Purpose ReadNPlay for a Bright Future develops a variety of projects aimed at promoting healthy living in families with young children in Appalachian Tennessee. The purposes of this research are to collect parents’ and caregivers’ perspectives on healthy eating for the purpose of designing a new book in the ReadNPlay children's book series to be entitled A Farmers Market Adventure and to collect the preferences of parents and guardians related to website and mobile application (app) usage to help shape the development of a new ReadNPlay My Baby Book app. Methods Anonymous clipboard surveys were administered to attendees of regional community events during July of 2014. Survey items asked parents about healthy eating in the context of their families and the role of parenting websites and mobile apps in their families. The results from these surveys were summarized using Excel. A total of 100 surveys were collected. Results It was found that when parents were asked to identify barriers to healthy eating, the most common responses were picky eaters in the household (30%) followed by lack of time (22%). When asked to identify things that have helped parents to encourage healthy eating in their families, the three most common responses were good recipes (20%), good role models (16%), and farmers markets (16%). Twenty-eight percent of parents surveyed do not use websites or apps for parenting, while those who do use parenting websites or apps identified advice from experts (20%) and advice from other parents (18%) to be the two features most commonly desired in such a resource. When asked what they do not like about website and app usage, 20% of parents indicated that these tools are “too complicated.” However, when parents are told that our group of pediatricians was developing a free mobile application for families designed to help them keep track of their baby’s growth, development, and eating habits, 75% of parents said such an app would be very helpful to them (25% said a little helpful). Conclusion These results will inform a new ReadNPlay children's book themed around healthy eating behaviors, overcoming pickiness, and shopping with families at farmers markets and a new ReadNPlay mobile app for families to use in conjunction with infant-toddler well child visits.

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Postpartum Depression (PPD) occurs in 10-20% of new mothers. PPD can lead to serious health risks to both the mother and infant, increase the risk of complications during birth, and cause lasting effects on the development and wellbeing of the child. Many mothers suffering from PPD do not receive treatment due to fear of being stigmatized, lack of education, or not being able to access mental health services. High prevalence of PPD, along with the negative and lasting effects it can cause point to the importance of developing an effective and feasible method of assessing and treating this disorder. A pediatric primary care office may be an opportune setting to screen for PPD since mothers often accompany their children to regularly scheduled well child visits. While some studies have examined PPD screening within the pediatric primary care setting, few have explored the addition of an on-site Behavioral Health Consultant to provide brief interventions for depressed mothers as part of a stepped care model. The primary aim of the current study is assess the feasibility of implementing a stepped care protocol that assesses PPD and provides brief interventions and referrals for depressed mothers within a pediatric primary care clinic. The protocol consists of several phases including: 1) distribution of the Edinburgh Postpartum Depression Screener to every mother arriving for a well child visit during the first six months of their child’s life; 2) appropriate documentation in the clinic’s electronic health record (EHR) of the Edinburgh score and resulting plan of action; 3) a brief same day intervention by the on-site Behavioral Health Consultant and referral to outside provider, if applicable; and 4) phone call follow up with the mother and referred provider, if applicable. Research assistants will monitor the EHR to determine the clinic’s fidelity to the protocol (e.g., if the Edinburgh is being administered properly). Data will also be collected from the EHR to determine if a correlation exists between Edinburgh scores and number of Emergency Room visits made by the child, immunizations administered to the child, and number of well child checks the child attended. Data collected throughout the month of March showing the Edinburgh uptake, consistency with protocol, and any correlation between Edinburgh scores and other variables will be presented.

Introduction. Previous research shows overweight children report poorer health-related quality of life (HRQoL), primarily in the areas of physical health and social functioning. These relations may be especially important to understand in rural populations characterized by poorer health behaviors and limited access to healthcare resources. Objective. The purpose of the current study was to investigate the relation between HRQoL (overall, physical, and social) and weight perception as well as actual weight status in middle school students residing in Southern Appalachia. Methods. 397 middle school students participating in Winning with Wellness, a school-based obesity prevention study, completed a written survey including the Pediatric Quality of Life Inventory. Results from a question on self-perceived weight were used to assign students to 1 of 4 weight-perception groups (underweight, healthy weight, overweight, or obese). Actual body mass index (BMI) percentile data collected by the schools was available for a subset of 152 students and used to classify students’ actual weight status according to Centers for Disease Control and Prevention guidelines. Results. Students who perceived them self to be overweight or obese reported significantly lower overall as well as lower physical and social HRQoL compared to students who perceived them self as a healthy weight. In the sub-sample with actual weight data, students whose actual weight status was obese reported significantly lower overall HRQoL than students whose weight status was in the healthy weight range. Conclusion. Our findings with students in Southern Appalachia are consistent with previous research documenting poorer HRQoL in overweight children and substantiate the need for more inclusive programs that target psychosocial well-being. The understanding of the role of weight perception in addition to actual weight may also inform future efforts at prevention and intervention.

