Helping Adolescents Get Into A Healthy Weight Range

Among adolescents aged 12-19 in the United States, the prevalence of obesity increased from 5% in the late 70s to 18.1% between 2007-2008. It has more than tripled over the last 30 years. Obese children are more likely to have: High blood pressure, high cholesterol, insulin resistance, type 2 diabetes, breathing problems, joint problems, fatty liver disease, gallstones, heartburn, and poor self-esteem. It does not stop there: Obese children are more likely to become obese adults. Obesity in adulthood is associated with many serious health conditions, such as heart disease, diabetes, and cancer. Adolescence is an excellent intervention period as this is a time when lifelong habits and a sense of self are formed. A school setting is ideal because school is where children are accessible and prepared to learn. Because losing weight may be seen as a complex and difficult process, to make this process less daunting we propose to study a simplified, stepwise approach to weight loss in adolescents

Results of a Pilot Walking School Bus Program to Prevent Obesity in Hispanic Elementary School Children

Thirty-three percent of children, 6-11years, in the US are overweight or obese.1 Walking to school is an affordable mode of transportation that may help reduce this high prevalence of childhood obesity.2 The Walking School Bus (WSB) is an innovative program designed to cut down on traffic congestion while providing a safe way to walk children to school.3 We are aware of no published studies examining the impact of this specific program on obesity prevention. In addition, low-income and minority neighborhoods have been underrepresented in the walkability literature.4 Therefore, we tested the feasibility of a modified WSB program in a low-income minority neighborhood as a strategy to prevent childhood obesity

Clinical Study An Adaptive CBPR Approach to Create Weight Management Materials for a School-Based Health Center Intervention

properly cited. Purpose. From our previous clinical work with overweight/obese youth, we identified the need for research to create an effective weight management intervention to address the growing prevalence of adolescent metabolic syndrome. Formative assessment through an adaptive community-based participatory research (CBPR) approach was conducted toward the development of a nutritional and physical activity (DVD) and clinician toolkit for a school-based health center (SBHC) weight management intervention. Methods. We first conducted parent and adolescent interviews on views and experiences about obesity while convening a community advisory council (CAC) recruited from two participating urban New Mexico high schools. Thematic findings from the interviews were analyzed with the CAC to develop culturally and developmentally appropriate intervention materials. Results. Themes from the parent and adolescent interviews included general barriers/challenges, factors influencing motivation, and change facilitators. The CAC and university-based research team reached consensus on the final content of nutrition and physical activity topics to produce a DVD and clinician toolkit through six monthly sessions. These materials used in the SBHC intervention resulted in a greater reduction of body mass index when compared to adolescents receiving standard care. Conclusions. Formative assessment using an adaptive CBPR approach resulted in the creation of culturally and age appropriate weight reduction materials that were acceptable to study participants. This trial is registered with ClinicalTrials.gov NCT00841334

An Adaptive CBPR Approach to Create Weight Management Materials for a School-Based Health Center Intervention

Purpose. From our previous clinical work with overweight/obese youth, we identified the need for research to create an effective weight management intervention to address the growing prevalence of adolescent metabolic syndrome. Formative assessment through an adaptive community-based participatory research (CBPR) approach was conducted toward the development of a nutritional and physical activity (DVD) and clinician toolkit for a school-based health center (SBHC) weight management intervention. Methods. We first conducted parent and adolescent interviews on views and experiences about obesity while convening a community advisory council (CAC) recruited from two participating urban New Mexico high schools. Thematic findings from the interviews were analyzed with the CAC to develop culturally and developmentally appropriate intervention materials. Results. Themes from the parent and adolescent interviews included general barriers/challenges, factors influencing motivation, and change facilitators. The CAC and university-based research team reached consensus on the final content of nutrition and physical activity topics to produce a DVD and clinician toolkit through six monthly sessions. These materials used in the SBHC intervention resulted in a greater reduction of body mass index when compared to adolescents receiving standard care. Conclusions. Formative assessment using an adaptive CBPR approach resulted in the creation of culturally and age appropriate weight reduction materials that were acceptable to study participants. This trial is registered with ClinicalTrials.gov NCT00841334

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. Parental concerns and misinformation about the efficacy and safety of the Human Papillomavirus (HPV) vaccine remain, and may be addressed by digital interventions tailored to their concerns. Reported here are results from a small scale randomized trial testing a mobile web app for parents and their adolescent daughters (ages 11-14 years) encouraging HPV vaccination in New Mexico, an ethnically-diverse U.S. state. Methods: A clinic-cluster randomized trial where pediatric clinics (n = 9) were recruited and randomized, and parent-adolescent pairs (n = 82) within clinics received either the Vacteens.org/Vacunadolescente.org mobile web app or Usual and Customary (UC) HPV Vaccination information. Parents completed online surveys at baseline and 3-months. Daughters' HPV vaccine data were collected from the New Mexico State Immunization Information System 1 year post baseline. Results: Three month survey results found Vacteens.org/Vacunadolescente.org parents to have higher positive HPV vaccine beliefs, informed decision making, intent to vaccinate and vaccine confidence outcomes than UC parents. HPV vaccine data found higher first dose HPV vaccination (Pearson χ2 = 6.13, p = 0.013, Vacteens.org/Vacunadolescente.org group 59.4%, UC group 40.6%), and higher HPV vaccination series completion (Pearson χ2 = 6.49, p = 0.011, Vacteens.org/Vacunadolescente.org group 68.4%, UC group 31.6%). Conclusions: The small trial results showed the Vacteens.org/Vacunadolescente.org web app prompted positive vaccine-related attitudes and beliefs, and more HPV vaccination initiation and series completion. Mobile web apps can make decision-making tools for HPV vaccination widely available on digital platforms, reducing vaccine hesitancy, and confusion and increase HPV vaccine uptake

