Child Care Research Articles

Main stream and scientific innovations in the field of obstetric services in the Ural Federal District

The article provides analytical data on the results of the obstetrics and childhood service of the Ural Federal District in 2023, analyzes the key indicators of the service over the past five years and provides directions for optimizing the work of the service. In the sphere of implementation of national projects “Healthcare” and “Demography”, applied scientific research and development of the “Ural Research Institute of Maternity and Child Care” of the Russian Ministry of Health makes a significant contribution to the development of medicine by improving methods of prediction, diagnosis, treatment and prevention of perinatal pathology, development of assisted reproductive technologies, which will improve the work of obstetrics and childhood services.

Happy People in Russia: The Role of Economic and Social Capital

Amid conditions of global instability in recent years, approximately one-tenth of the residents of Russia consistently report high levels of subjective well-being. The aim of this article is to analyze the socio-demographic characteristics of the “happy and satisfied” segment of Russians and the influence of economic and social capital on their high level of affective and cognitive components of subjective well-being. This study is based on data from the Russia Longitudinal Monitoring Survey – Higher School of Economics (RLMS-HSE), with surveys conducted from 2016 to 2020. For the purposes of analysis, a stable segment of "fully satisfied with life" and "very happy" Russians (10–12% of 5–6 thousand respondents annually) was selected from the sample array. Economic capital in the study is measured through indicators such as absolute income, assessment of material well-being and remuneration, and perception of economic inequality, while social capital is measured through the structure, intensity, and quality of social connections and the nature of group identity. The analysis of the empirical data shows that people who are fully satisfied with life and happy are aged 25–34, married, have children, and possess average incomes. Low incomes are associated with subjective disadvantage, but for maximum happiness and life satisfaction, it is quite enough to have an average income level. Additionally, the cognitive component of subjective well-being assessments is more related to material and financial factors than the affective component. It is demonstrated that high levels of subjective well-being are more influenced by parameters of social, rather than economic, capital. Representatives of the predominantly happy segment of Russians communicate more frequently with family members and friends, care for young children or grandchildren, and feel a sense of belonging to broader social communities (professional, national, or territorial).

Child Care Subsidy Generosity and Child Maltreatment: The Moderating Effects of Administrative Burden

Child Care Subsidy Generosity and Child Maltreatment: The Moderating Effects of Administrative Burden

Consensus-based recommendations for the diagnosis and treatment of anxiety and depression in children and adolescents with epilepsy: A report from the Psychiatric Pediatric Issues Task Force of the International League Against Epilepsy.

The Psychiatric Pediatric Issues Task Force of the International League Against Epilepsy (ILAE) aimed to develop recommendations for the diagnosis and treatment of anxiety and depression in children and adolescents with epilepsy. The Task Force conducted a systematic review and identified two studies that assessed the accuracy of four screening measures for depression and anxiety symptoms compared with a psychiatric interview. Nine studies met the eligibility criteria for treatment of anxiety and depressive disorders or symptoms. The risk of bias and certainty of evidence were assessed. The evidence generated by this review followed by consensus where evidence was missing generated 47 recommendations. Those with a high level of agreement (≥80%) are summarized. Diagnosis: (1) Universal screening for anxiety and depression is recommended. Closer surveillance is recommended for children after 12 years, at higher risk (e.g., suicide-related behavior), with subthreshold symptoms, and experiencing seizure worsening or therapeutic modifications. (2) Multiple sources of ascertainment and a formal screening are recommended. Clinical interviews are recommended whenever possible. The healthcare provider must always explain that symptom recognition is essential to optimize treatment outcomes and reduce morbidity. (3) Questioning about the relationship between symptoms of anxiety or depression with seizure worsening/control and behavioral adverse effects of antiseizure medications is recommended. Treatment: (1) An individualized treatment plan is recommended. (2) For mild depression, active monitoring must be considered. (3) Referral to a mental health care provider must be considered for moderate to severe depression and anxiety. (4) Clinical care pathways must be developed. (5) Psychosocial interventions must be tailored and age-appropriate. (6) Healthcare providers must monitor children with epilepsy who are prescribed antidepressants, considering symptoms and functioning that may not improve simultaneously. (7) Caregiver education is essential to ensure treatment adherence. (8) A shared-care model involving all healthcare providers is recommended for children and adolescents with epilepsy and mental health disorders. We identified clinical decisions in the management of depression and anxiety that lack solid evidence and provide consensus-based guidance to address the care of children and adolescents with epilepsy.

