Academic Pediatrics最新文献_第2页

Infant Feeding Outcomes From a Culturally-Adapted Early Obesity Prevention Program for Immigrant Chinese American Parents 针对美国华人移民父母的文化适应性早期肥胖预防计划的婴儿喂养结果。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2024-11-01 DOI: 10.1016/j.acap.2024.06.005

Objective

To examine whether a cultural adaptation of an early childhood obesity prevention program promotes healthy infant feeding practices.

Methods

Prospective quasi-experimental study of a community-engaged multiphasic cultural adaptation of an obesity prevention program set at a federally qualified health center serving immigrant Chinese American parent-child dyads (N = 298). In a group of historical controls, we assessed early infant feeding practices (breastfeeding, sugar-sweetened beverage intake) in 6-month-olds and then the same practices alongside early solid food feeding practices (bottle weaning, fruit, vegetable, sugary or salty snack consumption) in 12-month-olds. After implementation, we assessed these practices in an intervention cohort group at 6 and 12 months. We used cross-sectional groupwise comparisons and adjusted regression analyses to evaluate group differences.

Results

At 6 months, the intervention group had increased odds of no sugar-sweetened beverage intake (aOR: 5.69 [95% confidence interval (CI): 1.65, 19.63], P = .006). At 12 months, the intervention group also had increased odds of no sugar-sweetened beverage intake (aOR: 15.22 [95% CI: 6.33, 36.62], P < .001), increased odds of bottle weaning (aOR: 2.34 [95% CI: 1.05, 5.23], P = .03), and decreased odds of sugary snack consumption (aOR: 0.36 [0.18, 0.70], P = .003). We did not detect improvements in breastfeeding, fruit, vegetable, or salty snack consumption.

Conclusions

A cultural adaptation of a primary care-based educational obesity prevention program for immigrant Chinese American families with low income is associated with certain healthy infant feeding practices. Future studies should evaluate cultural adaptations of more intensive interventions that better address complex feeding practices, such as breastfeeding, and evaluate long-term weight outcomes.

研究目的研究设计：研究设计：一项前瞻性准实验研究，针对肥胖预防项目的社区参与式多阶段文化调整，该项目在一家联邦合格医疗中心开展，服务对象为移民华裔美国人亲子二人组（N=298）。在一组历史对照组中，我们评估了 6 个月大婴儿的早期喂养方式（母乳喂养、含糖饮料摄入量），然后评估了 12 个月大婴儿的早期固体食物喂养方式（奶瓶断奶、水果、蔬菜、含糖或含盐零食摄入量）。实施后，我们在 6 个月和 12 个月时对干预队列组中的这些做法进行了评估。我们采用横截面分组比较和调整回归分析来评估组间差异：6 个月时，干预组不摄入含糖饮料的几率增加（aOR：5.69 [95% CI：1.65, 19.63]，p=0.006）。12 个月时，干预组不摄入含糖饮料的几率也有所提高（aOR：15.22 [95% CI：6.33, 36.62]，P=0.006）：针对低收入华裔移民家庭的以初级保健为基础的预防肥胖教育计划的文化适应性与某些健康的婴儿喂养方式有关。未来的研究应评估更深入的干预措施的文化适应性，以更好地应对复杂的喂养方式，如母乳喂养，并评估长期体重结果。

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引用次数: 0

Recent Advances with Group Well-Child Care 儿童集体保健的最新进展。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2024-11-01 DOI: 10.1016/j.acap.2024.07.007

Rheanna Platt MD, PhD, MPH , Ashley Gresh PhD, CNM , Sarah Polk MD, MSc , Sara Johnson PhD, MPH , Tamar Mendelson PhD

引用次数: 0

Fighting Spirit 战斗精神。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2024-11-01 DOI: 10.1016/j.acap.2024.04.010

引用次数: 0

A Pilot Randomized Controlled Trial of Text Messages to Improve Well-Child Visit Attendance After No-Show 一项试点随机对照试验，通过短信提高未就诊儿童的就诊率。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2024-11-01 DOI: 10.1016/j.acap.2024.06.003

Objective

Evaluate the effectiveness of text messages to systematically engage parents/guardians (“caregivers”) to reschedule a well-child visit (WCV) that was missed (“no-show”) and attend that rescheduled WCV visits.

