ABSTRACT Shared physical activity (PA) in children and their parents is an approach to increase PA participation for both children and adults. Understanding variables associated with shared PA is essential to inform effective, tailored PA interventions for families. The purpose of this study was to identify predictors and to assess the acceptability of shared PA in parent–child dyads. Each parent–child dyad ( n = 31; mean ± SD age, parents: 38.0 ± 6.6 yr, children: 5.9 ± 1.7 yr) was guided through five standardized PAs (brisk walking, jumping games, body-weight exercises, dancing, and tag games) at a research fitness center. Parents reported demographic characteristics and PA-related variables (i.e., PA self-efficacy, family chaos, and annual household income). One week later, parents ( n = 28) reported their dyad’s weekly minutes spent in shared PA. A forward selection procedure was used to determine the optimal regression model for predicting minutes of shared PA. McNemar’s tests were used to determine the dyad’s acceptability of each shared PA. Lower family chaos ( β = −19.41, P = 0.034), higher parent body mass index ( β = 7.65, P = 0.003), and higher annual household income ( β = 11.85, P = 0.023) predicted minutes of shared PA. Jumping games, body-weight exercises, dancing, and tag games were not acceptable for parent–child dyads to participate in together ( P < 0.05). Brisk walking was an acceptable shared PA ( P = 0.125). Lower family chaos, higher parent body mass index, and higher annual household income predicted shared PA. Brisk walking was an acceptable PA for parent–child dyads to participate outside of a research laboratory setting. These results can aid future PA programs that include children and parents together.
Patrick M. Filanowski, Sarah M. Camhi, Jessica A. Whiteley et al.
Background: Current knowledge about parental reasons for allowing child participation in research comes mainly from clinical trials. Fewer data exist on parents’ motivations to enrol children in observational studies. Objectives: Describe reasons parents of preschoolers gave for participating in the Study to Explore Early Development (SEED), a US multi-site study of autism spectrum disorder (ASD) and other developmental delays or disorders (DD), and explore reasons given by child diagnostic and behavioural characteristics at enrolment. Methods: We included families of children, age 2–5 years, participating in SEED (n = 5696) during 2007–2016. We assigned children to groups based on characteristics at enrolment: previously diagnosed ASD; suspected ASD; non-ASD DD; and population controls (POP). During a study interview, we asked parents their reasons for participating. Two coders independently coded responses and resolved discrepancies via consensus. We fit binary mixed-effects models to evaluate associations of each reason with group and demographics, using POP as reference. Results: Participants gave 1–5 reasons for participation (mean = 1.7, SD = 0.7). Altruism (48.3%), ASD research interest (47.4%) and perceived personal benefit (26.9%) were most common. Two novel reasons were knowing someone outside the household with the study conditions (peripheral relationship; 14.1%) and desire to contribute to a specified result (1.4%). Odds of reporting interest in ASD research were higher among diagnosed ASD participants (odds ratio [OR] 2.89, 95% confidence interval [CI] 2.49–3.35). Perceived personal benefit had higher odds among diagnosed (OR 1.92, 95% CI 1.61–2.29) or suspected ASD (OR 3.67, 95% CI 2.99–4.50) and non-ASD DD (OR 1.80, 95% CI 1.50–2.16) participants. Peripheral relationship with ASD/DD had lower odds among all case groups. Conclusions: We identified meaningful differences between groups in parent-reported reasons for participation. Differences demonstrate an opportunity for future studies to tailor recruitment materials and increase the perceived benefit for specific prospective participants.
Laura A. Schieve, Gayle C. Windham, Carolyn G DiGuiseppi et al.
This study used data from the Survey on Early Learning and Child Care Arrangements (SELCCA) and the Longitudinal Immigration Database (IMDB) to examine patterns of child care use among Canadian immigrant and nonimmigrant families. Overall, children from immigrant backgrounds were less likely to be in child care. When considering only those in child care, children from immigrant families were more likely to be in licensed care than those from nonimmigrant families. Parents of children with immigrant backgrounds indicated various reasons for not enrolling their child in child care. Ensuring access to child care may have a positive impact on immigrant families.
Mila K. Kingsbury, Leanne Findlay, Rübab G. Arım et al.
