Health Screening Practices Research Articles

Stressing the System: Pediatric Trauma Centers May Be Unready to Implement Comprehensive Acute Stress Screening Programs for Pediatric Trauma Patients.

Children experiencing trauma are at risk of developing acute and chronic stress disorders. In 2022, the American College of Surgeons Committee on Trauma required verified pediatric trauma centers to screen at-risk patients and provide mental health provider referrals as needed. The study objective is to assess the current readiness of pediatric trauma centers to meet the new American College of Surgeons requirements. This study used an exploratory, electronic, cross-sectional survey design. The Pediatric Trauma Society distributed a survey on mental health screening practices to its members in February 2023. Results were summarized with descriptive statistics. Chi-square test was used to compare responses of Levels I and II pediatric trauma centers. There were 91 survey responses from the PTS membership of 1247 (response rate of 7.3%). Fifty-nine participants were from Level I and 27 from Level II pediatric trauma centers. 63.8% of Level I and 51.9% of Level II center respondents currently screened for acute stress (χ2(1)=1.09, p =.30). Of these, 75.7% of Level I and 57.1% of Level II center respondents routinely screened all admitted trauma patients (χ2(1)=1.68, p =.19). However, only 32.4% of Level I and 21.4% of Level II respondents reported having outpatient acute stress referral protocols. For pediatric trauma centers currently without screening, 65% of Level I and 46.2% of Level II pediatric trauma center respondents felt they needed more than six months to establish a program (χ2(1)=1.15, p =.28). Most respondents (68.9%) reported staff shortages as a barrier to the delivery of acute stress services. Pediatric trauma center compliance with acute stress screening requirements for verification is variable. Pediatric trauma centers may benefit from technical assistance with acute stress screening.

Healthcare Team Members’ Views on Social Determinants of Health Screening and Referral Practices in a Pediatric Emergency Department

Healthcare Team Members’ Views on Social Determinants of Health Screening and Referral Practices in a Pediatric Emergency Department

From pregnancy to the postpartum: Unraveling the complexities of symptom profiles among trauma-exposed women

BackgroundMany women experience new onset or worsening of existing posttraumatic stress disorder (PTSD) symptoms during pregnancy and the early postpartum period. However, perinatal PTSD symptom profiles and their predictors are not well understood. MethodsParticipants (N = 614 community adults) completed self-report measures across three methodologically similar longitudinal studies. Mixture modeling was used to identify latent subgroups of trauma-exposed women with distinct patterns of symptoms at pregnancy, 1-month, and 3-month postpartum. ResultsMixture modeling demonstrated two classes of women with relatively homogenous profiles (i.e., low vs. high symptoms) during pregnancy (n = 237). At 1-month postpartum (n = 391), results suggested a five-class solution: low symptoms, PTSD only, depression with primary appetite loss, depression, and comorbid PTSD and depression. At 3-months postpartum (n = 488), three classes were identified: low symptoms, elevated symptoms, and primary PTSD. Greater degree of exposure to interpersonal trauma and reproductive trauma, younger age, and minoritized racial/ethnic identity were associated with increased risk for elevated symptoms across the perinatal period. LimitationsOnly a subset of potential predictors of PTSD symptoms were examined. Replication with a larger and more racially and ethnically diverse sample of pregnant women is needed. ConclusionsResults highlight limitations of current perinatal mental health screening practices, which could overlook women with elevations in symptoms (e.g., intrusions) that are not routinely assessed relative to others (e.g., depressed mood), and identify important risk factors for perinatal PTSD symptoms to inform screening and referral.

Guidelines toward more socially just mental health screening in schools.