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

Introduction: 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. This article presents findings from a site assessment inventory completed during the initial year of the ISPCTN. Methods: An assessment inventory was developed for surveying ISPCTN sites. The inventory captured site-level activities designed to increase clinical trial research capacity for pediatrician scientists and team members. The inventory findings were utilized by the ISPCTN Data Coordinating and Operations Center to construct training modules covering 3 broad domains: Faculty/coordinator development; Infrastructure; Trials/Research concept development. Results: Key lessons learned reveal substantial participation in the training modules, the importance of an inventory to guide the development of trainings, and recognizing local barriers to clinical trials research. Conclusions: Research networks that seek to implement successfully completed trials need to build capacity across and within the sites engaged. Our findings indicate that building research capacity is a multi-faceted endeavor, but likely necessary for sustainability of a unique network addressing high impact pediatric health problems. The ISPCTN emphasis on building and enhancing site capacity, including pediatrician scientists and team members, is critical to successful trial implementation/completion and the production of findings that enhance the lives of children and families

Report of the Topical Group on Higgs Physics for Snowmass 2021: The Case for Precision Higgs Physics

A future Higgs Factory will provide improved precision on measurements of Higgs couplings beyond those obtained by the LHC, and will enable a broad range of investigations across the fields of fundamental physics, including the mechanism of electroweak symmetry breaking, the origin of the masses and mixing of fundamental particles, the predominance of matter over antimatter, and the nature of dark matter. Future colliders will measure Higgs couplings to a few per cent, giving a window to beyond the Standard Model (BSM) physics in the 1-10 TeV range. In addition, they will make precise measurements of the Higgs width, and characterize the Higgs self-coupling. This report details the work of the EF01 and EF02 working groups for the Snowmass 2021 study.Comment: 44 pages, 40 figures, Report of the Topical Group on Higgs Physics for Snowmass 2021. The first four authors are the Conveners, with Contributions from the other author

Internet-based training in a practice-based research network consortium: a report from the Primary Care Multiethnic Network (PRIME Net).

BACKGROUND: Continuing growth of the research spectrum of practice-based research networks (PBRNs) creates a need (1) for new approaches to training clinicians in research protocols and (2) to standardize clinician data collection. Each existing training method has shortcomings when used in geographically dispersed PBRNs. We describe here the use and costs of Internet-based training in support of a research protocol across a PBRN consortium. METHODS: Clinicians in 4 PBRNs in the PRIME Net consortium participated in training for a study of acanthosis nigricans (AN). We compared results of pre- and posttraining assessments of knowledge and ability to correctly diagnosis AN. We also calculated costs for placement of the training on the Internet. RESULTS: Among 103 participating clinicians, statistically significant increases in knowledge acquisition were demonstrated for all but 2 of the individual topics and in total scores on the assessments. AN diagnostic sensitivity increased from 52% to 99% to 96% to 100%, whereas specificity increased from 70% to 96% to 74% to 97%. Total costs for the web aspects of the training were $3732. CONCLUSION: The Internet can be an effective and feasible alternative method for training clinicians in support of PBRN research

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. In both cohorts, average BMI z-score significantly increased from baseline to 6 months for students with BMI \u3c 25. Average BMI z-score significantly decreased for the overweight (BMI 25 t

The ins and outs of provider-parent communication: perspectives from adolescent primary care providers on challenges to forging alliances to reduce adolescent risk.

PURPOSE: For several decades, the goal to protect adolescents\u27 confidentiality in addition to state and professional mandates to provide confidential health services have sometimes outweighed the interest of involving parents in risk reduction efforts. More recently, experts acknowledge that a balance must be found between maintaining adolescent confidentiality and involving parents in preventing poor adolescent outcomes resulting from risky behaviors. The purpose of this research was to elucidate the challenges in and identify solutions to realizing this newer vision in the primary care setting. METHODS: We conducted a qualitative study featuring in-depth interviews with 37 primary care providers among whom a significant component of their practice involved adolescent patients. Purposeful sampling was aimed at a diversity of gender, practice specialty, practice venues, and geographic areas. RESULTS: We identified individual and structural barriers and facilitators to involving parents in their adolescents\u27 primary care. Barriers included parents\u27 lack of knowledge and awareness of their children\u27s risk behaviors; providers time constraints and competing clinical demands, concerns for confidentiality and developing a trusting relationship with the child; and legal and system requirements that limit engagement with parents. Facilitators included interest and for some, planned approaches by the provider to engage the parent; encouragement by the provider to the adolescent to communicate with a trusted adult about their risky behavior; and opportunities to educate the parent about risk reduction in general. CONCLUSION: Opportunities for further research on strategies to improve communication and develop a partnership between providers and parents are described