Team Decision Making May Empower Child Welfare Decision Making and Improve Outcomes for Families

Public child welfare agencies are ultimately responsible for making the difficult decision of whether to remove a child from their home due to suspected abuse or neglect. Team Decision Making (TDM) is a model developed by agency staff to inform decision making in these situations. TDM values serving families in a culturally sensitive, community-based, and minimally disruptive way by considering the needs and strengths of each child and family.TDM is comprised of five key elements, of which the main component is a consistently held meeting between extended family members, formal and informal community agency representatives, and other supportive individuals to determine which services and assistance to offer to the family. A trained TDM facilitator guides meeting participants toward consensus on the least restrictive way to keep the child safe, with an emphasis on preventing removal of the child from home.This fact sheet provides an overview of key findings from a Child Trends evaluation of two TDM implementation sites and offers broader implications for the child welfare field

Early Obesity Prevention: A Randomized Trial of a Practice-Based Intervention in 0–24-Month Infants

Objective. A pediatric office-based intervention was implemented following a randomized, controlled design, aimed at improving child feeding practices and growth patterns and ultimately reducing risk for overweight and obesity later in life. Methods. Four clinics (232 infants) were randomized to control or intervention (I), the latter delivered by health care provider at each of 7–9 well-baby visits over 2 years, using a previously developed program (Growing Leaps and Bounds) that included verbal, visual, and text advice and information for parents. Results. The I group offered significantly less soda p=0.006, sweetened tea p=0.01, punch p=0.02 and/or cow’s milk p=0.001 to infants and delayed the introduction of drink/food other than breast milk p<0.05. Parents in the I group had a higher perceived parental monitoring p=0.05 and restriction p=0.01 on infant feeding. While the I group exhibited at baseline more adverse socioeconomic indicators than the control group, growth trajectory or body size indices did not significantly differ between groups. Conclusions. Education provided by health care providers in addition to follow-up monthly phone calls may help modify parental behaviors related to child feeding and increase parental sense of responsibility toward child eating behaviors

The relationship between unsupervised time after school and physical activity in adolescent girls

BACKGROUND: Rising obesity and declining physical activity levels are of great concern because of the associated health risks. Many children are left unsupervised after the school day ends, but little is known about the association between unsupervised time and physical activity levels. This paper seeks to determine whether adolescent girls who are without adult supervision after school are more or less active than their peers who have a caregiver at home. METHODS: A random sample of girls from 36 middle schools at 6 field sites across the U.S. was selected during the fall of the 2002–2003 school year to participate in the baseline measurement activities of the Trial of Activity for Adolescent Girls (TAAG). Information was collected using six-day objectively measured physical activity, self-reported physical activity using a three-day recall, and socioeconomic and psychosocial measures. Complete information was available for 1422 out of a total of 1596 respondents. Categorical variables were analyzed using chi square and continuous variables were analyzed by t-tests. The four categories of time alone were compared using a mixed linear model controlling for clustering effects by study center. RESULTS: Girls who spent more time after school (≥2 hours per day, ≥2 days per week) without adult supervision were more active than those with adult supervision (p = 0.01). Girls alone for ≥2 hours after school, ≥2 days a week, on average accrue 7.55 minutes more moderate to vigorous physical activity (MVPA) per day than do girls who are supervised (95% confidence interval ([C.I]). These results adjusted for ethnicity, parent's education, participation in the free/reduced lunch program, neighborhood resources, or available transportation. Unsupervised girls (n = 279) did less homework (53.1% vs. 63.3%), spent less time riding in a car or bus (48.0% vs. 56.6%), talked on the phone more (35.5% vs. 21.1%), and watched more television (59.9% vs. 52.6%) than supervised girls (n = 569). However, unsupervised girls also were more likely to be dancing (14.0% vs. 9.3%) and listening to music (20.8% vs. 12.0%) (p < .05). CONCLUSION: Girls in an unsupervised environment engaged in fewer structured activities and did not immediately do their homework, but they were more likely to be physically active than supervised girls. These results may have implications for parents, school, and community agencies as to how to structure activities in order to encourage teenage girls to be more physically active