Telemedicine Quality Improvement during the Corona Virus 2019 Pandemic Increases Pediatric Weight Management Access.

Background: The corona virus 2019 pandemic disrupted care for pediatric patients with chronic conditions, including those with childhood obesity. Lockdowns forced providers to create new ways of caring for this population. Telemedicine was a promising but previously unavailable solution.

Evaluating a web-based training curriculum for disseminating best practices for the care of newborns with neonatal opioid withdrawal syndrome in a rural hospital, the NOWS-NM Program.

Background: The incidence of neonatal opiate withdrawal syndrome (NOWS) in the US has grown dramatically over the past two decades. Many rural hospitals not equipped to manage these patients transfer them to hospitals in bigger cities.

Methods: We created a curriculum, the NOWS-NM Program, a web-based curriculum training in best practices.

High Prevalence of Elevated Alanine Aminotransferase in American Indian Children Seen in a Pediatric Weight Management Clinic.

Introduction: Elevated alanine aminotransferase (ALT) can indicate risk of metabolic dysfunction-associated steatotic liver disease. However, there is little data about the prevalence of elevated ALT in American Indian (AI) children.

Methods: Baseline data from children attending the pediatric weight management clinic were used to describe the prevalence of elevated ALT, stratified by race and ethnicity.

Evaluating a Web-based Training Curriculum for Disseminating Best Practices for the Care of Newborns with Neonatal Opioid Withdrawal Syndrome in a Rural Hospital, the NOWS-NM Program.

Background: The incidence of neonatal opiate withdrawal syndrome (NOWS) in the US has grown dramatically over the past two decades. Many rural hospitals not equipped to manage these patients transfer them to hospitals in bigger cities.

Methods: We created a curriculum, the NOWS-NM Program, a mobile/web-based curriculum training in best practices.

Pediatric Hepatitis C Quality Improvement Project Improves Healthcare Access.

Objectives: Incidence of hepatitis C virus (HCV) infection is increasing in women of reproductive age, leading to increased prevalence of HCV infection in children via vertical transmission. This quality improvement (QI) project aimed to increase referrals to and appointments scheduled with a specialty pediatric gastroenterology HCV clinic and the number of eligible children with HCV who completed treatment.

Methods: From July 2020 to August 2021, the QI team designed a project using the Model for Improvement and completed Plan Do Study Act cycles to test change ideas to improve HCV awareness and education for medical providers and families; standardize the referral process; track patients; increase clinic capacity; and connect families with community resource care coordination.

Teen and caregiver perspectives on success, clinician role, and family involvement in ACTION PAC, a weight management intervention trial.

Objective: Describe perspectives of teens and caregivers regarding motivations, successes, and challenges related to participation in ACTION PAC (ClinicalTrials.gov: NCT02502383), a two-year weight management trial.

Methods: Intervention group participants received 16 short motivational interviewing (MI) sessions with school-based health center (SBHC) primary care clinicians over two years.

Virtual Intrauterine Device Placement Training Improves Clinician Comfort.

Background And Objectives: Virtual intrauterine device (IUD) training options can improve clinician continuing education and patient IUD access. Our objective was to evaluate a virtual, hands-on IUD training for primary care clinicians.

Methods: Training sessions occurred via video conferencing and included didactic instruction on IUD eligibility, counseling, placement, and removal.

Facilitators and barriers to pediatric clinical trial recruitment and retention in rural and community settings: A scoping review of the literature.

Children in rural settings are under-represented in clinical trials, potentially contributing to rural health disparities. We performed a scoping review describing available literature on barriers and facilitators impacting participation in pediatric clinical trials in rural and community-based (nonclinical) settings. Articles identified via PubMed, CINAHL, Embase, and Web of Science were independently double-screened at title/abstract and full-text levels to identify articles meeting eligibility criteria.

Individual differences in the effects of the ACTION-PAC intervention: an application of personalized medicine in the prevention and treatment of obesity.