Paediatric medical imaging in Ireland- challenges, training, and the use of distraction techniques

The National Model of Care for Paediatric Healthcare Services, published in 2016, aims to ensure high-quality care for children across Ireland. However, with few exceptions, radiology departments in general hospitals “lack the necessary physical infrastructure, facilities, and staff training required for paediatrics.” These deficiencies can adversely affect a patient's behaviour and emotions, exacerbating fear of the healthcare system. This study sought to identify the challenges faced by radiographers in Ireland during paediatric imaging, with a focus on post-qualification training and the use of distraction techniques. A cross-sectional, qualitative online survey was conducted via Microsoft Forms, comprising 37 close-ended and eight open-ended questions on paediatric training, challenges, and distraction use. Ninety-six participants were recruited through snowball sampling from 26 hospitals and private clinics across Ireland. Only a small proportion of radiographers (n = 25, 26%) undertook post-qualification training in paediatric imaging, and many reported inadequate educational opportunities (n = 52, 60%). Patient cooperation (n = 45, 52%) and toddlers (n = 75, 90%) were identified as the most challenging aspect and age group, respectively. While distraction is commonly employed (n = 79, 91%), radiology departments often provide insufficient equipment (n = 65, 76%). The lack of equipment and training highlights the need for improvement in paediatric medical imaging services. The development of new training courses and distraction tools may enhance practice, ensuring the provision of high-quality paediatric care. Expanding radiographer training and implementing distraction tools may help paediatric patients better cope with the anxiety and stress associated with healthcare settings.

Beyond babysitting: an analysis of the quality of childcare service in Ethiopia

ABSTRACT Empirical evidence underscores the importance of investing in early childhood care to ensure its quality. This study examined the quality of child care in day-care centers in Bahir Dar and Gondar cities, Amhara region, Ethiopia, employing an embedded mixed-methods approach. Utilizing descriptive and inferential statistics, including t-tests, regression analysis, and thematic analysis, the research assessed both distal quality – encompassing environmental and staffing conditions – and proximal quality – focusing on caregiver–child interactions. The findings revealed significant deficiencies in distal quality, including inadequate space, activities, and staff qualifications. Proximal quality was also found to be lacking, with government centers exhibiting higher levels of harshness in caregiver interactions compared to private centers. Key factors influencing interaction quality were staff education, experience, and child-to-worker ratios. Despite existing regulatory standards, their enforcement was found to be inadequate. The study recommends that policymakers enhance and enforce regulations, improve staff training and invest in professional development. Further research should explore regulatory enforcement challenges and assess the long-term impacts of training improvements on care quality.

Who Cares? Women entrepreneurs and the transition to the Canada-wide Early Learning and Child Care Agreement in Nova Scotia

The Canada-wide Early Learning and Child Care Agreements signed in 2021/2022 represent an unprecedented investment into child care across Canada, supporting the expansion of care spaces, reductions in parent fees, and increased wages for care workers. In the province of Nova Scotia, however, the new funding model faced considerable pushback from women entrepreneurs in the care field, who felt overlooked and bullied by the provincial government amidst the policy rollout. This paper evaluates the experiences of child care owners in Nova Scotia during the transition to the new funding agreement through a series of interviews with entrepreneurs. The paper posits that the consultation and communications between the province and care owners reified gendered power relations, particularly through the devaluation and exploitation of women's care work. Interviewees report feeling treated as “glorified babysitters” and experiencing significant mental health strains as a result of the policy negotiation with the province.

Illness cognitions and parental stress symptoms following a child's cancer diagnosis.

