Child Health Professionals Research Articles

Advocacy and Child Health Outcomes: Do Child Health Professionals Realize Their Opportunities?

Advocacy and Child Health Outcomes: Do Child Health Professionals Realize Their Opportunities?

Social prescribing: Moving pediatric care upstream to improve child health and wellbeing and address child health inequities.

Social prescribing is a means for trusted individuals in clinical and community settings to connect people who have non-medical, health-related social needs to non-clinical supports and services within the community through a non-medical prescription. Evaluations of social prescribing programs for the pediatric population have demonstrated statistically significant improvements in participants' mental, physical, and social wellbeing and reductions in healthcare demand and costs. Experts have pointed to the particularly powerful impact of social prescribing on children's mental health, suggesting that it may help to alleviate the strain on the overburdened mental health system. Social prescribing shows promise as a tool to move pediatric care upstream by addressing non-medical, health-related social needs, hence why there is an urgent need to direct more attention towards the pediatric population in social prescribing research, policy, and practice. This demands rapid action by researchers, policymakers, and child health professionals to support advancements in this area.

Digital Psychosocial Follow-up for Childhood Critical Illness Survivors: A Qualitative Interview Study on Health Professionals' Perspectives.

Digital solutions have been reported to provide positive psychological and social outcomes to childhood critical illness survivors, a group with an increased risk for long-term adverse psychosocial effects. To explore health professionals' perspectives on the potential of digital psychosocial follow-up for childhood critical illness survivors. Using a qualitative approach, expert interviews with six health professionals working at a Norwegian hospital were conducted. Transcribed interviews were analyzed using Braun and Clarke's six-phase thematic analysis framework. Concurrent data collection and analysis using inductive coding was also employed, and a model of codes was constructed. The interview yielded thirteen unique codes regarding the health professionals' perspectives on the potential for digital psychosocial follow-up for childhood critical illness survivors, organized in a model comprising the two main themes: Affecting Factors and Digital Usage. Demographic factors (the child's medical condition, age, gender, and residence) and environmental factors (the child's family and health professionals) tended to affect the current psychosocial follow-up. Hospital limitations concerning a lack of digital solutions, worse relationship building with video communication, and children's already high screen time reflected the current state of digital usage. However, ongoing digitalization, existing successful digital solutions, children's good digital skills, and an ongoing process of creating an artifact are also seen as opportunities for digital usage in future psychosocial follow-up for childhood critical illness survivors. Researchers can build further on these findings to investigate the potential of digital psychosocial follow-up for childhood critical illness survivors, and clinicians can use it as a starting point for improving psychosocial follow-up.

Software evaluation on infant development to support teaching and professional training.

evaluate the functional performance and technical quality of the Wise Infant Development® educational software with experts. methodological research that followed the software evaluation process according to the ISO/IEC 25010 and NBR ISO-IEC 14598-6 standards. The software's functional performance was assessed by a group of nurse experts and its technical quality by information technology experts. The Content Validity Index and the Binomial test were used for statistical analysis. in both expert groups, agreement was greater than 70%, indicating that the software is suitable and pertinent to what was proposed in all its evaluated characteristics: functional suitability, reliability, usability, performance efficiency, compatibility, security, maintainability, and portability. The technology received suggestions for improvement, which were accepted. the Wise Infant Development® software was well evaluated by the experts and could contribute to teaching about infant development, both in undergraduate nursing courses and in professional training. (1) The software presents satisfactory technical quality and functional performance. (2) Technology is useful in the students' teaching-learning process. (3) The software can be used to train child health professionals.

Physical Development in Early Childhood

Physical development in early childhood is a complex and significant process in a child's life. In this age range, children experience rapid body growth, gross and fine motor development, as well as changes in the nervous system and body organs. Genetic, environmental, and nutritional factors play key roles in directing the course of this physical development. A deeper understanding of these stages can help parents, educators and child health professionals provide appropriate support to ensure optimal growth and development in children during this critical period. At this age, fine and gross motor skills develop rapidly, allowing children to perform daily activities such as drawing, writing, and playing sports more skillfully. Environmental factors such as sensory stimulation and play opportunities also contribute to children's physical development and social skills. Therefore, a comprehensive understanding of the dynamics of physical development in early childhood can help create an environment that supports their holistic growth.