Methods

Patients <18 years in one of five pediatrics or family medicine clinics, in one health system in the Southeast US, were eligible. Patients without a rescheduled WCV after a no-show were randomized into intervention (text messages) or care-as-usual comparison, stratified by language (English/Spanish). Enrollment occurred May–July 2022. Up to three text messages were sent to caregivers one week apart via REDCap and Twilio, advising how to reschedule the missed appointment by phone or health portal. Primary outcomes were 1) rescheduling a WCV within 6 weeks of no-show and 2) completing a rescheduled WCV within 6 weeks. Risk differences (RD) and odds ratios (OR) were used to evaluate the effect of text messages.

Results

Seven hundred and twenty patients were randomized and analyzed (texts: 361, comparison: 359). The proportion rescheduling WCV after text versus usual care was English: 18.85% versus 15.02%, respectively, and Spanish: 5.94% versus 8.14%, with overall RD + 1.98% (95% CI: −1.85, 5.81) and OR 1.21 (95% CI: 0.79, 1.84; P-value .38). Completed WCV rates in text or usual care were English: 13.08% versus 6.59%, and Spanish: 5.81% versus 5.94% with texts associated with RD + 2.83% (95% CI: 1.66, 4.00) and OR 1.86 (95% CI: 1.09, 3.19).

Conclusion

Text message follow-up after a no-show WCV may positively impact attendance at WCVs rescheduled in the subsequent 6 weeks.

Trial registration

ClinicalTrials.gov NCT05086237.

目标：评估短信在系统性地吸引父母/监护人（"照顾者"）重新安排已错过（"未到场"）的儿童健康检查（WCV）和参加重新安排的儿童健康检查的有效性：患者结果：随机对 720 名患者进行了分析（文本：361 人，对比：359 人）。文本与常规护理相比，重新安排 WCV 的比例为：英语：18.85% 对 15.15%：总体 RD +1.98% (95% CI: -1.85, 5.81)，OR 1.21 (95% CI: 0.79, 1.84; p 值 0.38)。在文本或常规护理中，完成 WCV 的比例为英语：13.08%对6.59%，西班牙语：5.81%对5.94%，短信相关的RD +2.83% (95% CI: 1.66, 4.00)和OR 1.86 (95% CI: 1.09, 3.19)：结论：WCV缺席后的短信跟踪可能会对随后6周内重新安排的WCV出席率产生积极影响：试验注册：ClinicalTrials.gov NCT05086237。

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引用次数: 0

Pediatric Utilization of Emergency Medical Services from Outpatient Offices and Urgent Care Centers 儿科利用门诊部和急诊中心提供的急诊医疗服务。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2024-11-01 DOI: 10.1016/j.acap.2024.03.008

Objective

National efforts have highlighted the need for pediatric emergency readiness across all settings where children receive care. Outpatient offices and urgent care centers are frequent starting points for acutely injured and ill children, emphasizing the need to maintain pediatric readiness in these settings. We aimed to characterize emergency medical services (EMS) utilization from outpatient offices and urgent care centers to better understand pediatric readiness needs.

Methods

We performed a retrospective cross-sectional analysis of EMS encounters using the National Emergency Medical Services Information System, a nationally representative EMS registry (2019–2022). We included four years of EMS encounters of children (<18 years old) that originated from an outpatient office or urgent care center. We described characteristics, including patient demographics, prehospital clinician impression, therapies, and procedures performed.

Results

Of 179,854,336 EMS encounters during the study period, 164,387 pediatric encounters originated at an outpatient setting. Most EMS encounters originated from outpatient offices. Evening and weekend EMS encounters more frequently originated from urgent care centers. The most common impressions were respiratory distress (n = 60,716), systemic illness (n = 23,583), and psychiatric/behavioral health (n = 13,273). Ninety-four percent of EMS encounters resulted in transportation to a hospital.

Conclusions

EMS encounters from outpatient settings most commonly originate from outpatient offices, relative to urgent care settings, where pediatric emergency readiness may be limited. It is important that outpatient settings and providers are ready for varied emergencies, including those occurring for a behavioral health concern, and that readiness guidelines are updated to address these needs.