This research aims to explore parents' cognitive beliefs, specifically illness cognitions, in response to their children being diagnosed with cancer. This study is an initial step toward providing regular psychosocial assessment as a standard for psychosocial care for children with cancer and their families in Latvia. Data were collected from 120 parents (mostly mothers, n = 109) as an initial evaluation of the psychosocial risks faced by families participating in the support program "Holistic and Multidisciplinary Support for Children with Functional Disabilities and Their Family Members," which was managed by the Children's Hospital Foundation at the Children's Clinical University Hospital in Riga (Latvia) from 2020 to 2023. The patients comprised 66 boys and 54 girls (M age = 7.1, SD = 4.7, range: 0-17 years) with diverse cancer diagnoses. The parents completed the Latvian version of the Psychosocial Assessment Tool [adapted from PAT 3.1], with five subscales included in the data analysis (Social Support, Child Problems, Family Problems, Stress Reactions, and Family Beliefs). The Family Belief subscale was adjusted specifically to address the unique objectives and research questions of the current study. Significant correlations were found between children's psychological problems (e.g., getting upset about medical procedures, hyperactivity, excessive use of electronic devices, etc.) and parental stress reactions after diagnosis and with self-reported symptoms of anxiety and depression. The associations were statistically significant, even after controlling for sociodemographic and medical factors such as diagnosis. The relationship between children's problems and parental stress reactions was partly mediated by Family Beliefs about illness. The most informative beliefs associated with parental stress symptoms and the family's psychosocial risk level were identified, and significant results were found according to the main component of beliefs (catastrophic vs. optimistic) that explained 42% of the variance in the Family Beliefs subscale. Understanding the habitual responses to stress and identifying the thinking patterns of parents that lead to distorted views and maladaptive coping are essential for customizing personalized interventions to enhance treatment compliance. The Latvian version of PAT is a useful psychosocial screening measure in pediatric oncology settings.

Rural-Urban Disparities in Hospital Services and Outcomes for Children With Medical Complexity

Limited availability of inpatient pediatric services in rural regions has raised concerns about access, safety, and quality of hospital-based care for children. This may be particularly important for children with medical complexity (CMC). To describe differences in the availability of pediatric services at acute care hospitals where rural- and urban-residing CMC presented for hospitalization; identify rural-urban disparities in health care quality and in-hospital mortality; and determine whether the availability of pediatric services at index hospitals or the experience of interfacility transfer modified rural-urban differences in outcomes. This retrospective cohort study examined all-payer claims data from Colorado, Massachusetts, and New Hampshire from 2012 to 2017. Analysis was conducted from May 2023 to July 2024. Participants included CMC younger than 18 years residing in these states and hospitalized during the study period. Rural or urban residence was determined using Rural-Urban Commuting Area codes. Hospitals were categorized as children's hospitals or general hospitals with comprehensive, limited, or no dedicated pediatric services using American Hospital Association survey data. Interfacility transfers between index and definitive care hospitals were identified using health care claims. In-hospital mortality, all-cause 30-day readmission, medical-surgical safety events, and surgical safety events were operationalized using Agency for Healthcare Research and Quality measure specifications. Among 36 943 CMC who experienced 79 906 hospitalizations, 16 525 (44.7%) were female, 26 034 (70.5%) were Medicaid-insured, and 34 008 (92.1%) were urban-residing. Rural-residing CMC were 6.55 times more likely to present to hospitals without dedicated pediatric services (rate ratio [RR], 6.55 [95% CI, 5.86-7.33]) and 2.03 times more likely to present to hospitals without pediatric beds (RR, 2.03 [95% CI, 1.88-2.21]) than urban-residing CMC, with no significant differences in interfacility transfer rates. In unadjusted analysis, rural-residing CMC had a 44% increased risk of in-hospital mortality (RR, 1.44 [95% CI, 1.03-2.02]) with no significant differences in other outcomes. Adjusting for clinical characteristics, the difference in in-hospital mortality was no longer significant. Index hospital type was not a significant modifier of observed rural-urban outcomes, but interfacility transfer was a significant modifier of rural-urban differences in surgical safety events. In this cohort study, rural-residing CMC were significantly more likely to present to hospitals without dedicated pediatric services. These findings suggest that efforts are justified to ensure that all hospital types are prepared to care for CMC.

