OBJECTIVES/GOALS: Early pediatric intensive care unit (PICU) mobilization is safe and associated with improved outcomes. Nursing-specific mobility training is desired and improves mobilization compliance. Thus, our aim is to implement a nurse-targeted, simulation-based early mobility curriculum to determine if it increases the frequency of PICU mobilizations. METHODS/STUDY POPULATION: We will conduct a single center pre-post interventional study of an in situ nurse-targeted, simulation-based early mobility curriculum. We will prospectively evaluate mobilization events in 100 patients admitted during the pre-intervention phase (n=50) and the post-intervention phase (n=50). Inclusion criteria are children ages 1 day to 17 years old admitted to the PICU for ≥3 days. Exclusion criteria include specific mobility contraindications. PICU-wide deployment will be complete when >80% of nurses have participated in the curriculum. Demographic and clinical information will be obtained. Mobility data obtained will include number of nursing-led mobilizations, highest level of mobility achieved, and potential safety events. Data will be collected from the EMR and the nurse caring for the patient. RESULTS/ANTICIPATED RESULTS: The primary endpoint will be the change in the number of nursing-led mobilization events per patient day. The secondary effectiveness outcome is the highest level of mobility achieved by patients during mobilization events in a day. A final secondary end point will be safety events defined as unplanned extubations, medical device dislodgement, falls, and cardiac arrests. Descriptive statistics for continuous variables will be presented as the median and interquartile range and categorical variables will be expressed as percentages. The effect of the simulation curriculum on the clinical outcomes will be assessed using mixed-effects models. Due to the lack of normality in number of nurse-led mobilizations and highest level of mobility achieved, the analysis will be performed using log-normal models. DISCUSSION/SIGNIFICANCE: We hypothesize that we will demonstrate the crucial importance of hands-on nursing education to improve and increase early mobility of critically ill children
This study examined the remote learning activities children born very preterm (VPT; gestational age ≤ 30 weeks) received, compared with children born full term (FT; gestational age ≥ 37 weeks), during the COVID-19 pandemic. Parents of 5- to 6-year-olds born VPT (n = 33) and FT (n = 33) reported on the provision, frequency, and duration of teacher-provided live instruction, educational materials, and homework; and parent-provided educational materials. More kindergarten children born VPT received small group instruction and fewer received large group instruction than FT children. Preschoolers born VPT engaged in parent-provided learning apps, educational videos, and reading activities less frequently or for shorter durations than FT children. Findings suggest that while teachers generally implemented remote learning similarly for children born VPT and FT, parents did not. Children born VPT are at higher risk for educational problems and may benefit from more intensive school- and home-based educational interventions to help offset the impact of school closures.
Abstract Bullying constitutes a major public health concern, on account of its high prevalence rates and its association with a wide range of adverse health outcomes across the lifespan, including increased incidence of mental disorders such as depression, anxiety, and psychotic disorders. Previous research suggests effectiveness of school-based programmes in reducing bullying prevalence and improving mental health outcomes in children and adolescents. Despite the fact that some subpopulations such as young people with special educational needs are at increased risk for both bullying victimisation and mental health difficulties, there is little information on the effectiveness of universal school-based programmes in these high-risk populations. We will review available evidence of the effectiveness of school-based anti-bullying interventions as a tool to improve youth mental health, including results from a cluster-randomised clinical trial conducted in 20 publicly funded schools in Madrid to test the effectiveness of a 12-week web-enabled, user-friendly, school-based, preventive programme incorporating universal and targeted components (LINKlusive; ISRCTN15719015) and discuss the potential implications, challenges, and unmet needs of such approaches. Disclosure of Interest None Declared