目的：全国性的努力强调了在儿童接受护理的所有环境中做好儿科应急准备的必要性。门诊办公室和紧急护理中心是儿童急性伤病的频繁起始点，强调了在这种环境中保持儿科准备状态的必要性。我们旨在了解门诊办公室和紧急护理中心使用紧急医疗服务（EMS）的情况，以便更好地了解儿科准备需求：我们利用具有全国代表性的急救医疗服务登记系统（2019-2022 年）"全国急救医疗服务信息系统 "对急救医疗服务的使用情况进行了回顾性横断面分析。我们纳入了四年来儿童的急救服务遭遇（结果：在研究期间的 179,854,336 次急救服务中，164,387 次儿童急救服务源自门诊环境。大多数急救服务都来自门诊办公室。夜间和周末的急救服务更多来自紧急护理中心。最常见的症状是呼吸困难（60,716 人次）、全身性疾病（23,583 人次）和精神/行为健康（13,273 人次）。94%的紧急医疗服务接诊结果是被送往医院：来自门诊环境的急救服务最常见于门诊办公室，而不是紧急护理环境，因为在紧急护理环境中，儿科急救准备可能有限。重要的是，门诊机构和医疗服务提供者要做好应对各种紧急情况的准备，包括因行为健康问题而发生的紧急情况，并更新准备指南以满足这些需求。新内容：在这项对美国急救医疗服务机构数据的分析中，源自门诊办公室和紧急护理中心的儿科紧急情况很常见。我们对常见的急诊类型和干预措施进行了描述，以进一步改善门诊准备工作。

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引用次数: 0

Place-Based Opportunity and Well Child Visit Attendance in Early Childhood 以地点为基础的机会与幼儿期儿童健康检查的出席率。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2024-11-01 DOI: 10.1016/j.acap.2024.06.012

Background

Lower neighborhood opportunity, measured by the Child Opportunity Index [COI], is associated with increased pediatric morbidity, but is less frequently used to examine longitudinal well child care. We aimed to evaluate associations between the COI and well child visit [WCV] attendance from birth – <36 months of age.

Methods

The Upstate KIDS population-based birth cohort includes children born 2008–2010 in New York state. The exposure, 2010 census tract COI (very low [VL] to very high [VH]), was linked to children’s geocoded residential address at birth. The outcome was attended WCVs from birth – <36 months of age. Parents reported WCVs and their child’s corresponding age on questionnaires every 4–6 months. These data were applied to appropriate age ranges for recommended WCVs to determine attendance. Associations were modeled longitudinally as odds of attending visits and as mean differences in proportions of WCVs by COI.

Results

Among 4650 children, 21% (n = 977) experienced VL or low COI. Children experiencing VL (adjusted OR [aOR] 0.68, 95% CI 0.61, 0.76), low (aOR 0.81, 95% CI 0.73, 0.90), and moderate COI (aOR 0.88, 95% CI 0.81, 0.96), compared to VH COI, had decreased odds of attending any WCV. The estimated, adjusted mean proportions of WCV attendance were lower among children experiencing VL (0.45, P < .01), low (0.53, P = .02), moderate (0.53, P = .05), and high (0.54, P = .03) compared to VH COI (0.56).

Conclusions

Lower COI at birth was associated with decreased WCV attendance throughout early childhood. Reducing barriers to health care access for children experiencing lower COI may advance equitable well child care.

背景和目的：以儿童机会指数（Child Opportunity Index [COI]）衡量的较低的邻里机会与儿科发病率的增加有关，但较少用于研究纵向儿童保健。我们的目的是评估儿童机会指数与出生后儿童保健就诊率之间的关系--方法：上州 KIDS 人口出生队列包括 2008-2010 年在纽约州出生的儿童。2010年人口普查区COI（极低[VL]至极高[VH]）与儿童出生时的地理编码居住地址相关联。结果是儿童从出生起就参加了世界儿童日活动：在 4,650 名儿童中，21% 的儿童（n=977）经历过 VL 或低 COI。与VH COI相比，经历过VL（调整OR [aOR] 0.68，95%CI 0.61，0.76）、低COI（aOR 0.81，95%CI 0.73，0.90）和中度COI（aOR 0.88，95%CI 0.81，0.96）的儿童参加任何WCV的几率都有所下降。在经历 VL 的儿童中，估计的、调整后的参加 WCV 的平均比例较低（0.45，p 结论：出生时COI较低与整个幼儿期参加WCV的人数减少有关。减少出生时COI较低儿童获得医疗保健的障碍可促进公平的儿童保健。

