Progression of Gender Dysphoria in Children and Adolescents: A Longitudinal Study.

Background And Objectives: The progression of gender-expansive behavior to gender dysphoria and to gender-affirming hormonal treatment (GAHT) in children and adolescents is poorly understood.

Methods: A cohort of 958 gender-diverse (GD) children and adolescents who did not have a gender dysphoria-related diagnosis (GDRD) or GAHT at index were identified. Rates of first GDRD and first GAHT prescription were compared across demographic groups.

Longitudinal Changes in Hematologic Parameters Among Transgender People Receiving Hormone Therapy.

Context: The effect of gender-affirming hormone therapy (HT) on erythropoiesis is an area of priority in transgender health research.

Objective: To compare changes in hematologic parameters and rates of erythrocytosis and anemia among transgender people to those of cisgender controls.

Design: Longitudinal observational study.

Changes in Size and Demographic Composition of Transgender and Gender Non-Binary Population Receiving Care at Integrated Health Systems.

Objective: To examine temporal changes in the number and demographic composition of transgender/gender non-binary (TGNB) population using data from integrated health care systems.

Methods: Electronic health records from Kaiser Permanente health plans in Georgia and Northern and Southern California were used to identify TGNB individuals, who sought care from January 2006 to December 2014, and the data were analyzed by year, site, age, and sex assigned at birth.

Results: In 2006, the number of TGNB people (and corresponding 95% CI) per 100 000 population were 3.

Costs and effectiveness of a culturally tailored communication training program to increase cultural competence among multi-disciplinary care management teams.

Background: Several studies have demonstrated that cultural competence improves patient-provider communication, which promotes adherence to established care plans and improves patient satisfaction and health outcomes. However, there is very little data available regarding the costs associated with the development and implementation of cultural competence training, or the cost-effectiveness of these programs. To that end, this evaluation aims to describe costs, program effectiveness, and cost-effectiveness of a culturally tailored communication training program to improve cultural competence among multi-disciplinary care management teams.

Visual Conformity With Affirmed Gender or "Passing": Its Distribution and Association With Depression and Anxiety in a Cohort of Transgender People.

Background: Visual conformity with affirmed gender (VCAG) or "passing" is thought to be an important, but poorly understood, determinant of well-being in transgender people. VCAG is a subjective measure that is different from having an inner sense of being congruent with one's gender identity.

Aim: We examined the frequency and determinants of VCAG and explored its association with mental health outcomes in a cohort of transgender adults.

Agreement between medical records and self-reports: Implications for transgender health research.

A key priority of transgender health research is the evaluation of long-term effects of gender affirmation treatment. Thus, accurate assessment of treatment receipt is critical. The data for this analysis came from an electronic medical records (EMR) based cohort of transgender individuals.

Development of an accelerometer-linked online intervention system to promote physical activity in adolescents.

Most adolescents do not achieve the recommended levels of moderate-to-vigorous physical activity (MVPA), placing them at increased risk for a diverse array of chronic diseases in adulthood. There is a great need for scalable and effective interventions that can increase MVPA in adolescents. Here we report the results of a measurement validation study and a preliminary proof-of-concept experiment testing the impact of Zamzee, an accelerometer-linked online intervention system that combines proximal performance feedback and incentive motivation features to promote MVPA.

Overweight and obesity among low-income women in rural West Virginia and urban Los Angeles County.

We described the prevalence of overweight and obesity among low-income women in rural West Virginia (WV) and urban Los Angeles County (LA County). Both communities participated in the national Communities Putting Prevention to Work program during 2010-2012. In each community, we completed health assessments on adult women recruited from public-sector clinics serving low-income populations.

Assessing moderate to vigorous physical activity in rural West Virginia elementary school physical education classes.

Background: Physical education (PE) provides a natural opportunity for students to be physically active during the school day; however, the amount and intensity of this activity varies. The Centers for Disease Control and Prevention recommends that students engage in MVPA for at least 50% of their PE class period. The purpose of the present study was to quantify the amount of MVPA that occurs during elementary school PE.

Exploring the relationship between parental concern and the management of childhood obesity.

Parental concern about child weight has been identified as a factor in parental monitoring and regulation of child diet. However, little is known about factors that influence parental concern or about how concern may influence parent management of child physical activity. The objectives of the current study were to identify the factors associated with parental concern about child weight and determine if parental concern is associated with specific actions to improve diet and increase physical activity.

Identifying the people and factors that influence children's intentions to make lifestyle changes.

Childhood obesity and health behavior programs are increasingly a focus within literature and individual provider practices. This study was designed to inform "best practices" for establishing effective programs in the medical setting by identifying persons and factors that influence children's willingness to be active, eat healthy, and lose weight when medically appropriate. A total of 342 child and parent dyads living in a rural setting participated in this study.

