@Article{info:doi/10.2196/58586,
author="Jalaludin, Yazid Muhammad
and Kiau, Bee Ho
and Hasim, Suriati
and Lee, Khew Wai
and Low, Angie
and Kazim, Nik Nik Harlina
and Hoi, Tse Jia
and Taher, Wahyu Sri",
title="A Noninvasive Approach to Assess the Prevalence of and Factors Associated With Anemia Risk in Malaysian Children Under Three Years of Age: Cross-Sectional Study",
journal="JMIR Pediatr Parent",
year="2025",
month="Mar",
day="24",
volume="8",
pages="e58586",
keywords="anemia",
keywords="iron deficiency",
keywords="children",
keywords="Masimo Rad-67",
keywords="noninvasive assessment",
keywords="Malaysia",
abstract="Background: Anemia remains a significant public health concern with adverse effects among children. Noninvasive screening assessments enable the early detection and prompt treatment of anemia. However, there is limited literature on the use of such screening assessments. Objective: The study aimed to assess the prevalence of and factors associated with being at risk of anemia among Malaysian children aged ?6 months to ?36 months by using a noninvasive hemoglobin assessment. Methods: This was a cross-sectional study (from July to December 2022) of outpatient Malaysian children, aged ?6 months to ?36 months, who were selected from five maternal-and-child health clinics by convenience sampling. At risk of anemia was defined as a total hemoglobin level of <12 g/dL, measured using the Masimo Rad-67, a noninvasive screening device for total hemoglobin levels. The $\chi$2 and multiple logistic regression analyses were used to assess the prevalence and factors associated with being at risk of anemia, using R-Studio (version 4.0.0). Results: The study included 1201 participants, of whom 30\% (95\% CI 28?33) were at risk of anemia. Children aged 6?12 months (210/364, 57.7\%, P<.001), those of Asian Malay race (238/364, 65.4\%, P<.05), those residing in the Klang district (123/371, 33.9\%, P<.05), those born via a normal vaginal delivery (275/364, 75.5\%, P<.05), those without a family history of thalassemia (284/364, 78.0\%, P<.05), and those with lower weight-for-age Z scores (P<.05) were associated with being at risk of anemia. Children aged 6?12 months (adjusted odds ratio=1.73; 95\% CI 1.34?2.24) had higher odds of being at risk of anemia compared to children aged >12?36 months. However, weight-for-age (adjusted odds ratio=0.88; 95\% CI 0.80?0.98) was associated with lower odds of being at risk of anemia. Conclusions: The current study revealed a substantial prevalence of Malaysian children being at risk of developing anemia. The study results therefore imply a need for more community education and awareness on anemia, including nutrition education, as well as targeted community screening to enable the early detection and prompt treatment of anemia cases. Anemia reduction strategies in Malaysia should consider the highlighted factors indicative of higher risk of anemia. Trial Registration: Clinicaltrials.gov NCT05181436, https://clinicaltrials.gov/study/NCT05181436 ",
doi="10.2196/58586",
url="https://pediatrics.jmir.org/2025/1/e58586"
}


@Article{info:doi/10.2196/53028,
author="Xu, Lijuan
and Li, Hanjia
and Li, Fang
and Zhang, Tinghui
and Yan, Jingyan
and Yan, Hong
and He, Lu
and Yu, Bin",
title="Investigating the Trajectories of Poor Vision in Children and Adolescents in Wuhan, China From 2016 to 2019: Prospective Cohort Study",
journal="JMIR Public Health Surveill",
year="2025",
month="Feb",
day="18",
volume="11",
pages="e53028",
keywords="children and adolescents",
keywords="poor vision",
keywords="group-based trajectory model",
keywords="myopia",
keywords="gender difference",
keywords="China",
keywords="normal vision group",
keywords="vision decline group",
keywords="moderate poor vision group",
keywords="prevalence",
abstract="Background: Poor vision is a challenging public health problem among children and adolescents globally and in China. It is well-recognized that early onset of poor vision and progressing to moderate and severe poor vision will increase the risk of irreversible blinding complications. To achieve the national goal of poor vision control and prevention, it is essential to investigate and understand the development of poor vision among children and adolescents in China. Objective: This study aims to investigate the progression of poor vision among children and adolescents in Wuhan, China, based on a prospective cohort and to provide scientific evidence for the development and implementation of effective poor vision prevention and control programs. Methods: Data were derived from a 4-year prospective cohort (2016?2019) of primary and middle school students (N=108,585) in Wuhan, China. Vision condition was measured using the standard