Success of topiramate to slow progression of Blount disease in a toddler: A case study.

Rates of Blount disease and childhood obesity have increased in parallel, although the co-management of this acquired comorbidity and obesity is not well described. This report shares the course of a toddler with severe obesity who experienced rapid and persistent weight gain without success from nutrition and behavior changes. After repeat subspeciality evaluation, the patient was ultimately diagnosed with signs of early-onset Blount disease, urging the need for adjunct medical therapy.

Food Insecurity and Family Dynamics: A Systematic Review.

Background: Undernutrition is related to numerous childhood outcomes. However, little research has investigated the relationship between food insecurity and family dynamics. This systematic review seeks to validate the evidence for a relationship between these 2 factors.

Differences in maternal and paternal pressure to eat and perception of household responsibilities.

Controlling feeding practices, such as pressure to eat, are associated with a child's disinhibited eating and extremes in bodyweight. We aimed to explore which factors are associated with parent dyads' pressuring feeding practices, including how mothers and fathers perceive the sharing of household tasks such as mealtime and child feeding responsibilities. In this cross-sectional study, parent dyads (mother and father) of healthy preschool-aged children completed an identical questionnaire consisting of measures of picky eating (food fussiness subscale of Child Eating Behavior Questionnaire), parental concern for undereating, and pressure to eat (Child Feeding Questionnaire).

Implementation of recommended treatment for children in weight management programs: Lessons from the stay in treatment study sites.

Objectives: Pediatric obesity remains a public health crisis in the United States, exacerbated by the COVID-19 pandemic. There are recommended guidelines for multidisciplinary care, but they remain challenging to implement, even in tertiary care weight management programs. The aim of this analysis is to describe the implementation of these recommendations among four pediatric weight management programs in the United States.

Association Between Child Sugary Drink Consumption and Serum Lipid Levels in Electronic Health Records.

Sugar-sweetened beverage (SSB) and fruit juice (FJ) consumption may promote lipid abnormalities in childhood. We examined the association between SSB/FJ intake and lipid levels using electronic health record data for 2816 adolescents. Multivariable logistic regression models treated clinical cutpoints for abnormal lipid levels (triglycerides [TG], high-density lipoprotein (HDL), low-density lipoprotein [LDL], and total cholesterol) as dependent variables.

Rethinking family-based obesity treatment.

Emerging research in paediatric obesity has demonstrated that parental involvement in the weight management process can improve weight outcomes in children. Recent guidelines by the American Academy of Pediatrics note the importance of parent and family involvement in treatment. However, it is currently unknown if including the entire family in obesity treatment can supersede outcomes associated with participation of only one parent.

A Pilot Study Examining the Association of Parental Stress and Household Food Insecurity with Dietary Quality in Pre-School-Aged Children.

Adequate dietary quality is necessary for children's appropriate development and may be influenced by family factors. This study with 24 healthy 3-5-year-old children assessed the associations of parental stress and household food insecurity (HFI) with a child's dietary quality. Parents completed three 24 h dietary recalls, and the Healthy Eating Index was calculated to assess dietary quality.

A Technology-Driven, Healthcare-Based Intervention to Improve Family Beverage Choices: Results from a Pilot Randomized Trial in the United States.

Healthcare-based interventions to address sugary beverage intake could achieve broad reach, but intensive in-person interventions are unsustainable in clinical settings. Technology-based interventions may provide an alternative, scalable approach. Within an academic health system in the United States that already performs electronic health record-based sugary drink screening, we conducted a pilot randomized trial of a technology-driven family beverage choice intervention.

Knowing Is Not Doing: A Qualitative Study of Parental Views on Family Beverage Choice.

Objective: Sugary drink consumption is associated with adverse health outcomes in children, highlighting the need for scalable family interventions that address barriers to water consumption. To inform development of a scalable, health-care-system-based intervention targeting family beverage choice, a formative qualitative study was conducted using semi-structured interviews with parents whose children were identified as over-consuming sugar-sweetened beverages (SSB) and/or fruit juice (FJ). The first goal of these interviews was to understand, in a diverse real-world patient population, what parents viewed as the primary drivers of their family's beverage choices, and explore how these drivers might need to be addressed in order to make changes to beverage consumption.

Examining the effect of parent participation in an adult weight management program on changes in children's weight.

Children of parents participating in weight management programs (WMPs) are more likely to adopt their parents' weight control practices. Little is known about the weight outcomes of children who have a parent participating in a WMP. This study aimed to assess this relationship.

The association of food insecurity with mental health in preschool-aged children and their parents.