Children's and young people's experiences of expressing their views and having them heard in health care: A deductive qualitative content analysis.

To gain an understanding of children's experiences of expressing their views and having them heard in Australian healthcare settings. Child-centred qualitative research. A deductive qualitative content analysis was undertaken. Data were collected from 20 Australian children and young people between the ages of 7 and 18 years old using the 'draw, write and tell' method. Children's experiences of 'space' and 'voice', and therefore the opportunity to express their views in health care were, in the main, positive. At the same time, their experiences of 'audience' and 'influence', the situations in which those views are given due weight, were overwhelmingly described as negative. Australian paediatric health services appear to have responded to calls to provide children with the opportunity to express their views and thus are delivering on the elements of 'space' and 'voice', whereas the realisation of 'audience' and 'influence' has some way to go. Due weight is not always given to children's views. The Lundy model can be used to facilitate a better understanding of the concept of voice, and the responsibility of health organisations in implementing the rights of children and young people, as articulated in Article 12. Children and young people have a right to express their views and have them heard in health care, but their experiences in Australian health care are unknown. While children's experiences of expressing their views in health care were mostly positive, their views are not always taken seriously or given due weight. This research impacts child health professionals in Australia and internationally. The study is reported using the Standards for Reporting Qualitative Research (SRQR). Members of the Youth Advisory Council of two tertiary children's hospitals were consulted and invited to become members of the research team.

Preventing Job Burnout: Could Workplace Support Protect Maternal and Child Health Professionals Who Are Doing Public Health Equity Work?

To assess the potential of workplace support to protect public health equity workers against job burnout and to identify key workplace support components. This mixed-methods, explanatory sequential study analyzed survey and interview data collected between August 2020 and June 2021. Participants included governmental and non-governmental public health employees whose programs largely focus on Maternal and Child Health populations and who reported that their jobs involved working to reduce health inequities ("equity work"). Regression analysis tested the effect of emotional labor on job burnout, and whether workplace support modified that effect. Qualitative analysis of interview transcripts explored possible components of needed workplace support. Emotional labor was positively associated with job burnout (p < .001), and there was a significant negative interaction between emotional labor and workplace support, meaning workplace support appeared to reduce the effect of emotional labor on burnout (p = .036). Qualitative analysis identified four support components: peer-to-peer mentoring connections, workplace accommodations, engaged and empathetic supervision, and mental health resources. Workplace support is associated with reduced job burnout for public health equity workers, especially those whose jobs involve high levels of emotional labor. Few public health employers are providing needed emotional supports for their equity workers, but certain supports appear to be helpful in reducing job burnout.

Parental Attitudes on Social Media Monitoring for Youth: Cross-Sectional Survey Study.

Online environments dominate the daily lives of American youth and pose evolving challenges to their health and well-being. Recent national poll data indicate that social media overuse, internet safety, and online bullying are among parents' top child health concerns, particularly during the COVID-19 pandemic. While parents are uniquely positioned to help youth navigate social media, their attitudes on monitoring media use may be impacted by a myriad of personal and family factors. This study aimed to examine factors associated with parental attitudes about monitoring social media use among youth. Data were analyzed from the Voices of Child Health in Chicago Parent Panel Survey, administered to parents over the web and by telephone. Parents with at least 1 child aged ≥11 years responded to questions about bullying and social media monitoring from May to July 2020. The primary outcome was their response to the following question: "Do you think parents should monitor their children's use of social media platforms such as Facebook, Twitter, and Instagram?" Bivariate analyses and multivariable logistic regression were used to examine parental agreement with frequent social media monitoring and concerns about bullying, adjusted for sociodemographic characteristics. Analyses were weighted to represent the parent population of Chicago. Among 1613 survey respondents, the analyzed sample included 808 parents with at least 1 child aged ≥11 years. Overall, 62.9% (n=566) of parents agreed with frequent parental monitoring of their children's social media use. Compared with parents aged ≤35 years, parents who were >35 years old were significantly less likely to agree with frequent social media monitoring (adjusted odds ratio [aOR] 0.45, 95% CI 0.25-0.81). Parents expressing a high level of concern regarding the effects of bullying were more likely to agree with frequent monitoring of youth social media (aOR 2.15, 95% CI 1.24-3.73). Parents' personal characteristics and concerns about bullying may influence their attitudes toward monitoring social media use among youth. Given the potential impact of these attitudes on parental monitoring behaviors and the subsequent health impact on youth, pediatricians should consider these factors when counseling about bullying and social media. Child health professionals can support families in developing a safe media use plan that fits family circumstances.