Mental health screening is a pivotal practice for promoting the social-emotional-behavioral (SEB) health and well-being of youth in schools. However, some aspects of traditional mental health screening practices may inadvertently perpetuate structural racism and unintentionally facilitate oppression and SEB disparities. We address this issue constructively by presenting an intentional approach to guide school psychologists and related professionals in implementing more socially just mental health screening in schools. Our guidelines are grounded within the four phases of the Participatory Culture-Specific Intervention Modeling (PCSIM) framework: system entry, culture-specific model development, culture-specific program development, and program continuation or extension. We propose that conceptualizing mental health screening within PCSIM methodology promotes more socially just practices by (a) displacing the implicit power of professionals, (b) giving transparent representation to local communities, and (c) employing methods that are recursive, culturally relevant, and intended to build capacity for sustained transformative change. Within each PCSIM phase, we recommend culturally responsive practices for professionals that foster equity in screening and SEB outcomes and discuss ways to resist practices that perpetuate oppression and disparities. We aim to convey a method for mental health screening that is not done to students and schools but rather done in partnership with and for the benefit of students and schools. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Factors associated with hypertension and diabetes in rural communities in the Asante Akim North Municipality of Ghana

Background Hypertension and diabetes are leading non-communicable diseases that have driven an epidemic of cardiovascular diseases globally. Understanding the factors associated with the occurrence of hypertension and diabetes, particularly in rural settings, is crucial for designing interventions to improve awareness, detection, and control. This study assessed factors associated with hypertension and diabetes in Asante Akim North Municipality, a rural community in Ghana. Methods This cross-sectional study involved 2,576 participants. Data were collected using a structured questionnaire covering sociodemographic, blood pressure measurements, anthropometric measurements, biochemical parameters, and modifiable risk factors for hypertension and diabetes. Descriptive statistics of the outcomes were performed. The factors associated with hypertension or diabetes were assessed using a multivariate logistic regression model. Results The study found that participants' mean age was 35 years (SD) with a slight female preponderance of 53.88%. Age, marital status, educational status, and occupation positively predicted the occurrence of hypertension. The prevalences of hypertension and diabetes were found to be 30.9% and 17.7%, respectively. Community members above 18 years of age had increased odds of developing hypertension [18–44 years (aOR=1.99, CI=1.06–3.71, p <0.05), 45–64 years (aOR=6.12, CI=3.15–11.9, p <0.001), and >64 years (aOR=14.55, CI=7.17–29.53, p <0.001)]. Community members who were fishing/farming (aOR=0.45, CI=0.26–0.76, p <0.01) and being student/apprentices (aOR=0.11, CI=0.02–0.56) were at reduced odds of developing diabetes. Participants who consumed snacks (aOR=0.64, CI=0.41–0.99, p <0.05) during working hours had reduced odds of developing diabetes. Conclusions The study concluded that commonly known risk factors (dietary behaviour, alcohol intake, tobacco use, and physical activities) were not associated with hypertension or diabetes. Sociodemographic characteristics and poor health screening practices were the main predictors of hypertension and diabetes in rural areas. Urgent steps to improve health education and population-level screening are pivotal for controlling hypertension and diabetes.

Bone health screening practices with dual-energy X-ray absorptiometry and prediction of abnormal results in pediatric inflammatory bowel disease.

Pediatric patients diagnosed with inflammatory bowel disease (IBD) are at risk of suboptimal peak bone mass attainment. This study aimed to understand rates of bone health screening adherence, describe factors associated with dual-energy X-ray absorptiometry (DXA) acquisition, and identify factors associated with abnormal DXA. We performed a retrospective cohort study of pediatric IBD patients over a 10-year time frame. We included IBD patients (2-20 years of age) enrolled in ImproveCareNow and excluded patients with primary metabolic bone disease. Time-to-event methods and multivariable logistic regression were employed to identify factors associated with DXA acquisition and abnormal DXA. In 676 patients, 464 (68.63%) pediatric patients with IBD had a risk factor for low bone mineral density (BMD); 137 (29.53%) underwent an initial DXA scan. Quiescent disease was significantly associated with a reduced likelihood of DXA (hazard ratio [HR]: 0.48; 95% confidence interval [CI]: 0.24-0.97), while weight z-score <-2 was significantly associated with DXA performance (HR: 2.07; 95% CI: 1.08-3.98). Abnormal DXA results (BMD z-score ≤-1) occurred in 59 (35.54%) individuals. After adjusting for visit diagnosis, delayed puberty, severe disease course, 6 months or greater of steroid exposure, and history of fracture, BMI z-score <-1 (odds ratio: 5.45; 95% CI: 2.41-12.33) was associated with abnormal DXA. DXA screening occurred in less than one-third of eligible pediatric IBD patients. Compliance was more common in patients with a weight z-score <-2 and less common in those with quiescent disease. BMI strongly predicted abnormal DXA results when adjusting for risk factors for abnormal BMD.

