Medicine and Health Sciences Commons^™

Screening Tools In Adolescent Health Care, David L. Wood

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Learning Objectives: (1) Identify three primary care friendly screening tools useful for identifying behavioral health concerns in adolescents. (2) Describe how a "champion" (quality improvement) team can help facilitate implementation of a screener in a primary care.

Tipqc Breastfeeding Collaborative: Lessons Learned, Karen E. Schetzina, Julie Ware, Anna Morad

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No abstract provided.

The National School Lunch Program In Rural Appalachian Tennessee – Or Why Implementation Of The Healthy, Hunger Free Kids Act Of 2010 Was Met With Challenges: A Brief Report, Jodi L. Southerland, Taylor M. Dula, W. T. Dalton, Karen E. Schetzina, Deborah L. Slawson

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Purpose: The purpose of this study was to investigate challenges faced by high schools in rural Appalachia in implementing the Healthy, Hunger Free Kids Act of 2010 (HHFKA). Methodology: We used qualitative, secondary analysis to analyze a collection of thirteen focus groups and 22 interviews conducted in 2013-14 among parents, teachers, and high school students in six counties in rural Appalachian Tennessee (n=98). Results: Five basic themes were identified during the thematic analysis: poor food quality prior to implementation of the HHFKA school nutrition reforms; students’ preference for low-nutrient energy-dense foods; low acceptance of healthier options after implementation of the …

The Use Of Vital Statistics Data For Research Of Consequence: Birth Outcomes And Population Health In A Rural Region, Claudia Kozinetz, Shimin Zheng, Eunice Mogusu

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Objective: The Affordable Care Act (ACA) has influenced increasing interests in population health and population health outcomes. The purpose of this study was to exemplify the importance of using existing vital statistics data for understanding and monitoring health outcomes and consequentially health disparities at the population level. Data from birth records for two geographic regions from 2009-2014 were compared; low birth weight (LBW) and preterm delivery (PD) were used as surrogates for population health outcomes.

Methods: A population-based, multi-year, cross-sectional study design using a pooled dataset of birth records from Tennessee (TN) was the framework for the analyses. …

College Students As Facilitators In Reducing Adolescent Obesity Disparity In Southern Appalachia: Team Up For Healthy Living, Deborah Slawson, William T. Dalton, Taylor Mckeehan Dula, Jodi Southerland, Liang Wang, Mary Ann Littleton, Diana Mozen, George Relyea, Karen Schetzina, Elizabeth F. Lowe, James M. Stoots, Tiejian Wu

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The proportion of obese adolescents in Southern Appalachia is among the highest in the nation. Through funding from the National Institute on Minority Health and Health Disparities — National Institutes of Health, the Team Up for Healthy Living project was a cluster-randomized trial targeting obesity prevention in adolescents through a cross-peer intervention. The specific aims of the project were to: 1) develop a peer-based health education program focusing on establishing positive peer norms towards healthy eating and physical activity (PA) among high school students, 2) test program efficacy, and 3) explore mechanisms underlying the program. The study was guided by …

Noroviruses As A Cause Of Diarrhea In Immunocompromised Pediatric Hematopoietic Stem Cell And Solid Organ Transplant Recipients, X. Ye, J. N. Van, F. M. Munoz, P. A. Revell, Claudia A. Korinetz, R. A. Krance, R. L. Atmar, M. K. Estes, H. L. Koo

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Case reports describe significant norovirus gastroenteritis morbidity in immunocompromised patients. We evaluated norovirus pathogenesis in prospectively enrolled solid organ (SOT) and hematopoietic stem cell transplant (HSCT) patients with diarrhea who presented to Texas Children's Hospital and submitted stool for enteric testing. Noroviruses were detected by real-time reverse transcription polymerase chain reaction. Clinical outcomes of norovirus diarrhea and non-norovirus diarrhea patients, matched by transplanted organ type, were compared. Norovirus infection was identified in 25 (22%) of 116 patients, more frequently than other enteropathogens. Fifty percent of norovirus patients experienced diarrhea lasting ≥14 days, with median duration of 12.5 days (range 1–324 …