logarithmic visual acuity charts. A group-based trajectory model was used to identify trajectories of poor vision overall and by gender and region. Results: The mean age of the study subjects was 11.13 (SD 3.33) years, 200,110 (53.91\%) were male and the majority (354404, 95.48\%) were from urban areas. The prevalence of poor vision was 58.51\% in 2016, 58.95\% in 2017, 53.83\% in 2018, and 54.79\% in 2019. Group-based trajectory model identified 3 groups, including normal vision group (NVG) (27.4\%), vision decline group (VDG) (17.8\%), and moderate poor vision group (MPVG) (54.8\%). A higher proportion of girls (57.8\%) were in the MPV group compared to boys (50.5\%), and the VDG showed greater changes in girls compared to boys. Furthermore, urban students (55.3\%) had a higher proportion of MPV compared to rural students (47.5\%), while urban students (17.2\%) had a smaller proportion in the VDG compared to rural students (24\%). Further analyses showed that as age increased, the likelihood of being categorized in the NVG decreased ($\beta$=?.417, P<.001), while the likelihood of being in the VDG ($\beta$=.058, P<.001) increased. Compared with boys, girls were more likely to be categorized in the VDG ($\beta$=.597, P<.001) and MPV group ($\beta$=.362, P<.001). Rural students were less likely than urban students to be categorized in the VDG ($\beta$=?.311, P<.001). Conclusions: The prevalence of poor vision among children and adolescents in Wuhan has remained high over the years, with a slight decrease in recent years. The study identified three groups: normal vision, vision decline, and moderate poor vision. Girls and students from urban areas were more likely to have moderate poor vision, while boys and rural students had a higher proportion of vision decline. These findings provide valuable information for implementing poor vision prevention and control policies in the region. ",
doi="10.2196/53028",
url="https://publichealth.jmir.org/2025/1/e53028"
}


@Article{info:doi/10.2196/64561,
author="Sablewski, Armin
and Eimer, Christine
and Nemeth, Marcus
and Miller, Clemens",
title="Preoperative Anxiety Management Practices in Pediatric Anesthesia: Comparative Analysis of an Online Survey Presented to Experts and Social Media Users",
journal="JMIR Pediatr Parent",
year="2025",
month="Jan",
day="27",
volume="8",
pages="e64561",
keywords="pediatric anesthesia",
keywords="pharmacological interventions",
keywords="nonpharmacological interventions",
keywords="preoperative",
keywords="anxiety",
keywords="anxiety management",
keywords="practices",
keywords="anesthesia",
keywords="comparative analysis",
keywords="online survey",
keywords="preoperative anxiety",
keywords="challenges",
keywords="postoperative outcome",
keywords="pediatric",
keywords="infant",
keywords="baby",
keywords="neonatal",
keywords="toddler",
keywords="child",
keywords="social media",
keywords="survey",
keywords="anesthesia provider",
abstract="Background: Managing preoperative anxiety in pediatric anesthesia is challenging, as it impacts patient cooperation and postoperative outcomes. Both pharmacological and nonpharmacological interventions are used to reduce children's anxiety levels. However, the optimal approach remains debated, with evidence-based guidelines still lacking. Health care professionals using social media as a source of medical expertise may offer insights into their management approaches. Objective: A public survey targeting health care professionals was disseminated via social media platforms to evaluate current practices in anxiety management in children. The same questions were posed during an annual meeting of pediatric anesthesiologists with their responses serving as reference. The primary objective was to compare pediatric anesthesia expertise between the groups, while secondary objectives focused on identifying similarities and differences in preoperative anxiety management strategies hypothesizing expertise differences between the groups. Methods: Two surveys were conducted. The first survey targeted 100 attendees of the German Scientific Working Group on Pediatric Anesthesia in June 2023 forming the ``Expert Group'' (EG). The second open survey was disseminated on social media using a snowball sampling approach, targeting followers of a pediatric anesthesia platform to form the ``Social Media Group'' (SG). The answers to the 24 questions were compared and statistically analyzed. Questions were grouped into 5 categories (pediatric anesthesia expertise, representativity, structural conditions, practices of pharmacological management, and practices in nonpharmacological management). Results: A total of 194 responses were analyzed (82 in EG and 112 in SG). The EG cohort exhibited