Attitudes of Chinese maternal and child health professionals toward termination of pregnancy for fetal anomaly: a cross-sectional survey.

This study explores the attitudes of Chinese maternal and child health professionals toward the termination of pregnancy for fetal anomaly (TOPFA) based on four case scenarios and further identifies the factors that influence their attitudes. This cross-sectional study, conducted from February 14-21, 2022, aimed to explore the attitudes of maternal and child health professionals toward TOPFA in Hunan Province. We targeted health service institutions across 14 prefecture-level cities and the autonomous prefecture. A questionnaire was made available online and shared via the instant communication platform, WeChat. Participants were recruited through the same platform and completed the survey online. Descriptive statistics were used to analyze the data, and binary logistic regression was performed to determine factors affecting the health professionals' attitudes toward TOPFA, expressed as the odds ratio (OR) and 95% confidence intervals (CI). The study found that 63.5% of health professionals approved of the birth of a fetus with cleft lip and palate, while 36.5% opposed it. Similarly, 39.7% approved of the birth of a fetus with phenylketonuria, while 60.3% opposed it. The percentages of those in favor of and against the birth of a fetus with precocious heart disease were 45.5 and 54.5%, respectively, and those for and against the birth of a fetus with missing fingers were 50.8 and 49.2%, respectively. The top three factors considered by health professionals when agreeing on TOPFA were "the impact of fetal disease on fetal function and growth," "the severity of fetal disease," and "the assessment of indications for fetal disease by professionals and related professional advice." The majority of health professionals (75-78%) preferred joint decision-making by parents regarding the right to decide TOPFA. Our study indicates that the attitudes of health professionals toward TOPFA can differ significantly depending on the specific birth defect under consideration. Notably, the majority of health professionals prioritized "the impact of fetal abnormalities on fetal function and development" when deciding their support for TOPFA, advocating for the decision to be a joint one between the parents. Additionally, factors such as religious beliefs, professional training, age, and job title appeared to influence these attitudes toward TOPFA. Our findings could serve as a reference point in the development of guidelines for the prevention and management of birth defects.

Parents’ concerns about the negative effects of television viewing on children’s behavior and school performance in Addis Ababa, Ethiopia

Very little is known regarding parents’ concerns about the undesirable effects of unsupervised TV viewing on children’s development in Ethiopia. This study investigated the extent and areas of parents’ concern about the harmful effects of TV viewing on children’s behavior and school performance. A mixed-methods study design was employed. Quantitative data were collected from 390 parents of schoolchildren aged 7–15 in Addis Ababa using a standardized measure of parental concern. Qualitative data were also collected from Parent-Teacher-Student Association (PTSA) members using FGDs. Results showed a moderate-to-high level of parental concern about the adverse effects of viewing on children’s behavior and school performance. The findings further indicated that children’s learning of offensive language, premature exposure to sexual content, engagement in violent activities, and drug use were reported as parents’ areas of concern in relation to children’s behavior. In the same way, disengagement in academic activities, mainly not doing homework, not studying, and getting poor exam results have been reported as parents' areas of concern in relation to school performance. Statistically significant differences in level of concern across parents’ and children’s socio-demographic characteristics were observed. As children’s screen and digital media environment is fast-changing in Ethiopia, future studies in the area by child developmentalists, educationalists, and health professionals are highly warranted.