There is an increased interest in the use of personalized medicine approaches in the prevention or treatment of obesity, however, few studies have used these approaches to identify individual differences in treatment effects. The current study demonstrates the use of the predicted individual treatment effects framework to test for individual differences in the effects of the ACTION-PAC intervention, which targeted the treatment and prevention of obesity in a high school setting. We show how methods for personalized medicine can be used to test for significant individual differences in responses to an intervention and we discuss the potential and limitations of these methods.

Vacteens.org: A Mobile Web app to Improve HPV Vaccine Uptake.

U.S. HPV vaccine uptake remains below the Healthy People 2030 goal of 80% series completion.

Capacity Building for a New Multicenter Network Within the ECHO IDeA States Pediatric Clinical Trials Network.

Research capacity building is a critical component of professional development for pediatrician scientists, yet this process has been elusive in the literature. The ECHO IDeA States Pediatric Clinical Trials Network (ISPCTN) seeks to implement pediatric trials across medically underserved and rural populations. A key component of achieving this objective is building pediatric research capacity, including enhancement of infrastructure and faculty development.

Formative Evaluation for Implementation of a Low Literacy Pictorial Asthma Action Plan Delivered via Telehealth Improves Asthma Control.

Consistently uncontrolled asthma in children is an increasing concern in the United States. The use of asthma action plans with asthma education is inconsistent and may be improved with adaptations for low literacy. The objective of this study was formative evaluation for implementation of the New Mexico Pictorial Asthma Action Plan (NM PicAAP).

Estimated Physical Activity in Adolescents by Wrist-Worn GENEActiv Accelerometers.

Background: Reports of physical activity (PA) measured via wrist-worn accelerometers in adolescents are limited. This study describes PA levels in adolescents at baseline of an obesity prevention and weight management trial.

Methods: Adolescents (n = 930) at 8 high schools wore an accelerometer for 7 days, with average acceleration values of <50 mg, >150 mg, and >500 mg categorized as sedentary, moderate, and vigorous PA, respectively.

Rural-Urban Differences in Baseline Dietary Intake and Physical Activity Levels of Adolescents.

Introduction: Differences in dietary intake and physical activity may explain the higher prevalence of obesity among adolescents living in rural versus urban settings. The objective of this cross-sectional secondary analysis was to compare baseline dietary intake and physical activity of adolescents by rurality.

Methods: We analyzed data on 940 adolescents who participated in ACTION PAC (Adolescents Committed to Improvement of Nutrition and Physical Activity), an obesity prevention and management intervention trial conducted from 2014 through 2017 in 8 public high schools in the southwestern United States.

Motivational Interviewing to Treat Adolescents With Obesity: A Meta-analysis.

Context: Successful treatment approaches are needed for obesity in adolescents. Motivational interviewing (MI), a counseling approach designed to enhance behavior change, shows promise in promoting healthy lifestyle changes.

Objective: Conduct a systematic review of MI for treating overweight and obesity in adolescents and meta-analysis of its effects on anthropometric and cardiometabolic outcomes.

Effect of Including Alcohol and Cannabis Content in a Sexual Risk-Reduction Intervention on the Incidence of Sexually Transmitted Infections in Adolescents: A Cluster Randomized Clinical Trial.

Importance: Adolescents in the juvenile justice system are at high risk for sexually transmitted infections (STIs). Concurrent use of alcohol and cannabis increase this risk.

Objective: To determine whether a theory-based sexual risk-reduction intervention that included alcohol- and cannabis-focused content resulted in greater reductions in STIs than an intervention that included alcohol-related content only and an intervention that did not include substance use content.

Risky Sex in High-Risk Adolescents: Associations with Alcohol Use, Marijuana Use, and Co-Occurring Use.

Risky sexual behavior and substance use appear to be interconnected behaviors among adolescents, but data are scarce regarding the extent to which sexual risk behavior is associated with high levels of marijuana and alcohol use, both separately and in combination. 301 adolescents were recruited from a short-term detention facility, and substance use and risky sexual behavior were assessed. We found that adolescents who frequently used marijuana, but not alcohol, reported significantly less risky sex as well as greater intentions to use condoms than either adolescents who frequently used alcohol, but not marijuana, or adolescents who frequently used both substances.