Abstract Background According to the Elaborated Environmental Stress Hypothesis, anxiety and depression in children are associated with poor motor competence, and these associations may be mediated by social support and self-perceptions. Improving children’s motor competence through school-based physical activity interventions may therefore be a mechanism for promoting positive mental health through psychosocial factors. Co-production provides opportunities to participate in intervention development processes, thereby ensuring that specific needs of stakeholders are targeted. The shared stakeholder ownership of the process provides a context-sensitive basis for acceptable interventions with increased likelihood of them being effectively implemented and resulting in positive outcomes. This presentation describes phase 1 of the Move Well, Feel Good study, which aimed to co-produce and evaluate the feasibility of a primary school physical activity intervention to improve children’s motor competence and mental health. Methods Five primary schools were recruited from a low socioeconomic status community in northwest England. From these schools, stakeholder groups were formed consisting of class teachers, school leaders, physical activity specialists, and children (aged 8-9 years). Stakeholders worked in single and multiple stakeholder groups through a 6-stage process aligned to the Double Diamond Design Approach by employing divergent and convergent thinking processes to discover, define, develop, and deliver a solution to the ‘problems’ of how best to improve children’s motor competence and mental health, and how best to facilitate real-world school context implementation of the intervention. Through this process the child and adult stakeholders worked separately in workshops and engaged in additional learning and consensus activities. The adult stakeholder co-production workshops were informed by the children’s views and current research evidence. Multiple-stakeholder groups worked collaboratively to develop intervention ideas, which were presented, critiqued, and refined in alignment with the TIDieR checklist. Results In the final stage of the process the research team presented the final co-produced interventions back to the stakeholders and a consensus vote was taken to decide which intervention would be implemented in the phase 2 feasibility trial in September 2022. Conclusions School stakeholders’ participation in intervention co-production ensures their ownership of the finalised programme, which may be important for subsequent implementation and engagement.
OBJECTIVES/GOALS: Individuals with intellectual and developmental disabilities (IDD) have lower levels of moderate-to-vigorous physical activity (MVPA) and a greater risk for sedentary-related comorbidities compared to their typically developing peers. Understanding activity patterns may provide opportunities for targeted physical activity interventions. METHODS/STUDY POPULATION: Secondary analyses were performed on baseline accelerometer data pooled from 2 clinical trials and a pilot study in adolescents (11-17 years) and young adults (18-21 years) with IDD. MVPA was assessed using accelerometers worn on the non-dominant hip during waking hours over 7 consecutive days. Data were collected at 60 hertz and activity counts were aggregated over 60 second epochs. Wear time was determined with the Choi algorithm and MVPA was classified using the Troiano adult or Freedson age-specific child cut-points. Mixed effects linear regressions were used to determine the effects of day of the week, time of the day, and season on MVPA. Diagnosis, gender, and age were used as fixed effect covariates with random intercepts varying among the participants and days of observation within each participant. RESULTS/ANTICIPATED RESULTS: There were 231 individuals (15.6 ± 2.8 years, 51.5% female) who had IDD (36.8% Autism, 48.1% Down syndrome) with 22,498 minutes of MVPA. Individuals with IDD wore the accelerometers an average of 592 ± 254 min./day and completed 13.5 ± 17.9 min./day of MVPA. Average MVPA was lowest in individuals with Autism (12.6 ± 11.4 min./day) and Down syndrome (13.2 ± 9.3 min./day) when compared to those with other IDDs (16.8 ± 10.8 min./day). Participation in MVPA was similar in males (13.4 ± 10.7 min./day) and females (13.7 ± 9.9 min./day). Mixed effects linear regressions showed that individuals participated in fewer minutes of MVPA on the weekend (β = -0.75, p < 0.001) and from 12-3 pm (reference) when compared to before 12 pm (β = 0.87, p < 0.001) and 3-7 pm (β = 0.66, p=0.007). No significant seasonal effects were found. DISCUSSION/SIGNIFICANCE: Individuals with IDD were significantly less active on the weekend, but they did participate in more minutes of MVPA in the morning and late afternoon/early evening. Physical activity interventions aiming to increase MVPA on the weekend and during the early afternoon may increase the number of weekly minutes of MVPA in individuals with IDD.
