Outdoor School: Creating A Passion for the Environment

Abstract Environmental education aids in creating deeper understanding, investigation, and decision-making skills among students. The goal of environmental education is to lead students to become effective environmental stewards. We created an ongoing service learning partnership that combines mentoring, environmental education, and community resources with elementary and college students in an Outdoor School program. This paper outlines the process and content of Outdoor School

A longitudinal look at Parent-child diagnostic agreement in youth treated for anxiety disorders

This study examined diagnostic agreement between children and their parents for seventy 9- to 13-year-olds (45 boys and 25 girls) who had received cognitive-behavioral treatment for anxiety disorders. Parent-child diagnostic rates and agreements for generalized anxiety disorder, separation anxiety disorder, and social phobia were evaluated at 3 time points: pretreatment, posttreatment, and 7.4-year follow-up. Results indicate that parent-child diagnostic agreement was typically poor to moderate (κ = -.03 to .64) and that estimates of agreement remained relatively unchanged (a) following treatment and (b) as the children enter adolescence and young adulthood. Parent-daughter agreement was better than parent-son agreement in some cases. Although it remains unclear whether parent or child diagnostic information is most accurate, positive treatment outcome appears to be possible despite poor parent-child diagnostic agreement. Copyright © 2005 by Lawrence Erlbaum Associates, Inc

Parent and Provider Perceptions of Use of the NIH We Can! Curriculum for Group Visits In Primary Care to Treat Child Overweight and Obesity

As part of a cluster randomized controlled trial of a parent-mediated approach to treating overweight and obese children ages 5-11 years in Southern Appalachia, feedback on use of the NIH We Can! curriculum for parent group visit sessions in primary care was obtained from parents and providers in two intervention clinics. Parents/caregivers of 28 children in two primary care clinics were randomized to the intervention group to participate in four on-site 1.5 hour group sessions held every other week during an 8-10 week period. Five primary care providers (PCPs) in the two clinics were trained to lead the group sessions using the NIH We Can! online training and an additional 1-hour face-to-face training conducted by the project team. The Project Coordinator and one project team clinician (Pediatrician, Pediatric Psychologist, or Registered Dietician (RD)) was present during each group visit to answer any questions about the study protocol, behavior (Pediatric Psychologist) or nutrition/eating (RD). The Project Coordinator or RD called each parent during the week following each group visit to discuss the family’s progress and answer questions. Written feedback surveys were completed by parents and focus groups were conducted with providers following the last group session. Provider focus groups were recorded and later transcribed and coded to indentify themes. Among 22 (79%) parents/caregivers who completed group sessions and a feedback survey, 91% agreed/strongly agreed that “this program was very useful to me as a parent.” In addition, 95% said that they would “recommend We Can! to a friend” citing benefiting from information received from healthcare providers and parents as well as the opportunity for “fellowship” with other parents. All five PCPs led at least 1 or 2 group sessions and participated in focus groups. Most PCPs agreed that the We Can! leader’s guide and training prepared them to lead the group sessions. All providers reported that preparation time to lead a session (15-90 minutes) was reasonable. On average, providers perceived the group sessions to be moderately effective in promoting healthier eating, physical activity, and reducing screen time in their patients. Some providers were interested in continuing to offer a monthly group session for long-term support. These findings suggest parent and healthcare provider acceptability of using NIH We Can! parent group sessions to treat child overweight in primary care

Provider Perceptions on Parent-Led Activity and Nutrition (PLAN) for Healthy Living Study Targeting Child Overweight and Obesity

Childhood overweight and obesity rates have grown immensely in recent years in the United States, especially in rural areas. The current study evaluated health care providers’ perceptions of training and implementation of a cluster-randomized clinical trial, Parent-Led Activity and Nutrition (PLAN) for Healthy Living, for treatment of overweight and obesity in children 5-11 years of age. Five physicians (3 in a pediatric clinic and 2 in a family medicine clinic) were trained in (1) brief motivational interviewing techniques for individual visits with parents, and (2) the National Institutes of Health (NIH) We Can! (Ways to Enhance Children’s Activity and Nutrition) Curricula to lead group sessions with these same parents aimed at providing them with the tools necessary to aid in changing their family’s eating and physical activity behaviors. Upon completion of the 10-week intervention, physicians (N = 4) participated in focus groups with research staff to discuss their experiences with the study. Based on the individual visit training in brief motivational interviewing, the principle of supporting self-efficacy was used by all providers during individual visits and was determined to be of most help. One physician commented that individual sessions would likely be more effective with families that are well-known by the provider, and several physicians believed that longer-term follow-up visits conducted by a registered dietician or nurse are feasible. Findings revealed that physician preparation time for a group session with parents was within the range of 15-90 minutes, with all providers believing this time was well-spent. The provider ratings of group session effectiveness were very high, approximately a 6 on a 7 point scale. Several providers felt the group visits were more effective than the individual visits. Additionally, some providers suggested continuing the group sessions on a monthly basis for long-term support. The collective data suggests that physicians view PLAN as an acceptable and feasible approach to the treatment of child overweight and obesity

Respiratory syncytial virus hospitalization in middle-aged and older adults

BACKGROUND: The importance of Respiratory Syncytial Virus (RSV) is increasingly recognized in hospitalized adults, but mainly in those ≥ 65 years. OBJECTIVES: We sought to describe the epidemiology and clinical severity of RSV compared to influenza in hospitalized adults ≥18 years. STUDY DESIGN: Adults hospitalized with acute respiratory illnesses (ARI) of ≤10days duration were prospectively enrolled from two Michigan hospitals during two influenza seasons. Collected specimens were tested for RSV and influenza by real-time, reverse transcription polymerase chain reaction (RT-PCR). Viral load and subtype were determined for RSV-positive specimens. We evaluated factors associated with RSV and outcomes of infection using multivariable logistic regression. RSV-positive patients were separately compared to two reference groups: RSV-negative and influenza-negative, and influenza-positive patients. RESULTS: RSV was detected in 84 (7%) of 1259 hospitalized individuals (55 RSV-B, 29 RSV-A). The highest prevalence was found in 50-64year olds (40/460; 8.7%); 98% of RSV cases in this age group had at least one chronic comorbidity. RSV detection was associated with obesity (OR: 1.71 95% CI: 0.99-3.06, p=0.03). Individuals with RSV were admitted to the hospital later in their illness and had a higher median Charlson comborbidity index (3 vs 2 p\u3c0.001) compared to those with influenza. Clinical severity of RSV-associated hospitalizations was similar to influenza-associated hospitalizations. DISCUSSION: In this study we observed the highest frequency of RSV-associated hospitalizations among adult 50-64 years old; many of whom had chronic comorbidities. Our results suggest the potential benefit of including these individuals in future RSV vaccination strategies