{"title":"Place-Based Opportunity and Well Child Visit Attendance in Early Childhood","authors":"","doi":"10.1016/j.acap.2024.06.012","DOIUrl":"10.1016/j.acap.2024.06.012","url":null,"abstract":"<div><h3>Background</h3><div>Lower neighborhood opportunity, measured by the Child Opportunity Index [COI], is associated with increased pediatric morbidity, but is less frequently used to examine longitudinal well child care. We aimed to evaluate associations between the COI and well child visit [WCV] attendance from birth – <36 months of age.</div></div><div><h3>Methods</h3><div>The Upstate KIDS population-based birth cohort includes children born 2008–2010 in New York state. The exposure, 2010 census tract COI (very low [VL] to very high [VH]), was linked to children’s geocoded residential address at birth. The outcome was attended WCVs from birth – <36 months of age. Parents reported WCVs and their child’s corresponding age on questionnaires every 4–6 months. These data were applied to appropriate age ranges for recommended WCVs to determine attendance. Associations were modeled longitudinally as odds of attending visits and as mean differences in proportions of WCVs by COI.</div></div><div><h3>Results</h3><div>Among 4650 children, 21% (n = 977) experienced VL or low COI. Children experiencing VL (adjusted OR [aOR] 0.68, 95% CI 0.61, 0.76), low (aOR 0.81, 95% CI 0.73, 0.90), and moderate COI (aOR 0.88, 95% CI 0.81, 0.96), compared to VH COI, had decreased odds of attending any WCV. The estimated, adjusted mean proportions of WCV attendance were lower among children experiencing VL (0.45, <em>P</em> < .01), low (0.53, <em>P</em> = .02), moderate (0.53, <em>P</em> = .05), and high (0.54, <em>P</em> = .03) compared to VH COI (0.56).</div></div><div><h3>Conclusions</h3><div>Lower COI at birth was associated with decreased WCV attendance throughout early childhood. Reducing barriers to health care access for children experiencing lower COI may advance equitable well child care.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"24 8","pages":"Pages 1220-1228"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Beyond ‘‘Screen & Refer’’: Understanding Families’ Use of Resources for Health-Related Social Needs Identified via Primary Care 超越 "筛查和转诊"：了解家庭对通过初级保健确定的健康相关社会需求资源的使用情况。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2024-11-01 DOI: 10.1016/j.acap.2024.06.016

Objective

As health-related social needs (HRSN) screening increases, attention to families’ resource preferences lags. This study of a pediatric primary care intervention (DULCE) with reliable HRSN screening and resource connection explored whether resources adequately addressed families’ needs and, when HRSN persisted, families' reasons for declining resources.

Methods

This retrospective cohort, mixed-methods study analyzed data from 989 families that received care at seven pediatric clinics implementing DULCE in three states. DULCE screens for seven HRSN around the 1-month and 4-month well-child visits; we calculated the percent of initial and ongoing positive screens. For positive rescreens, we calculated the percent that had all eligible or wanted resources and that were interested in further resources. We also analyzed case notes, which elicited families’ resource preferences, and explored demographic characteristics associated with ongoing HRSN.

Results

Half of enrolled families (508 of 989) initially screened positive for HRSN; 124 families had positive rescreens; 26 expressed interest in further assistance. Most families with ongoing concrete supports needs accessed all eligible resources (60–100%); 20–58% had everything they wanted. Fewer families with ongoing maternal depression and intimate partner violence accessed all eligible resources (48% and 18%, respectively); most reported having all wanted resources (76% and 90%, respectively). Families declined resources due to lack of perceived need, the HRSN resolving, or families addressed HRSN themselves. White families were more likely to rescreen positive.

Conclusions

Pediatric medical homes must honor family-centered decision-making while empowering families to accept beneficial resources. Health care systems should advocate for resources that families need and want.