Preventable harm in pediatric care requires coordinated, cross-institutional learning. The Child Health Patient Safety Organization established weekly safety huddles to enhance situational awareness and strengthen a protected learning network under the Patient Safety and Quality Improvement Act. This iterative time-series quality improvement study examined weekly huddle content, assessed targeted interventions to increase participation, and evaluated engagement trends over time. The primary outcome was composite engagement, defined as ≥80% annual attendance and ≥5 submitted reports. Secondary measures included attendance, quarterly reporting, and categorization of reported safety events. Frequently reported events involved medication issues, diagnostic errors, and device malfunctions. Targeted interventions increased composite engagement from 21% to 71.4%, alongside improvements in weekly attendance and quarterly reporting. Organizations also reported using huddle insights to guide internal risk assessments and escalate concerns. Child Health Patient Safety Organization safety huddles improved participation, supported shared learning, and strengthened safety culture consistent with learning-organization and high-reliability principles.
BACKGROUND: The United Nations Convention on the Rights of the Child (1989) affirms interdependent rights to protection and participation, but barriers continue to hinder participation in protection practices. OBJECTIVE: What can be learned from young people's participation in their own protection when it comes to harm reduction public policy efforts? PARTICIPANTS AND SETTING: This study focused on provincial public policy in New Brunswick, Canada and involved both children and adults in research design and data collection. The provincial Youth Voice Committee was created to inform the development and implementation of the provincial harm reduction strategy. This strategy promotes children's rights to live free from harm through the reduction of physical, sexual, emotional, and sociocultural harms, not only abuse and neglect. METHOD: This study involved international and local child and youth advisory committees to support research design and implementation. Participatory qualitative data collection methods included young people and adults separately as well as collectively in intergenerational meetings. RESULTS: Findings reveal a broad and unique interpretation of child protection as harm reduction, and that fear and policy processes continue to pose barriers even in contexts dedicated to children's rights. Adults should no longer exclusively influence protection policies, and children and youth are interested in effective intergenerational and relational collaborations. Greater commitment to diversity is needed in participatory efforts. CONCLUSIONS: A rights-based relational approach in research and policy-making necessitates the effective involvement of children and youth to support harm reduction in policy and practice. Policy makers are urged to engage young people alongside adults in child protection and public policies.
Abstract Dog bites are a common danger to children. Behavioral safety training strategies are more effective than nonbehavioral strategies, but questions remain about whether learned responses generalize to new dogs and settings. Three preschool-aged girls who exhibited unsafe dog-greeting behavior during in situ assessments were taught to safely greet unfamiliar, leashed dogs using TAGteach™ ( TAGteach International, 2016 ). The children acquired the six-step behavior chain, but responding did not generalize to a novel dog, handler, and setting even after completing the training three times in progressively more-naturalistic settings. These results suggest a need to investigate effective strategies for teaching safety skills around dogs. They also question whether dog-safety training via online modules, classroom-based instruction, or video modeling is sufficient to improve young children’s behavior around dogs in natural settings.
Rachelle L. Yankelevitz, April Michele Williams, Alexandra W. Knerr et al.
BACKGROUND: Transcranial direct current stimulation (tDCS) is a safe, tolerable, and acceptable technique in adults. However, there is limited evidence for its safety in youth. Although limited, there are a handful of important empirical articles that have evaluated safety and tolerability outcomes in youth. However, a synthesis of pediatric safety studies is not currently available. OBJECTIVE: To synthesize objective evidence regarding the safety and tolerability of pediatric tDCS based on the current state of the literature. METHODS: Our search and report used PRISMA guidelines. Our method systematically examined investigations purposefully designed to evaluate the safety, tolerability, and acceptability of tDCS in healthy and atypical youth that were submitted to three databases, from the beginning of the database to November 2019. Safety considerations were evaluated by studies utilizing neuroimaging, physiological changes, performance on tasks, and by analyzing reported and objective side effects; tolerability via rate of adverse events; and acceptability via rate of dropouts. RESULTS: We report on 203 sham sessions, 864 active sessions up to 2 mA, and 303 active hours of stimulation in 156 children. A total of 4.4% of the active sessions were in neurotypical controls, with the other 95.6% in clinical subjects. CONCLUSION: In spite of the fact that the current evidence is sporadic and scarce, the presently reviewed literature provides support for the safety, tolerability, and acceptability, of tDCS in youth for 1-20 sessions of 20 min up to 2 mA. Future pediatric tDCS research is encouraged.
Derrick Matthew Buchanan, Thomas Bogdanowicz, Neha Khanna et al.
We present the argument that privacy research related to adolescents and their online safety is lacking, in that the current research tends to focus on general populations of teens and not on those who are most vulnerable to encountering online risks. Therefore, we present a case study of the privacy and online safety tensions experienced by foster parents and the teens (ages 13 – 17) they take into their homes.
