Shiela M Strauss

Abstract

Schools’ health screenings can identify students’ missed health concerns. Data from the 2016 School Health Policies and Practices Study were used to determine the proportion of U.S. school districts with physical and mental health screening policies and the proportion that arrange off-campus mental health services. We also examined differences between districts with and without mental health screening policies regarding having physical health screening policies, patterns of these policies, and off-campus mental health service arrangements. Eleven percent of districts had no policies on any of the four physical health screenings assessed, and 87% lacked policies on mental health screenings, the latter especially concerning considering the impact of COVID-19. Districts with policies on mental health screenings were significantly more likely to have body mass index (p <.01) and oral health (p <.001) screening policies, and to arrange for off-campus case management (p <.001), family counseling (p <.05), group counseling (p <.01), self-help (p <.05) and intake evaluation (p <.05).

Abstract

Neighborhood factors may be associated with bully victimization, a serious health concern for adolescents with asthma. The purpose of this study was to examine associations between neighborhood factors and past year bullying in adolescents with asthma as reported by adult household respondents. Using data from the adolescent 2019 National Survey of Children’s Health, we analyzed responses which included 473 adult respondents of adolescent females with asthma and 551 adult respondents of adolescent males with asthma. Adult respondents also needed to have answered whether the adolescent was bullied over the past year. Neighborhood variables included whether the adolescent’s neighborhood had sidewalks or walking paths, a park or playground, a recreation center or a boys’ or girls’ club, and vandalism exposure. The complex samples module in IBM SPSS 27 with equal probability sampling without replacement was used to conduct the analyses. Descriptive statistics and chi-square analyses were also used. There were statistically significant differences in the proportion of adolescent females with asthma ever bullied compared to the proportion never bullied who had access to a park or playground (70.0% vs. 83.7%, respectively; p=.038) and were exposed to neighborhood vandalism (2.8% vs. 10.8%, respectively; p=.028). A significantly smaller proportion of adolescent males with asthma ever bullied than the proportion never bullied were exposed to neighborhood vandalism (4.9% vs. 14%, respectively; p=.032). It is important to examine the influence of neighborhood factors further to better understand their association with bully victimization in adolescents with asthma.

Abstract

Purpose The purpose of the study was to determine the extent to which arthritis-related limitations are salient in predicting less than the recommended amount of time for adults with prediabetes to spend on moderate or vigorous physical activity. Methods Data from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) in the United States were used to identify the predictors of insufficient physical activity in a large sample of adults with prediabetes 20 years of age and older (n = 2536). Results When extrapolated to more than 45 million adults in the United States at least 20 years of age with prediabetes, 42.7% had insufficient physical activity. Having arthritis- related functional limitations was a significant predictor of insufficient physical activity, even after accounting for the statistically significant contributions of female sex, older age, lower education level, higher body mass index, and depression. Conclusion When educating and counseling adults with prediabetes, diabetes educators should assess for arthritis-related functional limitations when examining factors that may affect prediabetes progression. Recommendations for physical activity for those with mobility and other limitations need to be individualized within a tailored exercise program to accommodate their specific limitations.

Abstract

Objectives: This study examined patient experiences after receiving elevated diabetes screening values using blood collected at a dental clinic. It explores patients' reactions to screening, whether or not they sought recommended medical follow-up, and facilitating factors and barriers to obtaining follow-up care. Methods: At the comprehensive care clinics at a large, urban College of Dentistry in the United States, haemoglobin A1C (HbA1C) values were obtained from 379 study participants who had not been previously diagnosed with diabetes. In all, 169 (44.6%) had elevated HbA1C values. We analysed quantitative and qualitative data concerning these patients' follow-up with primary care providers (PCPs). Results: We were able to contact 112 (66.3%) of the 169 study participants who had an elevated HbA1C reading. Of that group, 61 (54.5%) received recommended follow-up care from a PCP within 3 months, and an additional 28 (25.0%) said they intended to seek such care. Qualitative themes included the following: the screening letter – opportunity or burden, appreciation for the 3-month follow-up call and barriers to medical follow-up that included the following: lack of knowledge about diabetes, not understanding the importance of follow-up, busyness, financial concerns, fear and denial. Conclusions: Quantitative and qualitative data demonstrate that dentists, dental hygienists and nurses are well poised to discover and translate new models of patient-centred, comprehensive care to patients with oral and systemic illness.