Construction of indicators for evaluating the quality of extended care for children with asthma

Background and aims To construct a set of scientific and effective quality evaluation indicators of continuing care for children with asthma, and to promote the development of continuing care for children with asthma toward a more specialized and standardized direction. Methods Through literature research and semi-structured interview, the item pool of evaluation index was drawn up, and the first draft of expert inquiry questionnaire was formed based on the three-dimensional quality theoretical model of structure-process-result, and the construction of quality evaluation index was completed through two rounds of expert inquiry and analytic hierarchy process. Results The effective recovery rate was 94.44% in the first round and 100.00% in the second round, the expert authority coefficient was 0.852 and 0.863, and the Kendal coordination coefficient was 0.129 and 0.126, respectively (p < 0.01). Finally, the evaluation index of continuing care quality for children with asthma was formed, including 3 first-level indicators, 9 s-level indicators and 36 third-level indicators, and then the weight and combination weight of each index were obtained by AHP. Conclusions The evaluation index of continuing care quality for children with asthma is scientific and specific, which is of great significance to the improvement of continuing care quality for children with asthma.

Maternal Disability and Early Child Preventive Care.

Preventive health care for children comprises routine well-child visits and immunizations. Women with physical, sensory, or intellectual or developmental disabilities tend to experience more barriers to preventive health care; yet it is unknown whether such barriers are observed among their young children. This population-based study in Ontario, Canada included children born between 2012 and 2019 whose mothers had a physical (n = 74 084), sensory (n = 26 532), or intellectual or developmental (n = 1391) disability, multiple disabilities (n = 5774), or no disability (n = 723 442). Primary outcomes were receipt of the recommended number of well-child visits and routine immunizations in the first 2 years. Secondary outcomes included receipt of the enhanced 18-month developmental assessment and any developmental screen. Relative risks (aRR) were generated using modified Poisson regression and adjusted for maternal sociodemographics and mental health and child sex. Compared with children of mothers without disabilities, those whose mothers had intellectual or developmental disabilities were less likely to receive the recommended number of well-child visits (56.3% vs 63.2%; aRR 0.92, 95% confidence interval [CI] 0.88-0.97), routine immunizations (43.8% vs 53.7%; aRR 0.88, 95% CI 0.83-0.94), enhanced 18-month developmental assessment (52.3% vs 60.8%; aRR 0.92, 95% CI 0.88-0.97), or any developmental screen (54.9% vs 62.5%; aRR 0.94, 95% CI 0.90-0.99). Other disability groups did not experience such disparities. There is a need to develop resources to improve access to preventive health care for young children of women with intellectual or developmental disabilities.

Impact of a collaborative model on community clinician confidence in child and adolescent mental health care, wellbeing, and access to child psychiatry expertise.

