Hospitalization Risk Associated With Emergency Department Reasons for Visit and Patient Age: A Retrospective Evaluation of National Emergency Department Survey Data to Help Identify Potentially Avoidable Emergency Department Visits.

Background: Patients often present to emergency departments (EDs) with concerns that do not require emergency care. Self-triage and other interventions may help some patients decide whether they should be seen in the ED. Symptoms associated with low risk of hospitalization can be identified in national ED data and can inform the design of interventions to reduce avoidable ED visits.

Online Self-Triage of Ear or Hearing Concerns in a Patient Portal: Comparison of Subsequent Diagnoses and Hospitalizations to National Emergency Department and National Ambulatory Ear or Hearing Visits.

Background: Although online self-triage is easily accessible, little is known about the patients who use self-triage or their subsequent diagnoses. We compared ear/hearing self-triage subsequent diagnoses to ear/hearing visit diagnoses in emergency departments (ED) and ambulatory clinics across the United States.

Methods: We compared International Classification of Diseases version 10 (ICD10) coded diagnoses following online self-triage for ear/hearing concerns with those from national ED and ambulatory clinic samples.

Self-Triage Use, Subsequent Healthcare Utilization, and Diagnoses: A Retrospective Study of Process and Clinical Outcomes Following Self-Triage and Self-Scheduling for Ear or Hearing Symptoms.

Background: Self-triage is becoming more widespread, but little is known about the people who are using online self-triage tools and their outcomes. For self-triage researchers, there are significant barriers to capturing subsequent healthcare outcomes. Our integrated healthcare system was able to capture subsequent healthcare utilization of individuals who used self-triage integrated with self-scheduling of provider visits.

Use of the McIsaac Score to Predict Group A Streptococcal Pharyngitis in Outpatient Nurse Phone Triage and Electronic Visits Compared With In-Person Visits: Retrospective Observational Study.

Background: The McIsaac criteria are a validated scoring system used to determine the likelihood of an acute sore throat being caused by group A streptococcus (GAS) to stratify patients who need strep testing.

Objective: We aim to compare McIsaac criteria obtained during face-to-face (f2f) and non-f2f encounters.

Methods: This retrospective study compared the percentage of positive GAS tests by McIsaac score for scores calculated during nurse protocol phone encounters, e-visits (electronic visits), and in person f2f clinic visits.

Examination of Weight-Loss Motivators and Family Factors in Relation to Weight Management Strategies and Dietary Behaviors among Adolescents with Obesity.

The study aim was to test hypotheses informed by self-determination theory (SDT) regarding associations of adolescent motivators for weight loss and family feeding practices on understanding adolescent weight management and dietary behaviors. Adolescents ( = 71) with obesity were recruited from a large medical center in the Midwest USA and completed questionnaire assessments via an online survey. Results supported hypotheses that endorsement of health motivators for weight loss, conceptualized as autonomous (intrinsic) motivation, and positive family support would be associated with healthier weight management practices and dietary behaviors.

McIsaac score for group A streptococcal infection: Comparison of electronic visits versus face-to-face visits.

Introduction: Acute sore throat is a common complaint traditionally completed with an in-person visit. However, non-face-to-face telemedicine visits offer greater access at reduced cost. We evaluated patient/caregiver asynchronous text-based electronic visits (eVisits) for acute sore throat and whether there was concordance for individual components and total McIsaac score compared to a clinician's assessment.

Development and initial validation of the Support for Healthy Lifestyle (SHeL) questionnaire for adolescents.

This study developed and provided initial validation for the Support for Healthy Lifestyle (SHeL), a set of scales designed to measure adolescent-perceived social support of healthy eating and physical activity. Item pool development utilized a prior focus group study of adolescents' perceptions of socially supportive behavior and a review of the literature on social support for health behavior change in adolescents. Exploratory factor analysis of the item pool completed by 220 adolescents, internal consistency estimates, and expert review of items and consensus resulted in 9 scales for the SHeL: Family Healthy Eating Support, Family Physical Activity Support, Family Hypocritical Control, Peer Health Eating Support, Peer Physical Activity Support, Peer Undermining, Professional Healthy Eating Support, Professional Physical Activity Support, and Professional General Support.

Methodology of a multispecialty outpatient Obesity Treatment Research Program.

Despite the large number of U.S. adults who overweight or obese, few providers have ready access to comprehensive lifestyle interventions, the cornerstone of medical obesity management.

Self-Measured vs Professionally Measured Waist Circumference.

Purpose: Although waist circumference can provide important metabolic risk information, logistic issues inhibit its routine use in outpatient practice settings. We assessed whether self-measured waist circumference is sufficiently accurate to replace professionally measured waist circumference for identifying high-risk patients.

Methods: Medical outpatients and research participants self-measured their waist circumference at the same visit during which a professionally measured waist circumference was obtained.

Activity-promoting video games and increased energy expenditure.

Objectives: To test the hypothesis that both children and adults would expend more calories and move more while playing activity-promoting video games compared with sedentary video games.

Study Design: In this single-group study, 22 healthy children (12 +/- 2 years; 11 male, 11 female) and 20 adults (34 +/- 11 years; 10 male, 10 female) were recruited. Energy expenditure and physical activity were measured while participants were resting, standing, watching television seated, sitting and playing a traditional sedentary video game, and while playing an activity-promoting video game (Nintendo Wii Boxing).

Changing the school environment to increase physical activity in children.

We examined the hypothesis that elementary school-age children will be more physically active while attending school in a novel, activity-permissive school environment compared to their traditional school environment. Twenty-four children were monitored with a single-triaxial accelerometer worn on the thigh. The students attended school in three different environments: traditional school with chairs and desks, an activity-permissive environment, and finally their traditional school with desks which encouraged standing.

Energy expenditure of sedentary screen time compared with active screen time for children.

Objective: We examined the effect of activity-enhancing screen devices on children's energy expenditure compared with performing the same activities while seated. Our hypothesis was that energy expenditure would be significantly greater when children played activity-promoting video games, compared with sedentary video games.

Methods: Energy expenditure was measured for 25 children aged 8 to 12 years, 15 of whom were lean, while they were watching television seated, playing a traditional video game seated, watching television while walking on a treadmill at 1.

Laboratory measurement of posture allocation and physical activity in children.

Purpose: The purpose of this study was to validate the combined use of inclinometers and accelerometers to measure body posture and movement in children in a laboratory setting.

Methods: We performed two separate experiments. In the first experiment, we tested the hypothesis that four inclinometers (tilt sensors) could be used to capture body posture in children.