Exploring the content of self-help toolkits as an intervention for non-suicidal self-injury in young people in England.

Non-suicidal self-harm has been increasing in young people over the last decade leading to several self-help interventions being developed. Self-help toolkits are given a variety of names, such as 'hope box' and 'self-soothe kit', but all seek to provide young people with the tools to manage thoughts to self-harm by bringing together a collection of personal items, distress tolerance activities and help-seeking prompts. They represent a low-cost, low-burden and accessible intervention. This study explored what child and adolescent mental health professionals working with young people are currently recommending as the content of these self-help toolkits. A questionnaire was sent to child and adolescent mental health services and residential units across England and received 251 responses from professionals. Sixty-six per cent described self-help tool kits as being effective or very effective for helping young people manage self-harm urges. The content was categorized into sensory items (subcategorized by sense), distraction activities, relaxation and mindfulness activities, seeking positives and coping strategies, with the caveat that all toolkits should be individualized. The results of this study help to inform the future manualization of the use of self-help toolkits in clinical practice as a self-harm intervention for children and young people.

Child health screening program in French nursery schools: Results and related socioeconomic factors.

The study aims to describe the output of routine health screening performed in French nursery schools by the maternal and child health services among children aged 3-4 years and to quantify the level of early socioeconomic health disparities. In 30 participating départements, data on screening for vision and hearing impairments, overweight and thinness, dental health, language, psychomotor development, and immunizations were collected for children born on specific dates in 2011 and enrolled in nursery school in 2014-2016. Information was collected on the children, their socioeconomic characteristics and on the school attended. Odds of abnormal screening results were compared for each socioeconomic factor by logistic regressions adjusted for age, sex, prematurity and bilingualism. Among the 9,939 children screened, prevalence of disorders was 12.3% for vision, 10.9% for hearing, 10.4% for overweight, 7.3% for untreated caries, 14.2% for language and 6.6% for psychomotricity. Newly detected visual disorders were more frequent in disadvantaged areas. Children with unemployed parents were three time more likely to have untreated caries and twice as likely to present language or psychomotor impairments; 52% were referred to a health professional following screening compared to 39% of children with employed parents. Except for children in disadvantaged areas, vaccine coverage was lower among disadvantaged groups. The prevalences of impairments, which are higher among disadvantaged children, highlight the potential preventive impact of systematic screening under the comprehensive maternal and child healthcare program. These results are important to quantify early socioeconomic inequalities in a Western country known for its generous social welfare system. A more holistic approach to child health is needed with a coherent system involving families and aligning primary care, local child health professionals, general practitioners, and specialists. Further results are needed to evaluate its impact on later child development and health.

Survey on Reporting of Child Abuse by Pediatricians: Intrapersonal Inconsistencies Influence Reporting Behavior More than Legislation

Background: Internationally, various laws govern reporting of child abuse to child protection services by medical professionals. Whether mandatory reporting laws are in place or not, medical professionals need internal thresholds for suspicion of abuse to even consider a report ("reasonable suspicion" in US law, "gewichtige Anhaltspunkte" in German law). Objective: To compare internal thresholds for suspicion of abuse among US and German pediatricians, i.e., from two countries with and without mandatory reporting laws. Participants and Setting: In Germany, 1581 pediatricians participated in a nationwide survey among child health professionals. In the US, a survey was mailed to all Pennsylvania pediatricians, and 1249 participated. Methods: Both samples were asked how high in their rank order of differential diagnoses child abuse would have to be when confronted with a child's injuries to qualify for reasonable suspicion/gewichtige Anhaltspunkte (differential diagnosis scale, DDS). In a second step, both had to mark a 10-point likelihood scale (0-100%) corresponding to reasonable suspicion/gewichtige Anhaltspunkte (estimated probability scale, EPS). Results: While for almost two-thirds of German pediatricians (62.4%), child abuse had to be among the top three differential diagnoses for gewichtige Anhaltspunkte, over half of the US respondents (48.1%) had a lower threshold for reasonable suspicion. On the estimated probability scale, over 65% in both samples indicated that the probability of abuse had to exceed 50% for reasonable suspicion/gewichtige Anhaltspunkte. There was great variability between the two countries. Conclusions: There are similar uncertainties in assessing cases of suspected child abuse in different legal systems. There is a need for debates on thresholds among medical professionals in both countries.