The COVID-19 pandemic was associated with an increase in child and adolescent mental health disorders, with subsequent worsening of patient access to specialist mental health care. Clinicians working in the community were faced with increased demands to diagnose and manage pediatric mental health disorders, without always having the confidence and knowledge to do so. We therefore developed COnnecting Mental-health PAediatric Specialists and community Services (COMPASS)-a collaborative model designed to upskill community clinicians in child and adolescent mental health care and provide them with better access to child and adolescent psychiatry expertise. COMPASS comprises (1) an online Community of Practice (CoP) with fortnightly one-hour sessions covering: anxiety; aggression and challenging behaviours; depression; self-harm and suicidality; eating disorders; and autism spectrum disorder/complex cases and (2) primary and secondary consultations for general practitioners and paediatricians with an experienced child psychiatrist. We aimed to assess the impact of COMPASS on community clinician self-reported confidence in: managing common child and adolescent mental health disorders (Objective 1, primary outcome); navigating the mental health care system (i.e. knowing how services are organised, accessed, and how to refer patients, Objective 2); diagnosing conditions (Objective 3); prescribing psychotropic medications (Objective 4) as well as the impact on, clinician practice and wellbeing (Objective 5) and outcomes of patients referred by COMPASS clinicians to the child psychiatrist (Objective 6). We evaluated COMPASS in its first year, with COMPASS running from March to July 2021. Participating clinicians completed pre-post surveys evaluating change in Objectives 1 to 4 above, using study-designed measures. A purposive sample of clinicians was then invited to a semi-structured interview to understand their experience of COMPASS and its impacts on practice and wellbeing (Objective 5). We adopted an inductive approach to the qualitative analysis using the Framework Method. This involved selecting five random transcripts which were double coded and categorized, to generate an initial framework against which all subsequent transcripts were analysed. Themes and subthemes were generated from the data set, by reviewing the matrix and making connections within and between clinicians, codes and categories One child psychiatrist completed a 2-week logbook of the nature and outcomes of primary and secondary consultations (Objective 6). 51 (86%) clinicians attended CoP sessions and completed pre-post surveys, with 92% recommending COMPASS to peers. Clinicians reported increased confidence in the pharmacological and non-pharmacological management of all conditions, most notably for management of self-harm. They also reported increased knowledge of how to navigate the mental health system and prescribe medications. Qualitative analysis (n = 27 interviews) found that COMPASS increased clinician wellbeing and reduced feelings of professional isolation and burnout. Over the 2-week snapshot, the child psychiatrist consulted on 22 patients and referred all back to the community clinician. COMPASS is associated with improved clinician confidence to manage child and adolescent mental health concerns, navigate the mental health system, improved clinician wellbeing, and reduced need for ongoing mental health care by specialists.

Impact of Geopolitical Unrest on Surgical Delays and Outcomes in Immigrant Populations With Cleft Lip and Palate

Background: Geopolitical conflicts in the Middle East have led to mass migrations, with Turkey becoming a major host country. This influx has strained the health care system, particularly regarding specialized care for conditions like cleft lip and palate (CLP). Timely intervention is crucial for optimal outcomes, but cultural, socioeconomic, and logistical barriers often cause delays, impacting physical, functional, and psychosocial development. Methods: This retrospective study analyzed 72 immigrant pediatric CLP patients treated in Turkey between 2012 and 2022. Data on demographics, medical history, surgical interventions, complications, and treatment delays were collected. Surgical timing was compared with American Cleft Palate Craniofacial Association guidelines, and the impact of socioeconomic status on delays was assessed. Results: Seventy-two patients underwent a total of 91 surgical interventions, including 29 cleft lip repairs, 22 cleft palate repairs, 6 pharyngeal flaps, 15 fistula closures, 8 corrections of secondary lip scars and whistling deformities, and 11 alveolar bone graftings. A majority (73.6%) had poor socioeconomic status. The average delays for cleft lip, cleft palate, and alveolar bone grafting surgeries were 5.3±4, 7.3±6.1, and 34.1±23.5 months, respectively, and were significantly longer for patients with poor socioeconomic status (P=0.00502, 0.030741, and 0.041878). The average delay for pharyngeal flap surgery, performed in patients with poor socioeconomic status (except for one), was 43.7±14.1 months. Conclusions: This study highlights the challenges and disparities in CLP care for immigrant children in Turkey due to geopolitical conflict. While surgical complication rates are similar to established data, delays in treatment, especially among those with lower socioeconomic status, are a significant concern. The findings emphasize the need for comprehensive, culturally sensitive care and systemic interventions to improve access and outcomes for this vulnerable population.

Determininants of Diarrhea-Related Health Care Seeking Behavior among Indonesian Mothers with Under-five Children during the COVID-19 Pandemic

This study investigated factors influencing healthcare-seeking behaviours of Indonesian mothers during the COVID-19 pandemic when their children had diarrhea. The 117 participants completed a self-report which measured the socio-demographic condition, knowledge about diarrhea, illness perception, anxiety, and health care seeking behavior for diarrhea. The data were analyzed with the descriptive statistics, Chi-square, and logistic multinomial regression analysis. Analysis revealed critical determinants including child age, maternal occupation, education, transportation, knowledge of diarrhea, and illness perception. The model accurately predicted 84.6% of healthcare-seeking behaviours, with mothers favoring formal care for younger children and education positively influencing formal healthcare utilization. The type of public transportation significantly influenced healthcare-seeking behavior. While accurate knowledge of diarrhea increased professional care seeking, the model explained only 5.61% of behavior variation, suggesting unexplored factors. Addressing these factors could improve child health outcomes during pandemics. Policy enhancements and cultural sensitivity in health education are vital for efficacy. Deepening understanding and developing effective interventions amidst pandemics require further research.