Evaluating the West Virginia Healthy Lifestyles Act: methods and procedures.

Background: The West Virginia Healthy Lifestyles Act contained 5 school-based mandates intended to reduce childhood obesity. These addressed the sale of healthy beverages, physical education time, fitness assessment, health education and assessment, and Body Mass Index measurement. This article describes the processes and methods used to evaluate efforts to implement the legislation.

Developing culturally tailored health belief-based intervention materials to improve child and parent participation in a cardiovascular screening program.

The Coronary Artery Risk Detection in Appalachian Communities Project was developed to reduce children's future cardiovascular risk by implementing a school-based screening program statewide. Despite the elimination of environmental barriers related to screening cost and accessibility, only half of eligible children participate in the program each year. The authors used the theory of planned behavior to identify health beliefs associated with screening participation.

A video game improves behavioral outcomes in adolescents and young adults with cancer: a randomized trial.

Objective: Suboptimal adherence to self-administered medications is a common problem. The purpose of this study was to determine the effectiveness of a video-game intervention for improving adherence and other behavioral outcomes for adolescents and young adults with malignancies including acute leukemia, lymphoma, and soft-tissue sarcoma.

Methods: A randomized trial with baseline and 1- and 3-month assessments was conducted from 2004 to 2005 at 34 medical centers in the United States, Canada, and Australia.

BMI-based body size guides for women and men: development and validation of a novel pictorial method to assess weight-related concepts.

Objectives: To develop and evaluate two BMI-based instruments to determine perceptions of weight status, particularly perceptions of overweight and obesity, using pictorial images of women and men.

Methods: Pictures of adults with known BMI values were used to construct gender-specific body size guides (BSGs) containing 10 bodies that ranged from underweight to class III obesity. Figures were standardized and a composite face was added to each.

Preventive care in Appalachia: use of the theory of planned behavior to identify barriers to participation in cholesterol screenings among West Virginians.

Context: West Virginians are at increased risk for heart disease. Given that the process of atherosclerosis begins in childhood, the Coronary Artery Risk Detection in Appalachian Communities Project was developed to reduce this risk by implementing a cholesterol screening program in the schools. However, participation rates have been less than desired.

Pediatric oncology professionals' perceptions of information needs of adolescent patients with cancer.

In contrast to the extensive research on the information needs of older patients with cancer, the question of what information is most relevant for adolescents seems to have been addressed in only one published study. The aim of the present study was to update and extend the sole previous survey of oncology professionals' views about the information needs of adolescent patients. This was achieved by including professionals other than physicians, by structuring the questionnaire to show whether perceived information needs were different for the time of diagnosis versus during treatment, and by differentiating between the 6 cancer diagnoses most commonly affecting adolescents.

Health-related quality of life in pediatric oncology: current status and future challenges.

This article presents information regarding the current status of health-related quality of life (HRQL) assessment in pediatric oncology, including the substantial advances in our knowledge that have occurred during the past 10 years. Additionally, issues that continue to challenge researchers who are attempting to measure health-related quality of life in children from point of diagnosis to cure or to death are identified. It is posited that researchers must conduct investigations of the impact of health-related quality-of-life data on clinical care and outcomes for the field to continue to advance, and for these data to be valued by patients, families, and health care providers.

Quality-of-life research in the Pediatric Oncology Group: 1991-1995.

Quality-of-life end points for cancer clinical trials have received much attention in the adult literature. However, within pediatric cancer clinical trials, the inclusion of these alternate end points has only recently been considered. We review the Pediatric Oncology Group's approach to research in this area and describe our guidelines and protocols that incorporate quality-of-life end points and several of the methodologic barriers that must be addressed.

Quality of life assessment in pediatric oncology: a retrospective review of phase III reports.

Background: although the quality of life of cancer patients has been a topic of increasing interest, the research literature to date has generally noted minimal reporting of these data in adult clinical trials.

Purpose: the purpose of this investigation was to examine the frequency with which these measures are reported in pediatric cancer clinical trials.

Method: published reports of 70 Phase III clinical trials from the Pediatric Oncology Group and Childrens Cancer Group were reviewed for presentation of quality of life and toxicity data.

Individual differences in pediatric cancer patients' reactions to invasive medical procedures: a repeated measures analysis.

Previous research on child distress in pediatric cancer has addressed the issue of habituation to invasive procedures using correlational methodology. In addition, most studies have focused on the bone marrow aspiration (BMA); few have examined children's reactions to the lumbar puncture (LP) separately. The present investigation examined 13 pediatric cancer patients over time as they experienced five BMAs or LPs.