT) clinicians and patients experiencing severe mental illness towards physical healthcare and its provision. Design and setting: Qualitative study in a CMHT setting. Methods: Interviews were carried out with CMHT clinicians and patients with severe mental illness. Data were collected using semi-structured interviews and analysed using thematic analysis. Results: There were 14 patients and 15 clinicians recruited. Patients varied in their awareness of the association between physical and mental health, but were engaged in physical health monitoring. Clinicians were aware of the importance of physical healthcare but reported barriers to provision, including lack of training, resource constraints and uncertainty in their role. There was no consensus in either group regarding how physical healthcare should be provided, with diverse attitudes expressed for why CMHTs should and shouldn't provide more physical healthcare. Conclusions: Increasing physical healthcare provision from mental health teams requires healthcare-related barriers be addressed, but it remains unclear whether CMHT clinicians or patients believe this to be a solution. [ABSTRACT FROM AUTHOR]

Aim: Relative risks and odds ratios are widely reported in the medical literature, but can be very difficult to understand. We sought to further clarify these important indices. Methods: We illustrated both relative risks and odds ratios using bar charts, then looked at the types of study for which each statistic is suited. We demonstrated calculation of relative risks and odds ratios through analysis of tabled data from a recent published longitudinal study, using a 2 × 2 table and R, the open‐source statistical programming language. Simple rules for when and how to use relative risks and odds ratios are presented. Conclusion: Understanding the difference between relative risks and odds ratios and when and how to use them may aid clinical interpretation, dissemination and translation of research findings. [ABSTRACT FROM AUTHOR]

Background: Willingness to Pay (WTP) is an alternative to measure quality-adjusted life years for cost-effectiveness analyses. The aim was to evaluate longitudinal changes and determinants of parental WTP for the prevention of childhood overweight and obesity. Methods: Longitudinal data from post- (T2) and follow-up (T3) measurements of a school-based health promotion program in Germany. Parental questionnaires included general WTP and the corresponding amount to reduce incidental childhood overweight and obesity by half. Longitudinal differences were examined with the McNemar test for general WTP and the Wilcoxon signed-rank test for the amount of WTP. Regression analyses were conducted to detect determinants. Results: General parental WTP significantly decreased from 48.9% to 35.8% (p < 0.001, n = 760). Logistic regression analysis (n = 561) showed that parents with a tertiary education level and a positive general WTP at T2, families with a higher monthly household income, and those with abdominally obese children were significant predictors of general WTP at T3. Median amount of WTP at T3 was €20.00 (mean = €27.96 ± 26.90, n = 274). Assuming a WTP of €0 for those who were generally not willing to pay or did not answer, resulted in a median amount of WTP at T3 of €0 (m = €8.45, sd = €19.58, n = 906). According to linear regression analysis WTP at T2 was the only significant predictor for the amount of WTP at T3 (p = 0.000, n = 181). Conclusions: Despite the decline of general WTP, these results are a reflection of the public awareness of the problem and the need for action. Policy makers should recognize this and initiate sustainable public preventive strategies. Trial registration: DRKS, DRKS00000494. Registered 25 August 2010, https://www.drks.de/drks_web/. [ABSTRACT FROM AUTHOR]

Objective: To test relations between exposure to poverty, in the forms of family income and neighborhood deprivation, during three developmental stages, and children's body mass index (BMI) in early adolescence.Methods: Data came from a longitudinal sample of racially diverse, urban, low-income boys. Interactions between family income to needs and census-derived neighborhood deprivation at three developmental stages-early childhood (18 and 24 months), preschool-to-school entry (3.5 and 6 years), and school-age (8 and 10 years)-were tested in relation to BMI at age 11.Results: There was a significant interaction whereby higher income predicted lower BMI only in the context of low levels of neighborhood deprivation in early childhood. In high-deprivation neighborhoods, higher income was associated with risk for overweight/obesity in early adolescence. This pattern was found to be specific to income and neighborhood deprivation measured in early childhood.Conclusions: Findings have implications for policy relevant to obesity prevention. More research on associations between early exposure to poverty and later risk for obesity on low-income samples is warranted, as the relationship is likely complex and influenced by many different factors, including the family and neighborhood food environments and child health behaviors. [ABSTRACT FROM AUTHOR]

The Choking Game (TCG), practiced by adolescents, involves forced asphyxiation to obtain a 'high', occasionally causing seizures or death. Few parents report discussing TCG with their child despite their critical role in injury‐prevention. This paper examined parental knowledge of TCG and perceptions of TCG‐related discussions with their child. From parent responses, eight thematic elements were identified: Risks; Awareness; Peer Context; External Resources; Basic Information; Prevention Strategy; Participation; and Told Not To. We propose a guide for parents planning a TCG prevention discussion is offered based on naturally occurring parental conversations. [ABSTRACT FROM AUTHOR]

Adolescents and young adults (AYAs) with chronic medical conditions are at risk for reduced health-related quality of life (HRQoL). Recent research on AYAs without chronic medical conditions found that greater health care management skills were related to higher HRQoL. In addition, grit, an intrapersonal strength, has been linked to greater health care management skills and HRQoL. The current study extended these findings to AYAs with a chronic medical condition. Three hundred and seventy-five undergraduates with a chronic medical condition completed questionnaires, including the short Grit Scale, Transition Readiness Assessment Questionnaire, and RAND 36-Item Short Form Survey. Path analysis revealed a significant direct effect of grit on health care management skills and on both mental and physical HRQoL. Further, health care management skills had a significant indirect effect on the grit → mental HRQoL association, but not on the grit → physical HRQoL association. Higher levels of grit were linked to better health care management skills and better mental and physical HRQoL. Further, grit and mental HRQoL were indirectly linked through health care management skills, suggesting the utility of these skills in improving mental HRQoL. Given the observed benefits of higher grit and health care management skills on emotional HRQoL, and the potential impact of health care management skills on future physical HRQoL, interventions targeting the enhancement of grit and health care management skills may be beneficial in improving the efficacy of transition readiness interventions. • Grit, an intrapersonal strength, had a significant direct effect on mental and physical health-related quality of life. • Grit demonstrated a significant direct effect on health care management skills. • Grit had a significant indirect effect on mental health-related quality of life through health care management skills. • Health care management skills partially account for the association between grit and mental health-related quality of life. [ABSTRACT FROM AUTHOR]

Objective: To present a guiding framework from the perspective of psychologists and technologists to develop effective mobile health (mHealth) interventions for pediatric populations.Methods: This topical review uses the IDEAS framework as an organizational method to summarize current strategies to conceptualize, design, evaluate, and disseminate mHealth interventions.Results: Incorporating theories of behavior change and feedback from target populations are essential when developing mHealth interventions. Following user-centered approaches that fully incorporate end users into design and development stages increases the likelihood that the intervention will be acceptable. Iterative design cycles and prototyping are important steps to gather user feedback to optimize an mHealth intervention. Broad sharing of knowledge and products generated during intervention development also is recommended. Assessment of behavioral principles, intervention components, or a full intervention package should be conducted to evaluate usability and efficacy.Conclusions: Pediatric health-care researchers and clinicians are increasingly using mHealth technology to target health behaviors and improve related outcomes. Pediatric psychologists should consider applying the design strategies outlined in the IDEAS framework to produce and disseminate mHealth interventions tailored to the specific needs of pediatric populations. [ABSTRACT FROM AUTHOR]