Healthcare use by children in North West London 2015-2019 by deprivation and integrated care access

Abstract Background England has a health system offering universal coverage, but disparities in healthcare use are increasing. Between 2007-2017, children living in more deprived areas had higher rates of unplanned care (Emergency Department (ED) attendance and hospital admissions), whereas children from less deprived areas had higher rates of planned care (General Practitioner (GP) contact and outpatient appointments). More detailed research to find solutions for this divergent pattern is required. Aim To assess the rates of GP contact, outpatient appointments, hospital admissions and ED attendance in North West London, by Index of Multiple Deprivation (IMD) decile of home postcode and access to an integrated care service providing linked care between multiple child health professionals ‘Connecting Care for Children (CC4C)', for children aged 0-18 years between 2015-2019. Methods Retrospective analysis of a de-identified database of integrated care records for 495,357 children. Results Children from the most deprived decile had higher rates of emergency admissions (0.070 per child per year vs. overall mean 0.040), elective admissions (0.076 vs. 0.032), ED attendances (0.754 vs. 0.358) and outpatient appointments (1.702 vs. 0.756) between 01.01.2015- 31.12.2019. Children from the least deprived decile had the second highest rates of outpatient appointments (0.911 vs. 0.756) and GP contact (8.192 vs. 5.390) between 01.01.2015- 31.12.2019. Children with access to the CC4C service, despite being from more deprived backgrounds, had lower rates of emergency admissions (0.028 vs. 0.037) compared to patients with access to usual care. P values &amp;lt;0.001 in all cases. Conclusions Greater deprivation was linked to higher rates of emergency admissions, but this was partially mitigated by access to more integrated healthcare models. Children from the least deprived decile continued to have disproportionately higher use of planned care. Key messages • Despite universal health coverage, children from more deprived areas continue to have disproportionately higher use of unplanned care. • Further research is required to explore whether integrated care solutions can reduce the burden on unplanned health services and inequalities in access to care.

3.4 Psychopharmacological Treatment of Sleep Disorders

The objectives are to: 1) provide an update on the relative pros and cons of current prescription pharmacologic options available for the treatment of pediatric insomnia; 2) review the data supporting safety and efficacy of over-the-counter (OTC) medications, particularly melatonin; and 3) present an outline to assist child and adolescent mental health professionals in developing a practical and rational approach to using sedative hypnotic drugs in clinical practice, including patient and medication selection and potential pitfalls in management.

Healthcare service utilization of hill tribe children in underserved communities in thailand: Barriers to access

BackgroundHill tribe children, an ethnic minority group in Thailand, experience wide-ranging social and health inequalities. Previous reports indicate that hill tribe children, especially age under 5 years, face social health disadvantages but little is known about the underlying causes. Exploring healthcare utilization among hill tribe children is therefore essential and it may well provide some insight.MethodsA qualitative study was conducted using purposive sampling techniques to recruit participants based on our criteria. In-depth interviews and focus-group discussions were employed to explore the experiences of parents (n = 20), community leaders (n = 20), and healthcare providers (n = 20) when caring for children aged under 5 years. Interview transcripts were coded, and thematic analysis was then performed.ResultsThe participants shared their experiences with accessing healthcare services in underserved areas. Barriers to access was the central theme identified. Sub-themes included: (1) distance matters, (2) education and socioeconomic deprivation, (3) lack of cultural sensitivity, (4) communication problems, (5) tradition, beliefs, and differences in cultural practice, (6) lack of child health professionals, and (7) bureaucratic hurdles.ConclusionsHealthcare services and environments must be transformed to provide healthcare services, education, and information appropriate to the cultures and beliefs prevalent in the hill tribe population.

The Intersection of Race, Racism, and Child and Adolescent Health.