An Examination of Physical Activity, Non-Communicable Diseases, and Health Screening among People Living with HIV in Zamfara State, Nigeria

Aim: This study provides a comprehensive analysis of physical activity levels, non-communicable disease prevalence, and health screening practices of people living with HIV in Zamfara State, Nigeria.&#x0D; Methodology: This study is a cross-sectional study involving a total of 424 individuals living with HIV (PLWH) in Zamfara State, Nigeria.&#x0D; Results: The socio-demographic analysis reveals that the study participants were predominantly within the age group of 30-39 (38.7%) and were mainly female (70.3%). In terms of ethnicity, Hausa was the most common (75.7%), followed by Yoruba (9.7%) and Igbo (4.7%). The participants were largely married (57.8%) and had no formal schooling (45.8%). Physical activity levels were evaluated based on the time spent on different domains of activity in a typical week. The mean time spent on vigorous intensity activity was 28.6 minutes per week, while moderate-intensity activity and walking/cycling were higher at 69.9 minutes and 205.1 minutes per day, respectively. However, 47.2% of participants overall did not meet WHO recommendations on physical activity for health, with females demonstrating a higher rate of non-compliance (50.7%) compared to males (38.9%). A notable aspect of the study is the examination of the prevalence of non-communicable diseases (NCDs) among the participants. Overall, the highest prevalence was seen for raised blood pressure (10.4%), followed by cardiovascular diseases (7.3%) and raised blood sugar (4.0%), while raised cholesterol levels were minimal (0.2%). Females presented a higher prevalence of raised blood pressure and cardiovascular diseases. The study also scrutinized health screening practices, revealing that the screening for cervical cancer among female respondents was worryingly low at 2.3%. The mean weight and height for both sexes were 63.8 Kg and 1.6 meters, respectively. The mean Body Mass Index (BMI) was found to be 23.5 for males and 25.5 for females. Concerningly, 37.5% of the population had a BMI greater than 25, indicating overweight or obesity, with a higher prevalence among females (31.8%) than males (7.6%).&#x0D; Conclusion: This study provides valuable insights into physical activity trends, non-communicable disease prevalence, and health screening practices among PLWH in Zamfara State, Nigeria. The findings underline the importance of tailored interventions to promote physical activity, manage non-communicable diseases, and encourage routine health screenings in this demographic.

Assessment of non-communicable diseases screening practices among university lecturers in Ghana – a cross sectional single centre study

Background: Non-communicable diseases (NCDs) are a major cause of morbidity and mortality globally. In low-income settings, some NCDs are without symptoms so regular screening for early detection is key. However, routine screening for NCDs is limited in the general public and even among the elite. We therefore set out to assess health screening practices among lecturers in a university in Ghana. Methods: This was a cross-sectional study involving 205 lecturers in Kwame Nkrumah University of Science and Technology from February to August 2022. A questionnaire was used to gather data from both male and female university lecturers based on their self-reported declaration of being male or female. Data were analyzed using descriptive and inferential statistics. Results: We found that, 41 (20.0%) lecturers (both men and women) had never checked their blood pressure (BP), 140 (68.3%) check their BP twice a month and 24 (11.7%) do so more than 3 times a month. Overall, 105 (57.18%) lecturers have high BP (&gt;120 mmHg, &gt;80 mmHg). Among the lecturers with hypertension, 59 (50.9%) often checked their BP each month, whereas 22 (18.97%) did not. The study found that, 164 (80%) of the lecturers have never checked their blood sugar level since they assumed lectureship position. Among the lecturers who check their blood sugar, 78 (47.55) are not happy with their blood sugar levels. Lecturer’s age (40 to 49 years) was found to be associated with BP in the bivariate analysis (p=0.036), but not in the multivariate analysis (p=0.114). In the bivariate analyses, female lecturers were found to have a higher risk (OR 1.35; 95% CI 0.29-6.21) of developing hypertension compared to male lecturers. Conclusions: The study has revealed that lecturers, just like the general population have moderate health care checks. The need to setup occupational health therapy units in all universities is overdue.