目的：随着健康相关社会需求（HRSN）筛查的增加，对家庭资源偏好的关注却滞后了。本研究通过可靠的健康相关社会需求（HRSN）筛查和资源连接，对儿科初级保健干预措施（DULCE）进行了研究，探讨了资源是否能充分满足家庭的需求，以及当健康相关社会需求持续存在时，家庭拒绝资源的原因：这项回顾性队列混合方法研究分析了在三个州实施 DULCE 的七家儿科诊所接受治疗的 989 个家庭的数据。DULCE 在 1 个月和 4 个月的儿童健康检查中筛查了 7 项 HRSN；我们计算了初次和持续阳性筛查的百分比。对于阳性复筛，我们计算了已获得所有符合条件或想要的资源以及对进一步资源感兴趣的百分比。我们还分析了病例记录，其中询问了家庭的资源偏好，并探讨了与正在进行的 HRSN 相关的人口特征：半数登记家庭（989 个家庭中的 508 个）最初对 HRSN 筛查呈阳性；124 个家庭再次筛查呈阳性；26 个家庭表示有兴趣接受进一步援助。大多数有持续具体支持需求的家庭获得了所有符合条件的资源（60%-100%）；20%-58%的家庭获得了他们想要的一切。较少有持续产妇抑郁和亲密伴侣暴力问题的家庭获得了所有符合条件的资源（分别为 48% 和 18%）；大多数家庭表示拥有所有想要的资源（分别为 76% 和 90%）。家庭拒绝接受资源的原因有：认为没有需要、HRSN 正在解决或家庭自己解决了 HRSN。白人家庭更有可能重新筛查出阳性结果：儿科医疗之家必须尊重以家庭为中心的决策，同时授权家庭接受有益的资源。医疗保健系统应倡导提供家庭需要和想要的资源。

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引用次数: 0

The Associations between Neighborhood Characteristics and Childhood Overweight and Obesity in a National Dataset 全国数据集中的邻里特征与儿童超重和肥胖之间的关系。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2024-11-01 DOI: 10.1016/j.acap.2024.05.009

Background

National child obesity rates continue to climb. While neighborhood factors are known to influence childhood weight, more work is needed to further our understanding of these relationships and inform intervention and policy approaches reflective of complex real-world contexts.

Methods

To evaluate the associations between neighborhood components and childhood overweight/obesity, we analyzed sequential, cross-sectional data from the National Survey of Children’s Health collected annually between 2016 and 2021. To characterize the complexity of children’s neighborhood environments, several interrelated neighborhood factors were examined: amenities, detractions, support, and safety. We used ordinal logistic regression models to evaluate the associations between these exposures of interest and childhood weight status, adjusting for potential confounders.

Results

Our analytic sample contained 96,858 children representing a weighted population of 28,228,799 children ages 10–17 years. Child weight status was healthy in 66.5%, overweight in 16.8%, and obese in 17.2%. All four neighborhood factors were associated with child weight status. The odds of overweight or obesity generally increased with a decreasing number of amenities and increasing number of detractions, with the highest adjusted odds ratio seen with no amenities and all three possible detractions (1.71; 95% confidence interval [1.31, 2.11]).

Conclusions

Multiple factors within a child’s neighborhood environment were associated with child weight status in this sample representative of the US population aged 10–17 years. This suggests the need for future research into how policies and programs can support multiple components of a healthy neighborhood environment simultaneously to reduce rates of childhood overweight/obesity.

背景：全国儿童肥胖率持续攀升。虽然众所周知邻里因素会影响儿童体重，但我们还需要做更多的工作来进一步了解这些关系，并为反映复杂现实环境的干预和政策方法提供信息：为了评估邻里因素与儿童超重/肥胖之间的关系，我们分析了 2016 年至 2021 年期间每年收集的《全国儿童健康调查》的连续横截面数据。为了描述儿童邻里环境的复杂性，我们研究了几个相互关联的邻里因素：便利设施、干扰因素、支持因素和安全因素。我们使用序数逻辑回归模型来评估这些相关暴露与儿童体重状况之间的关联，并对潜在的混杂因素进行了调整：我们的分析样本包含 96,858 名儿童，代表了 28,228,799 名 10-17 岁儿童的加权人口。66.5%的儿童体重健康，16.8%的儿童超重，17.2%的儿童肥胖。所有四个邻里因素都与儿童体重状况有关。超重或肥胖的几率随着便利设施的减少和不利因素的增加而增加，没有便利设施和所有三种不利因素的调整后几率最高（1.71；95% 置信区间 [1.31，2.11]）：在这个代表美国 10-17 岁人口的样本中，儿童周围环境中的多种因素与儿童体重状况有关。新发现：在全国 96,858 名 10-17 岁儿童的样本中，家长认为不安全、不支持、有多种干扰因素（如故意破坏）和没有便利设施（如游乐场）的社区中，儿童超重/肥胖的几率最高。

