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Background: Future practitioners need to learn to communicate with culturally diverse patients, understand their perspectives on disease and provide individually tailored guidance. SHABI (Keeping our Children Safe in Hebrew) is a program set up with a dual purpose of improving families' home-safety and providing students with experience-based learning. 11 medical/ nursing students twice visited 135 families who were recruited in an emergency-room following unintentional injury of a preschool child on May 2019-March 2020. 50% of families were ultra-Orthodox Jews, 11% Arab, and 28% had 3 children <5 years old. Training included child injury prevention, communication skills and insights on religious communities led by a local ultra-Orthodox Rabbi and head of Arab municipal social services. Objective: To examine SHABI's impact on students' cultural competence, evaluated through student interviews 8 months after baseline, their written reports after home visits (n = 233), parent interview calls (n = 212) and change in observed home safety assessed by a checklist 4 months later (n = 233). Results: Students reported that training helped them to culturally adapt the visits, and that the home visits increased their understanding of cultural and religious groups with whom they had little familiarity. Students worried that they would be perceived as judgmental, but parents reported they were sensitive, and the visits were beneficial. Following the first visit, 64% of parents reported increased awareness about home safety and 59% that the visit improved home safety. Effectiveness of student skills were confirmed by observed 15% improvement in home-safety after 4 months. Conclusions: This experience-based learning helped to develop students' self-perceived cultural competence and improve families' home safety. SHABI may serve as a model of how students can learn to engage with disadvantage populations after a medical encounter, promoting their skills while benefitting families. Key messages: Participating in experience-based learning and engaging with diverse populations developed cultural competence and benefited local populations. The SHABI program presents a feasible model to introduce into healthcare education. [ABSTRACT FROM AUTHOR]

In our first article we considered literature for and about children, and how writing for the young has changed, reflecting different and evolving perspectives on childhood. In this second article, we will be asking whether literature can be used creatively and usefully in the training of doctors. The suggestion for the topic arose from a session we organised for paediatricians in the Communication and Management Skills module of the MMedSc in Child Health at Leeds University. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor about disappointing and frustrating experience of offering a program for obese children.

Objectives: The Bar Ilan Faculty of Medicine places public health as a priority in its medical curriculum, emphasizing its importance by strategically placing the required course as first on entry into medical school. Students are introduced to the importance of population health and community engagement through participatory community learning experiences. This study aims to examine how participatory community teaching methods impact students' understanding and attitudes towards community health. Study design: Mixed quantitative and qualitative design. Methods: 75 first year students completed the required public health course utilizing participatory community methods, including community visits, Team Based Learning, an ethnic forum, and lifestyle medicine. Evaluation comprised skills assessment through project work, analysis of reflective notes and comparison of assessment scores with students in the previous year who experienced a formal lecture-only based curriculum. Results: Students acquired public health skills, including conducting a needs assessment, searching for research evidence and designing an evaluation framework. Reflective notes revealed in-depth understanding not only of course aims, but an appreciation of the social determinants of health and the local community. Test marks indicated public health knowledge reached a comparable standard (83 ± 7.3) to the previous year (85 ± 9.3; P = 0.431). Conclusions: Participatory community learning equips students with public health skills, knowledge, and enhanced understanding of communities. It offers a way to effectively teach public health, while emphasizing the extended role and societal responsibilities of doctors. [ABSTRACT FROM AUTHOR]

Objectives: Increased understanding of the risk factors for childhood obesity has raised the possibility of identifying infants who are at risk of becoming overweight or obese, enabling early intervention for infants at high risk. This paper considers the known risk factors, describes statistical work aimed at identifying risk, and considers the ethical and practical issues of such a development. Study design and methods: An overview of the published evidence for risk factors in the early development of overweight and obesity, and a statistical assessment of the practicality of developing a simple obesity risk assessment tool (ORT) for use in the primary care setting. Results: Analysis of data from two currently available UK birth cohort studies suggests that an ORT based on these data does not provide acceptable levels of specificity and sensitivity for use in a primary care setting. Conclusion: Further development of an ORT using additional data and enhanced statistical analysis may lead to a practical tool. However the practical, ethical and legal issues involved in its use, and the public health policy considerations that follow must be resolved. [ABSTRACT FROM AUTHOR]

Objectives: One in five children in England are overweight/obese at school entry. Tackling obesity is therefore a priority. Right from the Start with HENRY is a widely-commissioned programme delivered by trained facilitators to small groups of parents over eight weekly sessions. It is designed to provide parents of infants and preschool children with the skills, knowledge and confidence required for a healthier family lifestyle. The aim of this work was to investigate programme impact using data collected routinely for quality control purposes. Study design: Analysis of routinely collected pre-post data from programmes delivered in the UK from January 2012 to February 2014. Methods: Data were analysed from 144 programmes, including questionnaires relating to parenting, family eating behaviours, dietary intake, and physical activity/screen time. Results: Over 24 months, 1100 parents attended programmes running in 86 locations. 788 (72%) completed >5 sessions of whom 624 (79%) provided baseline and completion questionnaires. Parents reported increases in healthiness of family lifestyle, parenting attributes, and emotional wellbeing following attendance (all P < .001). Both parents and children were reported to have increased their daily fruit/vegetable consumption, and reduced their consumption of high fat/sugar foods (both P < .001). There were also positive changes in eating behaviours, physical activity (P < .001) and children's screen time (P < .001). Conclusions: Significant changes were reported in all domains similar to those reported in a previous, smaller study in locations selected for experience and quality. The HENRY approach appears to have a beneficial impact even when delivered at scale in non-selected locations. Such changes, if maintained, may serve to protect against later obesity. [ABSTRACT FROM AUTHOR]