Pediatric Mental Disorders and Related Screening Practices: Qualitative Insights from Early Childhood Educators

ObjectiveThe purpose of this research is to qualitatively identify perceived concerns about mental disorders among children and related screening practices for mental illness among early childcare and education providers. DesignQualitative research design with a phenomenological approach was used. Sample53 early childcare and education providers from Nebraska participated in semi-structured interviews focused on mental disorders and related screening practices among children. MethodsThe recorded interviews were transcribed, coded, and systematically analyzed through thematic content analysis. ResultsThe analysis identified two themes concerning pediatric mental health disorders and screening practices. The first theme, mental health concerns, includes three categories: perceived level of mental disorder (n=39; 74 %), most common (attention-deficit disorder [n=28; 53.8 %] and anxiety [n=13; 25.6 %]), and least common (mood disorders [n=5; 10.2 %] and substance abuse [n=8; 15.4 %]). The second theme, screening practices, reflects the use of screening tools and their implication to screen mental disorders and suggested one category: screening measure usage (Ages and Stages and the Modified Checklist for Autism in Toddlers). ConclusionAmong the 53 participants, 39 or 74 % of them stated their concern about pediatric mental health disorders in their organization, with some of the most commonly reported disorders including attention-deficit/hyperactivity disorder (ADHD) (53.8 %), anxiety (25.6 %), depression (17.9 %), and substance use (15.4 %). Participants were also concerned about the lack of standard screening instruments for mental health issues among children of ages 0 to 5. There is a need for early childcare organizations, healthcare providers, and educational organizations to collaborate and implement a coordinated approach to improving Nebraska's pediatric mental health.

Assessment of non-communicable diseases screening practices among university lecturers in Ghana – a cross sectional single centre study

Background: Non-communicable diseases (NCDs) are a major cause of morbidity and mortality globally. In low-income settings, some NCDs are without symptoms so regular screening for early detection is key. However, routine screening for NCDs is limited in the general public and even among the elite. We therefore set out to assess health screening practices among lecturers in a university in Ghana. Methods: This was a cross-sectional study involving 205 lecturers in Kwame Nkrumah University of Science and Technology from February to August 2022. A questionnaire was used to gather data from both male and female university lecturers based on their self-reported declaration of being male or female. Data were analyzed using descriptive and inferential statistics. Results: We found that, 41 (20.0%) lecturers (both men and women) had never checked their blood pressure (BP), 140 (68.3%) check their BP twice a month and 24 (11.7%) do so more than 3 times a month. Overall, 105 (57.18%) lecturers have high BP (&gt;120 mmHg, &gt;80 mmHg). Among the lecturers with hypertension, 59 (50.9%) often checked their BP each month, whereas 22 (18.97%) did not. The study found that, 164 (80%) of the lecturers have never checked their blood sugar level since they assumed lectureship position. Among the lecturers who check their blood sugar, 78 (47.55) are not happy with their blood sugar levels. Lecturer’s age (40 to 49 years) was found to be associated with BP in the bivariate analysis (p=0.036), but not in the multivariate analysis (p=0.114). In the bivariate analyses, female lecturers were found to have a higher risk (OR 1.35; 95% CI 0.29-6.21) of developing hypertension compared to male lecturers. Conclusions: The study has revealed that lecturers, just like the general population have moderate health care checks. The need to setup occupational health therapy units in all universities is overdue.

A Systemwide Postpartum Inpatient Maternal Mental Health Education and Screening Program