Child Rights And Social Justice Framework For Analyzing Public Policy Related To Hpv Vaccine, David Wood, Rita Nathaward, Jeffrey L. Goldhagen

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Human papilloma virus (HPV) is the most common viral infection of the reproductive tract and a well-established cause of cervical, anal, and oropharyngeal cancers in both women and men worldwide. Despite data that supports HPV vaccine as an effective measure to prevent such cancers, vaccine uptake has not been optimal in many countries. In the United States (US) for example, rates have stagnated over the past few years and only one-third of adolescents are fully immunized, in contrast to other adolescent vaccines such as Tdap and meningococcal that have double the rates of uptake. Current approaches to HPV vaccine education …

Self-Reported Versus Actual Weight And Height Data Contribute To Different Weight Misperception Classifications, William T. Dalton, Liang Wang, Jodi Southerland, Karen E. Schetzina, Deborah L. Slawson

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Objectives: The purpose of the study was to examine potential differences between two approaches to defining adolescent weight misperception. Specifically, weight status perception was compared with self-reported weight status and actual weight status (based on body mass index percentiles calculated from self-reported and actual weights and heights, respectively). Furthermore, the accuracy of assigning weight status based on body mass index percentiles calculated from self-reported weights and heights was assessed by comparing them with actual weight status.

Methods: Data were extracted from Team Up for Healthy Living, an 8-week, school-based obesity prevention program in southern Appalachia. Participants (N = 1509) were …

Parent-Led Activity And Nutrition (Plan) For Healthy Living: Design And Methods, William T. Dalton, Karen E. Schetzina, Nicole Holt, Hazel Fulton-Robinson, Ai-Leng Ho, Fred Tudiver, Mathew T. Mcbee, Tiejian Wu

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Child obesity has become an important public health concern, especially in rural areas. Primary care providers are well positioned to intervene with children and their parents, but encounter many barriers to addressing child overweight and obesity. This paper describes the design and methods of a cluster-randomized controlled trial to evaluate a parent-mediated approach utilizing physician's brief motivational interviewing and parent group sessions to treat child (ages 5–11 years) overweight and obesity in the primary care setting in Southern Appalachia. Specific aims of this pilot project will be 1) to establish a primary care based and parent-mediated childhood overweight intervention program …

Primary Care Practice Addressing Child Overweight And Obesity: A Survey Of Primary Care Physicians At Four Clinics In Southern Appalachia, Nicole Holt, Karen E. Schetzina, William T. Dalton, Fred Tudiver, Hazel Fulton-Robinson, Tiejian Wu

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Objective: The prevalence of childhood overweight and obesity in southern Appalachia is among the highest in the United States (US). Primary care providers are in a unique position to address the problem; however, little is known about attitudes and practices in these settings.

Methods: A 61-item healthcare provider questionnaire assessing current practices, attitudes, perceived barriers, and skill levels in managing childhood overweight and obesity was distributed to physicians in four primary care clinics. Questionnaires were obtained from 36 physicians.

Results: Physicians' practices to address childhood overweight and obesity were limited, despite the fact that most physicians shared the attitude that …

Developing A Coordinated School Health Approach To Child Obesity Prevention In Rural Appalachia: Results Of Focus Groups With Teachers, Parents, And Students, Karen E. Schetzina, William Dalton, Elizabeth F. Lowe, Nora Azzazy, Katrina Vonwerssowetz, Connie Givens, H. P. Stern

ETSU Faculty Works

INTRODUCTION:

High prevalence rates of obesity, particularly among those residing in US rural areas, and associated physical and psychosocial health consequences, direct attention to the need for effective prevention programs. The current study describes an initial step in developing a school-based obesity prevention program in rural Appalachia, USA. The program, modeled on the Centers for Disease Control and Prevention Coordinated School Health (CSH) Program, includes a community-based participatory research approach to addressing the health needs specific to this region.

METHODS:

Focus groups with teachers, parents, and 4th grade students were used to understand perceptions and school policy related to nutrition, …