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IntroductionThe STARx Questionnaire was designed with patient and provider input, to measure self-management and transition skills in adolescents and young adults (AYA) with chronic health conditions. With proven reliability and an empirically-based factor structure, the self-report STARx Questionnaire requires further validation to demonstrate its clinical and research utility. In this study we examine the concurrent, predictive, and discriminant validity of the STARx Questionnaire.MethodsTo examine concurrent validity, the STARx Questionnaire was compared to two other published transition readiness tools. Predictive validity was examined using linear regressions between the STARx Total Score and literacy, medication adherence, quality of life, and health services use. Discriminant validity was examined by comparing the performance of three chronic illness conditions on the STARx Total Score and associated subscales.ResultsThe STARx Questionnaire and its subscales positively correlated with the scores for both transition readiness tools reflecting strong concurrent validity. The STARx Questionnaire also correlated positively with the literacy, self-efficacy, and adherence measures indicating strong predictive validity; however, it did not correlate with either quality of life or health care utilization. The performance of AYA across three different clinical conditions was not significant, indicating the clinical utility of this HCT tool for a variety of chronic health conditions.ConclusionThe strong validity of the STARx Questionnaire, in tandem with its strong reliability, indicated adequate psychometric properties for this generic self-report measure. These strong psychometric properties should contribute to the STARx being a viable measure of health care transition for both research and clinical purposes.

OBJECTIVE The transition of the young adult with spina bifida (YASB) from pediatric to adult health care is considered a priority by organized pediatrics. There is a paucity of transition programs and related studies. Jacksonville Health and Transition Services (JaxHATS) is one such transition program in Jacksonville, Florida. This study’s purpose was to evaluate the health care access, utilization, and quality of life (QOL) of a group of YASBs who have transitioned from pediatric care. METHODS A survey tool addressing access to health care and quality of health and life was developed based on an established survey. Records of the Spinal Defects Clinic held at Wolfson Children’s Hospital and JaxHATS Clinic were reviewed and YASBs (> 18 and < 30 years old) were identified. RESULTS Ten of the 12 invited YASBs in the Jacksonville area completed the surveys. The mean age of respondents was 25.1 years. All reported regular medical home visits, 8 with JaxHATS and 2 with other family care groups. All reported easy access to medical care and routine visits to spina bifida (SB) specialists; none reported difficulty or delays in obtaining health care. Only 2 patients required emergent care in the last year for an SB-related medical problem. Seven respondents reported very good to excellent QOL. Family, lifestyle, and environmental factors were also examined. CONCLUSIONS In this small group of YASBs with a medical home, easy access to care for medical conditions was the norm, with few individuals having recent emergency visits and almost all reporting at least a good overall QOL. Larger studies of YASBs are needed to evaluate the positive effects of medical homes on health and QOL in this population.

Book Summary: This title examines what our students need to know to be psychologically literate citizens of the contemporary world, caring family members, and productive workers who can meet today's challenges. It contains the expert opinions of a leading group on the topic, creates a powerful new model for educating psychologically literate citizens and provides a handbook of evidence-based practical pedagogy with substantive resource materials applicable to every campus and its faculty.

Researchers have demonstrated a persistent relationship between joint attention (JA) and language abilities. For example, 14-month JA is associated with concurrent performance on a word-object association task under control conditions as well as under distraction (Salley et al., 2012). Research has also shown associations between temperament and language. For example, 13-month temperament predicts 20-month productive vocabulary (Dixon & Shore, 1997). It has been suggested that "risky" temperamental profiles, such as when children have high negative affectivity and low effortful control, can especially lead to language delay (Dixon & Smith, 2000). In this investigation, we explored whether temperamental profile might moderate the relationship between JA and language ability. Eighty-three children (32 girls) visited the lab at M = 15.45 months (SD = 1.92 months). Caregivers completed the Infant Behavioral Questionnaire-Revised (IBQR) and the MacArthur-Bates Communicative Development Inventory: Words and Gestures (MCDI-WG). The IBQ-R produced three overarching superdimensions: surgency, negative affectivity, and effortful control, two of which were used to identify children as temperamentally "at-risk" or "buffered." Total receptive vocabulary was derived from the MCDI-WG. Temperamental risk was defined as scoring high in negative affectivity and low in effortful control; while temperamental buffering was defined as scoring low in negative affectivity and high in effortful control. JA was measured using a Brooks and Meltzoff (2005) type gaze-following procedure, with some gaze-following trials subjected to an exogenous distractor (Elmo video playing in the background), and others undistracted. JA was defined as total infant looking time to experimenter-fixated target objects. Overall, receptive vocabulary was correlated with JA in both nondistracted (r = .30, p = .01) and distracted conditions (r = .25, p = .04). Although infants did not differ in either JA or receptive vocabulary as a function of temperamental profile, we found that the correlation between JA and receptive vocabulary did. Specifically, JA was not associated with receptive vocabulary for children with risky temperament (see Table 1). But there was a large and positive association between receptive vocabulary and JA among children with a buffered temperament, regardless of distraction condition. Moderation analyses confirmed that temperamental risk was a significant moderator of the JA-receptive vocabulary relationship (moderator control = -1.09, p = .006; moderator distraction = - 0.75, p = .01). These results are partially consistent with theoretical expectations, although they need be supported by further research. They suggest, for example, that the JAlanguage relationship may be attenuated or enhanced depending on infants' temperament profiles. It may be that children who are low in negative affectivity and high in effortful control can maximize their allocation of attention both in the service of following the gaze of a social partner, and in making word-referent mappings during social exchange. The fact that the JA-receptive vocabulary correlation appeared unaffected by the presence of an exogenous distractor raises the possibility that one means through which a buffering temperamental profile may operate is by desensitizing children to ambient environmental distractions during real-time acquisition of linguistically relevant stimuli.

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