ObjectiveTo expand a hospital system’s maternal mental health program to standardize screening for perinatal mood and anxiety disorders. DesignQuality improvement initiative using a continuous Plan–Do–Study–Act (PDSA) cycle. Setting/Local ProblemIn a hospital system consisting of 66 maternity care centers across the United States, there was significant variation in maternal mental health screening, referral, and education practices. The COVID-19 pandemic and increasing rates of severe maternal morbidity further elevated system-level concern about the quality of maternal mental health care being provided. ParticipantsPerinatal nurses. MethodsAn “all-or-none” bundle methodology was used to measure adherence to a system standard for maternal mental health screening, referral, and education. InterventionsA toolkit was designed internally to support streamlined implementation and ensure standardization for screening, referral, and education. This comprehensive toolkit includes screening forms, a referral algorithm, staff education, patient education literature, and a community resource list template. Training on how to use the toolkit was provided to nurses, chaplains, and social workers. ResultsThe initial system bundle adherence rate was 76% (2017) in the first year of the program. The following year, the bundle adherence rate increased to 97% (2018). Despite the disruption caused by the COVID-19 pandemic, this mental health initiative has maintained an overall adherence rate of 92% (2020–2022). ConclusionThis nurse-led quality improvement initiative has been successfully implemented across a geographically and demographically diverse hospital system. The initial and sustained high rates of adherence with the system standard for screening, referral, and education illustrate perinatal nurses’ commitment to the delivery of high-quality maternal mental health care in the acute care setting.

Screening for pediatric behavioral health in primary care in rural and urban clinics.

The prevalence of behavioral health disorders in children is approximately 15%-20%, yet less than half of the children ever receive treatment for these conditions. The lack of access to behavioral health care is common in urban areas but even more difficult to access in rural areas. Screening for behavioral health in a primary care setting is one of the first strategies to reduce this problem and improve access to care. The primary goal of this study was to examine behavioral health screening practices of pediatric primary care providers in a rural midwestern state. A survey that queried family practice/internal medicine and pediatric providers who provide care to pediatric patients was delivered to over 300 primary care providers across the state. The number of surveys returned was 112. The Modified Checklist for Autism tool was administered by 80% of pediatric providers and 30% of family practice primary care providers. The Patient Health Questionnaire for depression was administered by 72% of pediatric and 80% of family practice providers. Most of the primary care providers had a behavioral health provider present in the clinic, which likely resulted in higher screening rates compared to the national average. The screening practices of the family practice and pediatric subspecialities reflect their respective current professional organization recommendations. Although most providers believe it is important to screen for developmental and behavioral disorders, further system changes are needed to support screening for development and broader behavioral problems along with depression among family practice providers. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Use of Social Determinants of Health Screening among Primary Health Care Nurses of Developed Countries: An Integrative Review.

The aims of the study are to evaluate and synthesise research that has investigated social determinants of health screening by primary healthcare nurses; how and when primary health care nurses perform social determinants of health screening; and implications for advancing nursing practice. Systematic searches in electronic databases identified fifteen published studies which met the inclusion criteria. Studies were synthesised using reflexive thematic analysis. This review found little evidence of primary health care nurses using standardised social determinants of health screening tools. Eleven subthemes were identified and collapsed into three main themes: organisation and health system supports are required to enable primary health care nurses; primary health care nurses are often reluctant to perform social determinants of health screening; and the importance of interpersonal relationships for social determinants of health screening. The social determinants of health screening practices of primary health care nurses are poorly defined and understood. Evidence suggests that primary health care nurses are not routinely using standardised screening tools or other objective methods. Recommendations are made for valuing therapeutic relationships, social determinants of health education and the promotion of screening by health systems and professional bodies. Overall, further research examining the best social determinant of health screening method is required.

Prevalence and factors associated with depression, anxiety and stress in Malaysia during COVID-19 pandemic: A systematic review.

The COVID-19 pandemic has had severe impacts on mental health status worldwide. Several studies have investigated the prevalence and factors associated with depression, anxiety, and stress in different countries, however, a systematic review on the research topic during COVID-19 is presently lacking in Malaysia's context. To fill this gap, electronic databases including PubMed, Scopus, Science Direct, Sagepub, CINAHL, Psychology, and Behavioral Sciences Collection were searched for relevant studies. A total of 16 studies were included in the systematic review. To fill this gap, electronic databases including PubMed, Scopus, Science Direct, Sagepub, CINAHL, Psychology, and Behavioral Sciences Collection were searched for relevant studies. A total of 16 studies were included in the systematic review. The analyses showed that the prevalence of depression, anxiety, and stress ranged from 14.3% to 81.7%, 8.0% to 81.7%, and 0.9% to 56.5% respectively. Adult populations demonstrated the highest prevalence of depression, whereas university students reported the highest prevalence of anxiety and stress. Several factors were associated with mental health conditions including age, gender, family income, and perception of COVID-19. Differentials in mental health screening practices call for standardised screening practices. Mental health intervention should be targeted at high-risk populations with effective risk communication.