OBJECTIVES/GOALS: Determine if exposure to violence at different life stages (childhood versus recent exposure) in postpartum women is associated to increased risk of weight retention more than 1 year and no more than 2 years after delivery, thus increasing health risk in short and long term. METHODS/STUDY POPULATION: Participants will be recruited from a cohort of post-partum women who received services from the Puerto Rico Women and Children Program (PR WIC) during pregnancy and postpartum period as per PR WIC established criteria. Families that have completed their participation in a Lifestyle intervention trial will be paired 2:1 with eligible nonparticipants that fulfill trial enrollment criteria. Language, culture validated instruments will be used to document maternal violence exposure in childhood and recent exposure, defined as within the last 12 months. To asses weight retention, pre-pregnancy weight will be compared to actual weight at the moment of evaluation, anthropometric measurements (weight, length, body composition, and fat mass) will be used to determine the health risk category for each participant. RESULTS/ANTICIPATED RESULTS: Expected results will be that there is an association between violence exposure and weight retention among post-partum women, thus influencing their weight status. The use of the questionnaires as screening tool for history of violence and whether recent or childhood exposure should be considered a health risk during pregnancy and post-partum predisposing women to adipose tissue related disorders. DISCUSSION/SIGNIFICANCE: Findings will reinforce the importance of integrated screening and proactive management of social determinants of health within clinical and social services that target this population. Also, contribute to the development of strategies tailored to break violence cycle as a public health measure.
López Mancebo L, Acosta-Pérez E, Rosario-Matos N et al.
Abstract INTRODUCTION This study aimed to understand how ASD symptoms may relate to different sleep problems. METHODS 128 parents of children with ASD aged 4-14 participated in an anonymous survey. Parents completed the Short Sensory Profile (SSP), Children Sleep Habits Questionnaire (CSHQ), Strengths and Weaknesses of Attention-Deficit/Hyperactivity-symptoms and Normal-behaviours (SWAN) and Revised Child Anxiety and Depression Scale (RCADS). It was hypothesised that: 1) hyper-sensitivity indicated by the SSP, would be positively correlated with night waking from the CSHQ; 2) children at risk of Delayed Sleep Phase Syndrome (DSPS), indicated by the CSHQ, would be more light sensitive as indicated by the SSP; 3) anxiety measured by the RCADS would be positively correlated with longer Sleep Onset Latency (SOL) from the CSHQ; and 4) hyperactivity and inattentiveness from the SWAN would be positively correlated with SOL and parasomnias from the CSHQ. RESULTS Results revealed: 1) under-responsivity and low energy from the SSP were correlated with night waking (r = -.31 and r = .36, p < .05). 2) children at risk of DSPS demonstrated greater light sensitivity than those not at risk (t (55) = 2.83, p < .01); 3) Anxiety was not correlated with SOL; 4) Hyperactivity and inattention were related to longer SOL (r = .25 and r = .61, p < .05) and hyperactivity was correlated with parasomnias (r = .29, p < .05). DISCUSSION These findings suggest that different sleep problems may relate to different ASD symptomology, and that symptom-based approaches should be considered for future research.
Abstract A growing number of grandparents are assuming care of their grandchildren, and both grandparents and children report higher levels of stress than their peers, although the source of this stress remains largely unexplored. In Conger & Donnellan’s Family Stress Model, a parent’s distress can impact the levels of distress experienced by their child, and previous research indicates that parent/child relationship quality impacts children’s mental health. This study extended this to custodial grandfamilies, by investigating whether the relationship quality of custodial grandparents (GP) and grandchildren (GC) would moderate the relation between the health of GC and the wellness of their GP. Participants include 322 custodial grandparents within the United States recruited via Qualtrics Research Panel Survey (m age = 55.66 yr., 86.1% female). Measures included the Achenbach Child Behavior Checklist, Kivnick’s Grandparent Meaning Scale, and grandparents’ wellness. Moderation of relationship quality on the relation between the GP’s wellness and internalizing behaviors of the GC was tested using SPSS’ Process macro. A significant interaction was found (t = 2.31, p = .02) wherein GP’s wellness was not predictive of changes in GC’s behavior for the group with high relationship quality, but greater GP wellness was associated with less GC internalizing behaviors when relationship quality was low (p < .001). These findings indicate that when a GP feels that they have a more positive relationship with their GC, there is a greater likelihood that they will report fewer health concerns and fewer GC’s internalizing behavior symptoms.