Rates of strokes in Californians with sickle cell disease in the post-STOP era

AbstractNeurovascular complications, including strokes and transient ischemic attacks (TIAs), are common and cause significant morbidity in individuals with sickle cell disease (SCD). The Stroke Prevention Trial in Sickle Cell Anemia (STOP) (1998) established chronic transfusions as the standard of care for children with SCD at high risk for stroke. Using statewide emergency department and hospitalization data from the California Department of Health Care Access and Innovation (1991-2019), we determined the cumulative incidence and rates of primary and recurrent strokes and TIAs in people with SCD before and after the STOP trial. For the 7636 patients included in our SCD cohort, the cumulative incidence of the first ischemic stroke was 2.1% (95% confidence interval [CI], 1.8-2.4) by the age of 20 years and 13.5% (95% CI, 12.3-14.7) by the age of 60 years. The cumulative incidence of the first intracranial hemorrhage (ICH) was 0.5% (95% CI, 0.4-0.7) by the age of 20 years and 6.8% (95% CI, 5.9-7.7) by the age of 60 years. Ischemic stroke rates increased in children (age <18 years; 234.9 vs 165.1 per 100 000 PY; P = .012) and adults (age 31-50 years; 431.1 vs 303.2 per 100 000 PY; P = .031) in 2010 to 2019 when compared with the preceding decade. There was an increase in the rates of ICH in those aged 18 to 30 years and TIA in children <18 years from 2010 to 2019 when compared with the previous decade. Risk factors for stroke and TIA included increasing age, hypertension, and hyperlipidemia. These findings underscore the need for prevention of strokes in adults with SCD and suggest an emphasis on the management of modifiable cerebrovascular risk factors that have been demonstrated to be effective in the general population.

Debate: How much should nonspecialists be involved in mental health care for children and young people when resources are limited?

From the barber-surgeons of the Middle Ages to the digitally enabled clinical interventions of today, the role of nonspecialists in delivering accessible health care remains relevant and important. Their contribution in developing and supporting appropriate interventions and care pathways in the community can make a big difference for the overwhelming majority of children and young people with diagnosable mental health conditions who are not eligible for specialist treatment or do not seek help. Even if resources for specialist services were unlimited, there are independent benefits in involving nonspecialists in mental health care, albeit not without limitations and concerns. The natural shift over time in the boundaries of specialisms, the omnipresence and omnipotence of digital media in our lives and the vision of 'no wrong door' for service users, mean that it is not a question of whether, but of how, nonspecialists should be involved. We need to get past the point of considering them just as alternative providers of mental health interventions and services. Instead, they are best placed to protect children and young people's mental health through ubiquitous everyday actions, which counter the negative and maximise the positive elements in current practices, environments and interactions that influence families and communities.

Analysis of Risk Factors for Dengue Virus Infection with Warning Signs in Child Care at Haji Hospital Makassar City for the 2022-2023 Period

Analysis of Risk Factors for Dengue Virus Infection with Warning Signs in Child Care at Haji Hospital Makassar City for the 2022-2023 Period

Abstract C179: Train the trainer series in Southern California a call to action for cancer prevention and screening