ADVERSE CHILDHOOD EXPERIENCES (ACES) AND PARTICIPATION IN ROUTINE HEALTH SCREENING AMONG OLDER INDIVIDUALS

Abstract Adverse Childhood Experiences (ACEs) are a collective term used to define traumatic events before the age of 18. Individuals with ACEs are at risk for various negative health behaviors and chronic diseases. Routine screenings help in early detection of the disease and minimize the impact of the disease, disability, early death, and higher medical costs. Research on ACEs focusing exclusively on older population has received inadequate attention. Additionally, it is not clear whether different types of childhood adversities impact older individuals to participate in routine health screenings. This study included 3997 individuals above 65 years from the 2015 Texas Behavioral Risk Factor Surveillance System (BRFSS) to examine the prevalence of ACEs and their health screening practices. The dependent variable was participating in routine health checkup in the past year and 8 ACEs were the independent variables where gender, age, race, and having a personal doctor were controlled. Logistic regression models showed that prevalence of four ACEs (Physical, sexual, and emotional abuses and parental divorce/separation) were likely to reduce older individuals’ participation in routine checkup in the past year. Similarly, older individuals with personal doctor were twice more likely to visit for routine checkup compared to those without personal doctor. Lastly, older Black individuals were less likely to participate in routine checkup than their White counterparts. This study provided preliminary results to consider the impact of specific ACEs in routine health screening behaviors among older individuals. Future research might benefit from longitudinal study examining causal relationship between ACEs and health behaviors.

Universal Mental Health Screening Practices in Midwestern Schools: AWindow of Opportunity for School Psychologist Leadership and Role Expansion?

The conducting of universal mental health screening is one widely endorsed practice suitable for use within P-12 school settings to more proactively identify children and young people experiencing or displaying characteristics of a mental health disorder. Absent routine screening, many school-age youth with mental health concerns, especially those of an internalizing nature, may go unidentified and left without timely treatment, support, and services. The current study, which employed survey methodology with principal respondents from four Midwestern states, primarily sought to contribute to and update the literature on the universal mental health screening practice habits of P-12 schools. Most principal respondents reported that their school does not currently conduct universal mental health screening and cited barriers (e.g., money, time, lack of support system in place) to screening commonly documented in prior studies. Many principals reported at least a moderate degree of interest in their school beginning to conduct universal screening in their buildings; however, a similar majority reported little to no knowledge about this important practice. Fortunately, principal respondents were generally interested in and receptive to support from their school psychologist in exploring and eventually implementing the conducting of universal mental health screening in their building. Implications for practice and future research, along with the potential for school psychologist leadership and role expansion, are discussed.

Assessment of Canadian perinatal mental health services from the provider perspective: Where can we improve?

PurposePerinatal mental health disorders are common, and rates have increased during the COVID-19 pandemic. It is unclear where providers may improve perinatal mental health care, particularly in countries lacking national guidelines, such as Canada.MethodsA cross-sectional survey of perinatal health providers was conducted to describe the landscape of perinatal mental health knowledge, screening, and treatment practices across Canada. Providers were recruited through listservs, social media, and snowball sampling. Participants completed an online survey that assessed their perinatal mental health training, service provision types, their patient wait times, and treatment barriers, and COVID-19 pandemic-related impacts.ResultsA total of 435 providers completed the survey, including physicians, midwives, psychologists, social workers, nurses, and allied non-mental health professionals. Most (87.0%) did not have workplace mandated screening for perinatal mental illness but a third (66%) use a validated screening tool. Many (42%) providers stated their patients needed to wait more than 2 months for services. More than half (57.3%) reported they did not receive or were unsure if they received specialized training in perinatal mental health. Most (87.0%) indicated there were cultural, linguistic, and financial barriers to accessing services. Over two-thirds (69.0%) reported the COVID-19 pandemic reduced access to services.ConclusionSurvey findings reveal significant gaps in training, screening tool use, and timely and culturally safe treatment of perinatal mental health concerns. There is critical need for coordinated and nationally mandated perinatal mental health services in Canada to improve care for pregnant and postpartum people.