Roberto Hoyle, Karla A. Badillo-Urquiola, Tamara Peyton et al.
The present study aimed to verify the instrument's reliability and validity for assessing children and adolescents' risk perception, knowledge, and food safety practices in the school context. Moreover, it aimed to test the hypothesis that both application methods (paper and pencil (PAPI) and online) are valid. The instrument comprised three questionnaires and followed a strict protocol to combine online and PAPI models, resulting in five application forms. The sample consisted of 439 Brazilian students from 10 to 14 years old (y/o). The results related to reliability and validity indicated that the knowledge questionnaire presented adequate stability and discriminant validity coefficients. The self-reported practices questionnaire obtained acceptable coefficients of stability and internal consistency. Regarding risk perception data, it was observed that students attribute a low probability of Foodborne Diseases (FBD) outbreaks occurrence and low severity of possible symptoms. In addition, students demonstrated insufficient knowledge and inadequate practices on issues related to failures associated with the time and temperature of preparation, storage, and exposure of food, contamination of food, and consumption of unsafe food. In this context, the reproducibility and validity indices need to be interpreted and discussed correctly, and young people in food safety actions are a priority in facing FBD.
Sueny Andrade Batista, Verônica Cortez Ginani, Elke Stedefeldt et al.
BACKGROUND: Continued emergence and spread of circulating vaccine-derived type 2 polioviruses and vaccine-associated paralytic poliomyelitis from Sabin oral poliovirus vaccines (OPVs) has stimulated development of two novel type 2 OPV candidates (OPV2-c1 and OPV2-c2) designed to have similar immunogenicity, improved genetic stability, and less potential to reacquire neurovirulence. We aimed to assess safety and immunogenicity of the two novel OPV candidates compared with a monovalent Sabin OPV in children and infants. METHODS: We did two single-centre, multi-site, partly-masked, randomised trials in healthy cohorts of children (aged 1-4 years) and infants (aged 18-22 weeks) in Panama: a control phase 4 study with monovalent Sabin OPV2 before global cessation of monovalent OPV2 use, and a phase 2 study with low and high doses of two novel OPV2 candidates. All participants received one OPV2 vaccination and subsets received two doses 28 days apart. Parents reported solicited and unsolicited adverse events. Type 2 poliovirus neutralising antibodies were measured at days 0, 7, 28, and 56, and stool viral shedding was assessed up to 28 days post-vaccination. Primary objectives were to assess safety in all participants and non-inferiority of novel OPV2 day 28 seroprotection versus monovalent OPV2 in infants (non-inferiority margin 10%). These studies were registered with ClinicalTrials.gov, NCT02521974 and NCT03554798. FINDINGS: The control study took place between Oct 23, 2015, and April 29, 2016, and the subsequent phase 2 study between Sept 19, 2018, and Sept 30, 2019. 150 children (50 in the control study and 100 of 129 assessed for eligibility in the novel OPV2 study) and 684 infants (110 of 114 assessed for eligibility in the control study and 574 of 684 assessed for eligibility in the novel OPV2 study) were enrolled and received at least one study vaccination. Vaccinations were safe and well tolerated with no causally associated serious adverse events or important medical events in any group. Solicited and unsolicited adverse events were overwhelmingly mild or moderate irrespective of vaccine or dose. Nearly all children were seroprotected at baseline, indicating high baseline immunity. In children, the seroprotection rate 28 days after one dose was 100% for monovalent OPV2 and both novel OPV2 candidates. In infants at day 28, 91 (94% [95% CI 87-98]) of 97 were seroprotected after receiving monovalent OPV2, 134 (94% [88-97]) of 143 after high-dose novel OPV2-c1, 122 (93% [87-97]) of 131 after low-dose novel OPV2-c1, 138 (95% [90-98]) of 146 after high-dose novel OPV2-c2, and 115 (91% [84-95]) of 127 after low-dose novel OPV2-c2. Non-inferiority was shown for low-dose and high-dose novel OPV2-c1 and high-dose novel OPV2-c2 despite monovalent OPV2 recipients having higher baseline immunity. INTERPRETATION: Both novel OPV2 candidates were safe, well tolerated, and immunogenic in children and infants. Novel OPV2 could be an important addition to our resources against poliovirus given the current epidemiological situation. FUNDING: Fighting Infectious Diseases in Emerging Countries and Bill & Melinda Gates Foundation.
Xavier Sáez‐Llorens, Ananda Sankar Bandyopadhyay, Christopher Gast et al.