There has been an increasing focus on the impact of racism both within pediatrics and throughout society as a whole. This focus has emerged as a result of the current sociopolitical climate in the United States coupled with the recent deaths of Black Americans by law enforcement and the maltreatment of Latina/o immigrants. In 2019, the American Academy of Pediatrics released the landmark policy statement "The Impact of Racism on Child and Adolescent Health," which describes the profound effects of racism on health, its function in perpetuating health disparities, and the potential role of child health professionals in addressing racism as a public health issue. (1) Foundational knowledge regarding race, racism, and their relation to health are not consistently included in standard medical education curricula. This leaves providers, including pediatricians, with varying levels of understanding regarding these concepts. This article seeks to provide an overview of the intersection of race, racism, and child/adolescent health in an effort to reduce knowledge gaps among pediatric providers with the ultimate goal of attenuating racial health disparities among children and adolescents. Please reference the Table for additional resources to reinforce concepts described throughout this article.

Fluoxetine misuse by snorting in a teenager: a case report

Introduction Self-harm and substance use disorders (SUD) are leading causes of Years of Life Lost (YLLs) among young people aged 10-24 years as per the Global Burden of Disease (GBD) Study 2019. The co-occurrence of these conditions can complicate the clinical picture and often poses a challenge to child and adolescent mental health professionals. Moreover, substance use by adolescents, due to the probable physical, legal and psychiatric complications, has the potential to progress into full-blown SUD in adolescence or adulthood. Case Report We present the case of a 15-year-old female with a history of multiple serious suicidal attempts and drug use disorders who misused fluoxetine as part of maladaptive coping. Selective serotonin reuptake inhibitors (SSRIs) are not known to be commonly abused drugs, let alone sniffed or snorted. To the best of our knowledge, this is the first reported case of an adolescent snorting the drug fluoxetine (SSRI). Conclusion This case highlights three main aspects for child and adolescent mental health professionals. First, the importance of screening for recreational drugs misuse in general, including fluoxetine, in a comprehensive assessment of a young person with coexisting substance misuse issues or its history. Second, ‘comorbidity is the rule rather than the exception’ in adolescents with SUDs. Third, the possible benefit of quetiapine in managing emotional dysregulation in a high-risk adolescent with traits of an emerging borderline personality disorder.

Esports: What Do Pediatricians Need to Know?

Esports has seen a massive increase in the number of players, especially adolescents. Given the recent addition of gaming disorder as a diagnostic disorder, it is especially timely to understand the pattern and psychological factors associated with Esports. Esports is a recent phenomenon, and there is very limited awareness about its related consequences among child health professionals. The aim of this article is to familiarize pediatricians with these games/Esports, as well as gaming disorder assessment and management. Because digital life begins at a young age, pediatricians can empower parents to foster healthy digital citizenship. [Pediatr Ann. 2022;51(6):e254-e256.].

Trends and patterns of stunted only and stunted-underweight children in Malawi: A confirmation for child nutrition practitioners to continue focusing on stunting

AimTo analyse the trends and patterns of stunted only and stunted-underweight children in Malawi between the 2000 and 2015. MethodsThe study used the 2000 and 2015 Malawi Demographic and Health Survey data and employed bivariate and multivariate statistical analysis techniques to explore the difference in the levels of stunted only and stunted-underweight children and key socio-economic factors between 2000 and 2015 and identify key attributes of being stunted only and being stunted-underweight. ResultsThe percentage of stunted only was 37.2% in 2000 and 26.8% in 2015 and the stunted-underweight percentage was 14.5% in 2000 and 8.8% in 2015. Out of the 6.9% children classified as wasted, 2.4% were also underweight and stunted, 2.4% were underweight and 2.1% did not have any other forms of undernutrition. The analysis did not identify any children that were both stunted and wasted. Only 0.7% in 2000 and 0.4% in 2015 were underweight and free of any other forms of undernutrition. There were improvements in mother education level and mother weight during this time-period which may explain the improvements in child nutritional status. ConclusionThe most common form of undernutrition is stunting and nearly all children that are underweight are also stunted. Child nutrition practitioners and health professionals should consider focusing on tackling child stunting.