Summary Background: The UK Government has set a target of halting the rise in childhood obesity by 2010. However, at the time the target was set, no monitoring process existed. The English Department of Health has now issued guidelines to primary care trusts for the annual weighing and measuring of all children on entry to primary school and in year 6. Aim: Development of an inexpensive school-based monitoring scheme for trends in childhood obesity suitable for national implementation. Method: The methodology was developed in 10 pilot schools in 2004 and implemented in 25 primary schools and three secondary schools in 2005. Specially trained heatthcare support workers (HCSWs) recorded height and weight measurements of primary school children in reception and year 4, and secondary school children in year 8 (aged 5, 8 and 13 years, respectively, on average). The ethnic and socio-economic profile of the sample was compared with census data, and the levels of obesity were calculated using standard age cut-offs. Results: While monitoring in primary schools was achieved with no evidence of disruption to the schools or distress to the subjects, monitoring in secondary schools was deemed to be impractical. Cost analysis indicated an estimated cost of less than £1.50 per primary school child measured. Conclusions: The model provides a viable means of monitoring childhood obesity trends. Monitoring should be confined to primary schools and should be conducted by specially trained Chews rather than school nurses. [ABSTRACT FROM AUTHOR]

The article focuses on a study on the reliability of the routine surveillance of the height and weight of children as a method of monitoring obesity epidemic in Great Britain. Under the study, the data collected by the local school nursing service was compared with those by specially trained teams on a class-by-class basis on the same group of schoolchildren. It adds that the specially trained teams collected data in the context of the TRENDS project. It cites the advantages of the TRENDS model over routine surveillance which include a defined aim.

Background: Eating behaviours vary by culture and religion, and an understanding of attitudes and practices are essential for providing culturally competent nutritional guidance. The Ultra-orthodox Jewish community is characterized by poor diet, high rates of obesity, anemia and diabetes. This study aimed to acquire insights that could influence the promotion of healthier eating in the Ultra-orthodox and other closed religious communities, particularly regarding children's eating habits and the food they consume., Methods: In depth face-to-face recorded interviews were conducted with 20 information-rich participants: religious leaders, opinion leaders and education/health professionals from Gur and Chabad, two Ultra-orthodox Jewish religious communities in Israel. The focus was on exploring young family eating behaviours and perceived challenges to encouraging healthier nutrition in the community. Interviews were transcribed and thematic analysis employed using grounded theory., Results: Seven themes were identified with findings that had clear implications for the promotion of health at both the community and individual level. These included spiritual aspects of eating, deficits in knowledge and awareness, less relevance of kashrut than previously thought, the centrality of motherhood and family meals, the quality of food in educational institutions, the significance and sensitivity of Sabbath and festive meals and pragmatic considerations., Discussion and Conclusions: By illuminating attitudes and behaviors, the study broadens and enhances our understanding of the Ultra-orthodox communities' perspectives on eating behaviours in the family. The findings have the potential to contribute to strengths-based health promotion for children's nutrition. Recommendations regarding culturally competent guidance and implications for other secluded religious communities are discussed., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objective: The present study explored how Israeli and UK mothers integrate feeding into their conceptualisations of mothering 2-6 months post-partum., Background: The nature and importance of motherhood is subject to differential contextual, cultural, political and historical influences. We set out to compare experiences of motherhood and feeding between these two countries using a qualitative approach., Methods: Forty one women (mean age 36.4 ± 2.7 years) from Israel and the UK, mostly married or in a committed relationship were interviewed about their experience of pregnancy, motherhood and feeding. Data were analysed thematically., Results: The experience of motherhood in the early postnatal period was dominated, for all mothers, by the experience of breastfeeding and clustered around three representations of mothering, namely; 1) a devoted mother who ignores her own needs; 2) a mother who is available for her infant but acknowledges her needs as well; and 3) a struggling mother for whom motherhood is a burden. Such representations existed within both cultural groups and sometimes coexisted within the same mothers. UK women described more struggles within motherhood whereas a tendency towards idealising motherhood was observed for Israeli women., Conclusion: There are similarities in the ways that UK and Israeli women experienced motherhood and feeding. Where family life is strongly emphasized, mothers reported extremes of idealism and burden and associated an "ideal" mother with a breastfeeding mother. Where motherhood is represented as just one of many roles women take up, they are more likely to represent a "good enough" approach to mothering. Understanding the experience of motherhood and feeding in different cultural settings is important to provide the context for postnatal care specifically where mothers are reluctant to share problems or difficulties encountered., (Copyright © 2015 Elsevier Ltd. All rights reserved.)