First name
Meredith
Middle name
R
Last name
Hickson

Title

A qualitative study of caregiver perspectives on health policy discussions initiated by pediatricians.

Year of Publication

2021

Date Published

2021 Sep 02

ISSN Number

1876-2867

Abstract

<p><strong>BACKGROUND AND OBJECTIVES: </strong>Prior studies suggest that pediatricians believe discussing health policy issues with families is important. Caregiver preferences on these discussions, however, have not been examined. We explored circumstances in which caregivers may be receptive to discussing health policy issues with pediatricians.</p>

<p><strong>METHODS: </strong>We conducted 26 semi-structured interviews with mostly Black female caregivers at three urban academic pediatric primary care practices. Using both structured and open response questions, we explored four primary content areas: 1) caregivers' perspectives on discussing health policy issues in pediatricians' offices; 2) which health policy topics caregivers may prefer to discuss; 3) factors that render policy discussions in the clinic inappropriate to caregivers; and 4) which communication modalities caregivers prefer. Interview transcripts were coded and analyzed using content analysis.</p>

<p><strong>RESULTS: </strong>Themes that emerged from interviews included: 1) pediatricians are perceived as trusted information sources on health policy; 2) caregivers want to talk with pediatricians about children's health insurance policy changes; 3) time-constraints are a barrier to health policy discussions; 4) caregivers prefer to discuss health policy topics during well-child visits; 5) caregivers want the option to opt out of these conversations; 6) preferred modalities for communicating about health policy issues, including printed materials and health fairs or educational events.</p>

<p><strong>CONCLUSION: </strong>Caregivers expressed a satisfactory view of pediatricians discussing directly relevant health policy issues, including congressional debates on health insurance, in the primary care setting. Our findings highlight other caregiver preferences for engaging families in health policy discussions, including the timing of these conversations.</p>

DOI

10.1016/j.acap.2021.08.019

Alternate Title

Acad Pediatr

PMID

34482016

Title

Effectiveness of Deworming with Single-Dose Albendazole for Preschool-Aged Children in the Dominican Republic.

Year of Publication

2021

Number of Pages

2333794X211002949

Date Published

2021

ISSN Number

2333-794X

Abstract

<p><em>Background</em>. The World Health Organization recommends biannual deworming with single-dose albendazole for all children over 1 year in regions where soil-transmitted helminths (STH) are endemic. There are limited data from the Dominican Republic (DR) on the effectiveness of deworming programs.&nbsp;<em>Methods</em>. Between January and June 2019, we enrolled 63 preschool-aged children at a community clinic in the DR. Participants received albendazole at enrollment. Stool samples were collected and examined for parasites at enrollment, 2 to 4 and 12 to 16 weeks post-albendazole. Caregivers were surveyed on home hygiene practices and children's symptoms.&nbsp;<em>Findings</em>. At enrollment, 1 or more parasites were noted in 89% of samples.&nbsp;<em>Ascaris lumbricoides</em>&nbsp;(68%) was the most common species, followed by&nbsp;<em>Entamoeba histolytica</em>&nbsp;(35%) and&nbsp;<em>Giardia intestinalis</em>&nbsp;(8%). Two-to-four weeks post-albendazole, fewer than half of those with&nbsp;<em>A. lumbricoides</em>&nbsp;infections at baseline had cleared the infection. STH symptoms significantly improved between enrollment and 2 to 4 weeks. By 12 to 16 weeks after treatment,&nbsp;<em>A. lumbricoides</em>&nbsp;infections were as high as baseline.&nbsp;<em>Interpretation</em>. Although limited by size and available technology, our study contributes data on STH in the DR. Single-dose deworming with albendazole did not reduce&nbsp;<em>Ascaris lumbricoides</em>&nbsp;infections in our sample. As STH are the most common neglected tropical diseases and negatively impact children's health globally, further studies on both effective deworming programs and interventions to prevent STH are needed.</p>

DOI

10.1177/2333794X211002949

Alternate Title

Glob Pediatr Health

PMID

33796636

Title

Psychological Reactance is a Novel Risk Factor for Adolescent Antiretroviral Treatment Failure.

Year of Publication

2020

Date Published

2020 Aug 04

ISSN Number

1573-3254

Abstract

<p>Psychological reactance is an aversive response to perceived threats against personal agency. For adolescents receiving HIV treatment in Botswana, we utilized a two-question, medication-specific reactance tool to assess whether: (1) verbal reminders to take medicines made adolescents want to avoid taking them, and, (2) whether adolescents felt anger when reminded to take medicines. Reactant adolescents had 2.05-fold (95% CI 1.23, 3.41) greater odds of treatment failure than non-reactant adolescents (p = 0.03). Adjusted risk of treatment failure was 14% (95% CI 3%, 28%) greater for each point elevation in reactance score (p = 0.016). Autonomy over medication-taking did not modify the association between reactance and treatment failure. Psychological reactance may be a useful interventional target for improving adolescent adherence.</p>

DOI

10.1007/s10461-020-02986-z

Alternate Title

AIDS Behav

PMID

32754779

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