Background: Household food insecurity (HFI) is associated with poor general and mental health. Prior studies assessed parent and child mental health separately and did not assess other social risks.

Objective: To assess the relationship between HFI and both parental and child mental health.

Staff Knowledge, Attitudes, and Beliefs About Child Sugar-Sweetened Beverage Intake and Acceptability of a Pediatric Clinic-Based Beverage Screener.

Beverages are the leading source of sugar in children's diets and a modifiable risk factor for adverse health conditions. Electronic health record-based screeners could facilitate health systems' efforts to reduce child consumption of sugary beverages. Before implementing a sugar-sweetened beverage screener in the electronic health record within academic healthcare system, 228 pediatric and family medicine clinic staff completed an online educational training to familiarize them with the screener and its rationale.

Associations Between Weight and Lower Respiratory Tract Disease Outcomes in Hospitalized Children.

Objective: To identify associations between weight status and clinical outcomes in children with lower respiratory tract infection (LRTI) or asthma requiring hospitalization.

Methods: We performed a retrospective cohort study of 2 to 17 year old children hospitalized for LRTI and/or asthma from 2009 to 2019 using electronic health record data from the PEDSnet clinical research network. Children <2 years, those with medical complexity, and those without a calculable BMI were excluded.

Changes in Child Weight, Behaviors, and Family Dynamics during Parental Participation in a Medical Weight Management Program: A Longitudinal Uncontrolled Pilot Study.

There is limited evidence of the effects of parental participation in outpatient medical weight management (MWM) programs on children. The aims of the project were to (1) identify time effects from parental participation in the MWM program on changes in child weight trajectories, healthy and unhealthy weight control practices, physical and sedentary activity, parental restrictive feeding and pressure to eat, and family functioning and communication and (2) determine differences based on child factors. A longitudinal uncontrolled pilot study was conducted, in which parent-child (ages 7-19) dyads completed assessments at parents' MWM program initiation, 3 months (mid-program), 6 months (end of program), and 12 months to determine sustained effects.

Patient Characteristics Associated With Missed Appointments in Pediatric Subspecialty Clinics.

Objectives: Missed appointments negatively affect patients, providers, and health systems. This study aimed to (1) quantify the percentage of missed appointments across 14 pediatric subspecialties in a tertiary-care children's hospital and (2) identify patient characteristics associated with missed appointments in those subspecialties.

Methods: We extracted patient characteristics from 267,151 outpatient appointments, between January 1, 2013, and December 31, 2018, across 14 subspecialty clinics.

Community-engaged research in translational science: Innovations to improve health in Appalachia.

Health disparities between Appalachia and the rest of the country are widening. To address this, the Appalachian Translational Research Network (ATRN) organizes an annual ATRN Health Summit. The most recent Summit was held online September 22-23, 2020, and hosted by Wake Forest Clinical and Translational Science Institute in partnership with the Northwest Area Health Education Center.

Engaging Food Insecure Families on the Weekend to Improve Nutrition and Health.

Background: The school meals program provides food during the week, but there is limited evidence on how to address the needs of families with food insecurity (FI) on the weekend.

Objectives: We conducted a prospective mixed methods pilot study to evaluate the potential effect of a community-based program that delivers free meals to children and fresh produce to their families at different sites on weekends combined with cooking classes.

Methods: We recruited 41 parent-child dyads from the neighborhood where a new delivery site opened.

Weight Status and Risk of Inpatient Admission for Children With Lower Respiratory Tract Disease.

Objectives: To identify associations between weight category and hospital admission for lower respiratory tract disease (LRTD), defined as asthma, community-acquired pneumonia, viral pneumonia, or bronchiolitis, among children evaluated in pediatric emergency departments (PEDs).

Methods: We performed a retrospective cohort study of children 2 to <18 years of age evaluated in the PED at 6 children's hospitals within the PEDSnet clinical research network from 2009 to 2019. BMI percentile of children was classified as underweight, healthy weight, overweight, and class 1, 2, or 3 obesity.

Trends in food insecurity rates at an academic primary care clinic: a retrospective cohort study.

Background: Healthcare organizations are increasingly screening and addressing food insecurity (FI); yet, limited data exists from clinic-based settings on how FI rates change over time. The objective of this study was to evaluate household FI trends over a two-year period at a clinic that implemented a FI screening and referral program.

Methods: In this retrospective cohort study, data were extracted for all visits at one academic primary care clinic for all children aged 0-18 years whose parents/guardians had been screened for FI at least once between February 1, 2018 to February 28, 2019 (Year 1) and screened at least once between March 1, 2019 to February 28, 2020 (Year 2).