Training Primary Care Providers in the Use of Motivational Interviewing for Youth Behavior Change.

Background And Purpose: Adolescent obesity is a global epidemic. Motivational interviewing (MI) is a promising strategy to address adolescent obesity risk behaviors. However, primary care providers (PCPs) tend to express discomfort with learning and adopting MI practices and with addressing patient weight issues.

Outcome Evaluation of a Policy-Mandated Lifestyle and Environmental Modification Program in a National Job Training Center.

Excess weight gain is common when adolescents become young adults, but there are no obesity prevention or weight management interventions that have been tested for emerging adults who follow non-traditional post-secondary paths, such as enrolling in job training programs. We evaluated Healthy Eating & Active Lifestyles (HEALs), a policy-mandated lifestyle education/environmental modification program, at a job training center for low-income 16-24 year olds. We examined average change in body mass index (BMI) z-score from baseline to 6 months for emerging adults (aged 16-24 years) in pre-HEALs implementation (n = 125) and post-HEALs implementation (n = 126) cohorts living at the job training center, by baseline weight status.

Overweight adolescents' brain response to sweetened beverages mirrors addiction pathways.

Many adolescents struggle with overweight/obesity, which exponentially increases in the transition to adulthood. Overweight/obesity places youth at risk for serious health conditions, including type 2 diabetes. In adults, neural substrates implicated in addiction (e.

Association between circulating CCL2 levels and modifiable behaviors in overweight and obese adolescents: a cross-sectional pilot study.

Background: We evaluated the relationship between an early inflammatory biomarker, chemokine (C-C motif) ligand 2 (CCL2), and other clinical biomarkers and lifestyle behaviors, in overweight/obese adolescents at high risk of developing cardiometabolic derangements.

Methods: We collected anthropometric measurements, clinical biomarkers, and three 24-h dietary recalls from 21 vocational high school students (91% male), 14-19 years, with body mass index (BMI) ≥25 kg/m2. Pearson's or Spearman's correlation coefficients were used to examine relationships.

Usability Testing of an HPV Information Website for Parents and Adolescents.

Objective: Parents make the decisions regarding their children's health care. Unfortunately, many parents are misinformed about HPV and HPV vaccines. In order to help parents make an informed decision regarding HPV vaccination for their daughter, the website was created for parents and their adolescent daughters.

Investigating stakeholder attitudes and opinions on school-based human papillomavirus vaccination programs.

Background: In several countries worldwide, school-based human papillomavirus (HPV) vaccination programs have been successful; however, little research has explored US stakeholders' acceptance toward school-based HPV vaccination programs.

Methods: A total of 13 focus groups and 12 key informant interviews (N = 117; 85% females; 66% racial/ethnic minority) were conducted with 5 groups of stakeholders: parents of adolescent girls, parents of adolescent boys, adolescent girls, middle school nurses, and middle school administrators throughout the 5 public health regions of New Mexico.

Results: All groups of stakeholders lacked knowledge on HPV and HPV vaccines.

Beta-test Results for an HPV Information Web site: GoHealthyGirls.org - Increasing HPV Vaccine Uptake in the United States.

A web site, , was developed to educate and inform parents and their adolescent daughters about human papillomavirus (HPV) and HPV vaccines. This article provides an overview of web site development and content followed by the results of a beta-test of the web site. 63 New Mexican parents of adolescent girls tested the site.

Different models of HPV vaccine decision-making among adolescent girls, parents, and health-care clinicians in New Mexico.

Objective: Human papillomavirus (HPV) vaccination rates in the United States have been lower than anticipated since the vaccine became widely available globally in 2006. Of particular concern are data that suggest disparities in vaccine receipt among US ethnic minority and health disparity populations such as Hispanics, who are disproportionately affected by cervical cancer. Given these trends, it is important to examine actual vaccination decision-making processes among clinicians, parents, and adolescents to identify strategies to enhance uptake.