Abstract Regular physical activity (PA) in youth has mental and social health outcomes (Ekelund, 2016; Biddle, 2019). Available data also suggest that the level of PA in youth predicts PA in adulthood (Telama, 2014; Varma, 2017). However, international studies (Aubert et al, 2018) have shown that the majority of young people do not achieve the PA levels recommended for health benefits (Guthold, 2020). However, despite policy intentions to develop sports infrastructure (Deguilhem, 2016; Esteban, 2016), a decrease in the overall level of physical inactivity will not be achieved by 2025 (Guthold, 2020). It seems to be a gap between the willingness of public services and the concrete actions of citizens. One of the commonly recognized obstacles to PA is the lack of time (Embersin, 2007). Thus, based on Elias' temporal model (1997) we propose to move beyond the linear view of time (chronos) to a perspective of timely time (kairos). Adopting an ecological perspective on human development, postulating that multiple determinants impact on our choices of physical activity (Bauman, 2012), we qualify and quantify the social times conducive to physical activity and inactivity. Using objective measurements of PA by accelerometry (ActiGraph GT3X) and a measure of social time by digital daily diary, we identify three profiles of adolescents whose perceptions of time vary according to their level of PA. Adolescents with an active profile (>3000 METs per week) practice PA within the framework of school and out-of-school by optimizing active transports, whereas those with a low activity profile (600>PA>3000 METs per week) are mainly involved in school PA. Finally, adolescents with an inactive profile (PA > 600 METs per week) only practice during compulsory physical education lessons and no social time records intense PA. As the only social time conducive to PA captured by all adolescents, the physical education lesson does not seem to be able, in its current form, to reduce inequalities in access to daily PA opportunities. There is scope for research into the organization of a school ecology (Waters, 2013; Turcotte, 2018) conducive to health education through PA.
Abstract Introduction Congenital heart diseases (CHD) represent abnormalities of cardiovascular structure or function present at birth. The degree of knowledge of parents of children with CHD determines the quality of care and the quality of life of their children. Several studies have shown that parents’ knowledge is still lacking. Objectives This study aims to translate and validate in Italian the Leuven Knowledge Questionnaire for Congenital Heart Disease (LKQCHD) and to assess the knowledge of parents of children with CHD about heart defect, treatments, preventive measures, opportunities for physical activity and reproductive problems of their children. Methods Translation and validation of the questionnaire were performed using a multistep method: forward translation, backward translation, and pilot testing. Five experts in CHD were included for the validation of the questionnaire. The sample consisted of fifty-four pairs of parents of children with CHD. Parents were contacted by telephone; knowledge was assessed using an electronic questionnaire. Results Five items were found to have an Item Content Validity Index (I-CVI) of 0.6, 2 of 0.5, and 2 of 0.2. The Scale ContentValidity Index (S-CVI) was found to be 0.80. Regarding parental knowledge, the results show that almost all parents are able to correctly state the name of the diagnosis and the description and location of the heart defect. However, parental knowledge has important gaps; in particular, parents are less informed about the most characteristic sign of endocarditis, the possibility of contracting endocarditis more than once in a lifetime, and risk factors. Parental knowledge also seems to be lacking regarding symptoms suggesting worsening health status in their children. Conclusions The Italian version of the LKQCHD has proved to be a valid tool to measure the level of knowledge of parents of children with CHD, allowing to identify in which areas it is necessary to improve the education addressed to parents. Key messages • Assessing the knowledge of parents of children with CHD allows to improve their education. • The Italian version of the LKQCHD is a valid tool to measure the level of knowledge of parents of children with CHD.