Abstract Background: Alarmed by low rates of cancer screening in disenfranchised communities and medical deserts in Southern California, City of Hope launched a cancer prevention and control training program to broadly disseminate cancer screening and healthy living educational resources to Health Educators who serve the most vulnerable within our Catchment areas. Methods: The project was IRB approved as exempt came internally from City of Hope. To increase cancer prevention and uptake of cancer screening, we focused on training of Community Health Workers (CHW) from Federally Qualified Health Centers (FQHC’s), community hospitals, faith-based organizations. This community co-designed training included Cancer 101 , on best practice for Breast, Cervical, Colorectal, Lung, and Prostate screening, and Clinical and Biospecimen Studies and SB 987. Complete and online redcap enrollment survey, along with 2 brief pre and post surveys per series topic. The presentations and surveys will be facilitated by COE staff. Trainees completed surveys via RedCap. Surveys will be conducted via Redcap. Results: TTT series trained 101 trainees on 8 topics. Trainees included: Asian (14.9%), Black/African-American (6.9%), Latino/Hispanic (73.3%), Pacific Islander (2.0%), White/European American (5, 5.0%), Mix (3.0%). The gender identities trained were Male (10.9%), Female (87.1%), Transgender: Female to Male (2.0%). Facilitators of screening included Someone to talk about worries/fears about cancer (73.0%), Someone to go with and help at the appointment (53.0%), Paid time off from work (63.0%), Clinical provider recommendation/encouragement (57.0%), Free/ Low cost exams (81.0%), Insurance to pay for exams (68.0%), Free transportation (64.0%), Child care services (53.0%), In-language educational materials (62.0%), Language Interpretation services (51.0%), Community education programs (66.0%), Gift Cards or Incentives (4.0%).The participants' education level was mostly college educated (64.0%), high school (33.0%), and less than high school (3.0%). The top 3 cancers affect our community the most are breast, colon, and lung. Conclusion: The conclusion is community partners are ready to be engaged and trained in cancer prevention and screening. Cancer centers, leveraging their COE, can respond to this call to action. Citation Format: Kimlin Ashing, Lauren D'Souza, Brenda Gascon, James Morrison, Veronica Tejada, Alexis Garden, Jose Gomez, Sophia Yeung. Train the trainer series in Southern California a call to action for cancer prevention and screening [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C179.

Challenges experienced by caregivers working in institutions for children. A case of four children’s homes in Zimbabwe

ABSTRACT Institutional care is one of the child care strategies used to provide secure family environments to children at risk. In this vein, institutions provide care through caregivers who look after children round the clock. These caregivers are trained and expected to provide high-quality services. However, in so doing, the caregivers face several challenges. This paper is based on a qualitative study that collected data from 24 caregivers working at four childcare institutions in Harare, Zimbabwe. The study employed a multiple case study design that was embedded in a phenomenological design. Findings from the study revealed that challenges experienced by caregivers include high caseloads and lack of resources, regulations which do not promote proper child development, inadequate training for caregivers, and nonexistence of a representative body for caregivers and the existence of multiple reporting systems for children. Noteworthy, is the fact that these challenges result in the provision of inappropriate services to children in institutions culminating in dilution of quality-of-care services’ provision to children. To this end, the author suggests a redress of caregivers’ roles and revision of institutional care framework; to address the challenges faced by caregivers.

Does Childhood Cochlear Implantation Spill Over to Carers' Employment Status?

Carers of children with disabilities, especially primary carers, tend to have poorer labor market outcomes than carers of typically developing children. However, the extant literature has been largely silent on whether interventions for children's disabilities spill over to carers' employment outcomes, if at all. We aimed to fill this gap. We analyzed data from the Longitudinal Outcomes of Children with Hearing Impairment study, which is a unique panel dataset of Australian children who are deaf or hard-of-hearing (DHH). The Longitudinal Outcomes of Children with Hearing Impairment dataset includes information about 449 DHH children. We used 3 waves covering the same children at ages 0 to 3, 5 to 7, and 8 to 10 years during 2005 and 2018. We used a panel random-effects model, the use of which was supported by the Hausman specification test to control for time-invariant individual heterogeneity. We found that primary carers (typically mothers) of DHH children with cochlear implants (CI) were more likely to be employed relative to DHH children without a CI. The positive association was stronger among carers from a lower socioeconomic background. The association between childhood CI and carer employment may potentially be due to relaxed primary carers' time constraints to care for the child, increased self-efficacy, and reduced carer stress, enabling them to engage in other activities, including employment. Further research through large-scale, longitudinal studies is warranted to solidify the findings of this research.