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引用次数: 0

Prolonged Early Food Insecurity and Child Feeding Practices among a Low-Income Hispanic Population: Role of Parenting Stress 低收入西班牙裔人口中长期的早期粮食不安全和儿童喂养方式：育儿压力的作用。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2024-11-01 DOI: 10.1016/j.acap.2024.06.013

Objective

To examine associations between prolonged early household food insecurity (FI) during pregnancy, infancy, and toddlerhood, and child feeding practices, and the mediating role of dysfunctional parent-child interactions.

Methods

We conducted secondary longitudinal analyses of data from the Starting Early Program (StEP) randomized controlled trial, which studied a primary care-based child obesity prevention program for low-income Hispanic families. Our independent variable was FI, using the USDA Food Security Module, during the third trimester of pregnancy and at child ages 10- and 19-months. Frequency of reported FI was defined by the number of periods with FI (0, 1, 2, or 3). Our dependent variables were feeding practices at child age 28-months using the Comprehensive Feeding Practices Questionnaire. Our mediating variable was dysfunctional parent-child interactions using the Parenting Stress Index subscale at age 19-months. We used linear regression to determine associations between frequency of reported FI and feeding practices adjusting for covariates, and mediation analyses to determine if dysfunctional parent-child interactions mediate these associations.

Results

Three hundred and forty four mothers completed assessments at child age 28-months. Of the 12 feeding practices examined, higher frequency of reported FI was positively associated with using food as a reward, restriction of food for weight control, and using food for emotional regulation, and was negatively associated with monitoring of less healthy foods. There was a significant indirect effect of frequency of reported FI on these practices through dysfunctional parent-child interactions.

Conclusion

Higher frequency of reported FI was associated with four feeding practices, through dysfunctional parent-child interactions. Understanding these pathways can inform preventive interventions.

目的研究妊娠期、婴儿期和学步期早期长期家庭食物不安全（FI）与儿童喂养方式之间的关系，以及亲子互动失调的中介作用：我们对 "早期开始计划"（StEP）随机对照试验的数据进行了二次纵向分析，该试验针对低收入西班牙裔家庭开展了一项以初级保健为基础的儿童肥胖预防计划。我们的自变量是怀孕三个月期间和孩子 10 个月和 19 个月大时使用美国农业部食品安全模块得出的 FI。报告的 FI 频率由 FI 期数（0、1、2 或 3）定义。我们的因变量是孩子 28 个月大时的喂养方式，使用的是喂养方式综合问卷。我们的中介变量是使用育儿压力指数分量表（Parenting Stress Index subscale）计算的19个月大时功能失调的亲子互动。我们使用线性回归来确定所报告的FI频率与喂养实践之间的关联，并对共变量进行调整，同时使用中介分析来确定功能失调的亲子互动是否对这些关联起中介作用：344名母亲在孩子28个月大时完成了评估。在所研究的 12 种喂养方式中，较高的 FI 报告频率与将食物作为奖励、限制食物以控制体重和使用食物调节情绪呈正相关，而与监控较不健康的食物呈负相关。通过不正常的亲子互动，报告的食物摄入频率对这些行为有明显的间接影响：结论：通过不正常的亲子互动，较高的FI报告频率与四种喂养方式有关。了解这些途径可为预防性干预措施提供依据。

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引用次数: 0

Steps Forward From Co-created Entrustable Professional Activities in Pediatric Complex Care 儿科复杂护理中共同创建的受托专业活动的前进步伐。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2024-11-01 DOI: 10.1016/j.acap.2024.07.002

引用次数: 0