Nursing students' experiences of health screening in rural areas of southern Turkey: a qualitative study.

Individuals in rural areas live with healthcare disadvantages relating to, for example, access to health institutions, necessary treatments, and healthcare professionals during medical emergencies. The aim of this study was to explore the experiences, beliefs and attitudes of nursing students to identify advantages and disadvantages of health screening in several rural areas in rural Turkey. Health screening practices with senior nursing students were conducted in six rural areas. A qualitative descriptive study was performed using thematic analysis of open-ended responses to a web-based survey of 34 students aged 18 years and over. This study was conducted in March and April 2020. The practices of nursing students in rural areas included measuring vital signs, body mass index calculation, blood glucose and cholesterol measurement, depression screening, cancer screening and health education. Students undertook various health screening practices in rural health care including colorectal cancer screening, evaluation of scales used in diabetes and depression risk. Characteristics referred to by student nurses as part of public health nursing roles were protector, advocate, supporter, caregiver, coordinator, collaborator, educator, counsellor, researcher, therapist, case manager, leader and care provider. The main themes generated related to student emotions, feedback of screening participants to nursing students, positive nursing characteristics, advantages and disadvantages of doing health screening in rural areas, benefits of working with health professionals to nursing student education, and feedback for nursing educators and researchers. Participants recognised their emotions, and the benefits and advantages of health screening practices, and disadvantages were determined across the themes. Health services should be planned by taking these experiences into account in health screenings to be carried out in rural areas.

Longitudinal trajectories of depressive symptoms among sexually abused adolescents involved in child protection services

BackgroundChildhood sexual abuse (CSA) contributes to depression in several populations. However, there is a significant lack of longitudinal research on depressive symptoms among sexually abused adolescents involved in Child Protection Services (CPS). Given the systemic challenges in CPS research, it is also unclear as to whether depressive symptoms vary according to CSA severity. ObjectiveThe research aimed to determine whether depressive symptoms increased over time and to assess whether CSA severity predicted the variation of change in depressive symptoms over time. Participants and settingThe study included 135 sexually abused adolescents (M = 16.01, 71.9 % female) from the Maltreatment and Adolescent Pathways (MAP) Longitudinal Study who were involved in three densely populated urban CPS agencies in Ontario, Canada. MethodsThe project involved the collection of self-report questionnaires to be completed every six-months for three years. The questionnaires encompassed measures on psychological outcomes, selected resiliency factors, and abuse and neglect history. Hierarchical Linear Modeling (HLM) via mixed model analyses were used to estimate depressive symptom trajectories. ResultsWe found that depressive symptoms significantly reduced over time (β. = −3.62, p < .001). Furthermore, the results showed that CSA severity significantly predicted depressive symptoms over time (β = 0.19, p < .001). ConclusionsThe findings contrast previous longitudinal research in community-based samples, suggesting a different trajectory for depressive symptoms among sexually abused adolescents involved in CPS. Moreover, the results reveal a strong association between depressive symptoms and CSA severity, further supporting early mental health screening practices.

National Cross-Sectional Study of Mental Health Screening Practices for Primary Caregivers of NICU Infants.

Universal screening for postpartum mood and anxiety disorders (PMADs) has been recommended for all new parents at outpatient postpartum and well-child visits. However, parents of newborns admitted to the NICU are rarely able to access these services during their infant’s prolonged hospitalization. The objective of this study was to determine the prevalence of mental health screening and treatment programs for parents or other primary caregivers in NICUs across the country. In this cross-sectional study, US NICU medical directors were invited to complete an online survey about current practices in mental health education, screening, and treatment for primary caregivers of preterm and ill infants in the NICU. Comparative analyses using Fisher’s exact test were performed to evaluate differences in practices among various NICU practice settings. Survey responses were obtained from 75 out of 700 potential sites (10.7%). Of participating NICUs, less than half routinely provided caregivers with psychoeducation about mental health self-care (n = 35, 47%) or routinely screened caregivers for PPD or other mental health disorders (n = 33, 44%). Nearly one-quarter of the NICUs did not provide any PMAD screening (n = 17, 23%). Despite consensus that postpartum psychosocial care is essential, routine mental health care of primary caregivers in the NICU remains inadequate.