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Purpose: It is well established that individuals with a communication disability, including being deaf or hard of hearing (DHH), experience inequities in health services and outcomes. These inequities extend to DHH children's access to psychosocial evidence-based interventions (EBIs). Behavioral parent training is an EBI that can be used to improve caregiver and child outcomes. Despite being supported by decades of effectiveness research, this EBI is rarely accessed by, or studied with, caregivers of DHH children. The purpose of this article is to describe a program of stakeholder-engaged research adapting and assessing behavioral parent training with caregivers of young DHH children followed in hearing health care, aimed at reducing inequities in access to this EBI. Method: The first section briefly summarizes the literature on disruptive behavior problems in young children, with a focus on preschool-age DHH children. The evidence base for behavioral parent training is described. Next, the gaps in knowledge and practice regarding disruptive behaviors among DHH children are highlighted, and the potential integration of behavioral parent training into the standard of care for this population is proposed. Conclusions: Young DHH children who use hearing aids and/or cochlear implants experience disruptive behavior problems at rates at least as high as typically hearing children, but their access to EBIs is limited, and behavioral parent training programs tailored to this population have not been rigorously tested. Caregivers and hearing health care service providers affirm the potential benefits of behavioral parent training and were partners in adapting this EBI. This research highlights several principles and approaches essential for reducing inequities and improving the quality of life not only for DHH children and their families but also for individuals with communication disabilities more broadly: engagement of key stakeholders in research, collaboration across disciplines, and using implementation science methods and models to design for implementation, dissemination, and sustainment.

BACKGROUND. Beige adipose tissue is associated with improved glucose homeostasis in mice. Adipose tissue contains [beta]3-adrenergic receptors ([beta]3-ARs), and this study was intended to determine whether the treatment of obese, insulin-resistant humans with the [beta]3-AR agonist mirabegron, which stimulates beige adipose formation in subcutaneous white adipose tissue (SC WAT), would induce other beneficial changes in fat and muscle and improve metabolic homeostasis. METHODS. Before and after [beta]3-AR agonist treatment, oral glucose tolerance tests and euglycemic clamps were performed, and histochemical analysis and gene expression profiling were performed on fat and muscle biopsies. PET-CT scans quantified brown adipose tissue volume and activity, and we conducted in vitro studies with primary cultures of differentiated human adipocytes and muscle. RESULTS. The clinical effects of mirabegron treatment included improved oral glucose tolerance (P < 0.01), reduced hemoglobin A1c levels (P = 0.01), and improved insulin sensitivity (P = 0.03) and [beta] cell function (P = 0.01). In SC WAT, mirabegron treatment stimulated lipolysis, reduced fibrotic gene expression, and increased alternatively activated macrophages. Subjects with the most SC WAT beiging showed the greatest improvement in [beta] cell function. In skeletal muscle, mirabegron reduced triglycerides, increased the expression of PPAR[gamma] coactivator 1 [alpha] (PGC1A) (P < 0.05), and increased type I fibers (P < 0.01). Conditioned media from adipocytes treated with mirabegron stimulated muscle fiber PGC1A expression in vitro (P < 0.001). CONCLUSION. Mirabegron treatment substantially improved multiple measures of glucose homeostasis in obese, insulinresistant humans. Since [beta] cells and skeletal muscle do not express [beta]3-ARs, these data suggest that the beiging of SC WAT by mirabegron reduces adipose tissue dysfunction, which enhances muscle oxidative capacity and improves [beta] cell function. TRIAL REGISTRATION. Clinicaltrials.gov NCT02919176. FUNDING. NIH: DK112282, P30GM127211, DK 71349, and Clinical and Translational science Awards (CTSA) grant UL1TR001998., Introduction The [beta]3-adrenergic receptor ([beta]3-AR) has long been a therapeutic target to combat obesity and metabolic disease. Since the [beta]3-AR is present in adipose tissue, but not in most other [...]

Background: More than one third of college students are either overweight or obese, making college campuses an ideal setting to target at risk behaviors while tailoring programs to the evolving lifestyle of college students. Purpose: The purpose of this study was to determine the impact of a 15-week, campus-based lifestyle modification program on obese college students with regard to physical activity behaviors, attitudes, and self-efficacy. Methods: Eighteen college students completed pre- and postintervention surveys that measured participants' behaviors, attitudes, stage of change, self-efficacy, social support, environmental factors, and body mass index. The PACE Adult Measure was used to assess physical activity variables for the study. Results: The intervention was successful at increasing physical activity level and self-efficacy and decreasing body mass index (BMI) when comparing pre- and post measures (P < 0.05). Discussion: The results of this study suggest that collaborative programming on college campuses targeted toward obese individuals is beneficial in increasing physical activity and self-efficacy. Future research should examine the long-term impact of these on-campus collaborative programs on college students' health and well-being. Translation in Health Education Practice: The findings support the implementation of similar programming aimed to improve physical activity outcomes on a college campus.

Background: Preseason movement screening can identify modifiable risk factors, deterioration of function, and potential for injury in baseball players. Limited resources and time prevent high school baseball coaches from performing movement screens on their players. Hypothesis: The arm care screen (ACS) will be highly sensitive to detecting musculoskeletal risk factors. Study Design: Cross-sectional. Level of Evidence: Level 3. Methods: A total of 150 baseball players were independently scored on the ACS electronically by reviewing a video recording of each player's screening performance. Discriminability of the ACS was determined with a 2 × 2 contingency table dichotomizing musculoskeletal risk factors as present or absent based on a predetermined cutoff value and those who passed or failed the corresponding ACS subtest. Results: High sensitivity was observed on the reciprocal shoulder mobility (0.89; 95% CI 0.81-0.94), 90/90 total body rotation (0.86; 95% CI 0.79-0.92), and lower body diagonal reach (0.85; 95% CI 0.78-0.91) tests of the ACS suggesting sufficient ability to identify musculoskeletal impairments and risk factors. Conclusion: The ACS is a simplistic screening tool that the coach can administer to discriminate between youth, high school, and college-level baseball players who possess musculoskeletal risk factors. The ACS subtests demonstrated high sensitivity for correctly identifying musculoskeletal risk factors common in baseball players and can be useful as a screening tool for baseball coaches developing arm care exercise programs. Clinical Relevance: A field-expedient screen could provide coaches the ability to identify musculoskeletal risk factors that need to be addressed to minimize injury risk factors in a time-efficient manner. [ABSTRACT FROM AUTHOR]