significantly greater professional experience in pediatric anesthesia than the SG cohort (median 19 vs 10 y, P<.001), higher specialist status (97.6\% vs 64.6\%, P<.001), and a greater pediatric anesthesia volume (43.9\% vs 12\% with more than 500 cases per year, P<.001). Regarding the representativity, 2 items out of 4 were statistically significant (level of care of institution, annual caseload of institution). Regarding the overall anxiety management practices used, there is a heterogeneous response pattern within both groups. Conclusions: Despite heterogeneous approaches, health care professionals using social media demonstrated less expertise in pediatric anesthesia but showed minimal differences in the daily management of preoperative anxiety compared with pediatric anesthesia experts. Our study highlights the potential for meaningful use of social media but future studies should explore the impact of social media health care professionals' knowledge in other specific topics. Additionally, regarding preoperative anxiety, further recommendations are needed that could help to standardize and improve anxiety levels in children. ",
doi="10.2196/64561",
url="https://pediatrics.jmir.org/2025/1/e64561"
}


@Article{info:doi/10.2196/63410,
author="Karupaiah, Tilakavati
and Rahman, Mahfuzur Shah Md
and Zhang, Juan
and Kumar, Naveen
and Jamiyan, Batjargal
and Pokharel, Kumar Raj
and Borazon, Quintana Elaine
and Thoradeniya, Tharanga
and Tho, Thi Nguyen Thi
and Mackay, Sally
and Kelly, Bridget
and Swinburn, Boyd
and Chinna, Karuthan
and Dashzeveg, Enkhmyagmar
and Ong, Rick Gild
and Narayanan, Sankara Sreelakshmi
and Sameeha, Jamil Mohd
and Uddin, Ahsan Mohammad
and Tang, Yuxiang
and Sharma, Kumar Naresh
and Pokharel, Rishav
and Rome, Christine Anna
and Wickramasinghe, Pujitha V.
and Huy, Thanh Phan",
title="Extent and Nature of Television Food and Nonalcoholic Beverage Marketing in 9 Asian Countries: Cross-Sectional Study Using a Harmonized Approach",
journal="JMIR Pediatr Parent",
year="2024",
month="Dec",
day="4",
volume="7",
pages="e63410",
keywords="children",
keywords="Asian food marketing",
keywords="television",
keywords="unhealthy food",
keywords="WHO nutrient profile model",
keywords="World Health Organization",
keywords="pediatrics",
keywords="commercial",
keywords="Asia",
keywords="unhealthy",
keywords="nutrition",
keywords="diet",
keywords="market",
keywords="advertisement",
keywords="food",
keywords="beverage",
keywords="consumption",
abstract="Background: Rising childhood obesity rates in Asia are adding risk for the future adult burden of obesity and noncommunicable diseases. Weak policies across most Asian countries enable unrestricted marketing of obesogenic foods and beverages to children. Television is the common medium for food marketing to reach this audience. Objective: This study aimed to assess the extent and nature of television food and nonalcoholic beverage marketing in 9 Asian countries (Bangladesh, China, India, Malaysia, Mongolia, Nepal, the Philippines, Sri Lanka, and Vietnam) with capacity building support from the International Network for Food and Obesity/Non-Communicable Disease Research, Monitoring and Action Support, who enabled harmonization of data collection method and content analyses. Methods: Advertised foods were categorized as permitted or not permitted based on the nutrient profile models established by the World Health Organization regional offices for South-East Asia (SEARO) and the World Health Organization regional offices for Western Pacific (WPRO). Overall rates of food advertisements (advertisements per hour per channel) and persuasive strategy use were analyzed along with comparisons between children's peak viewing time (PVT) and non-PVT. Results: Cross-country comparisons, irrespective of country income level, indicated that not permitted food advertising dominated children's popular television channels, especially during PVT with rates as per WPRO or SEARO criteria ranging from 2.40/2.29 (Malaysia) to 9.70/9.41 advertisements per hour per channel (the Philippines). Persuasive strategy rates were also comparatively higher during PVT. Sugar-sweetened beverages, sugar-containing solid foods, and high salt- and fat-containing snacks and fast foods were frequently advertised. Evaluation of the application of WPRO and SEARO nutrient profile models identified inconsistencies due to regional taste and cuisine variations across Asia. Conclusions: This study clearly showed that unhealthy food marketing through popular children's television channels is widely occurring in Asia and is a clear breach of child rights. Evidence outcomes will benefit advocacy toward stronger policy regulations to control unhealthy food marketing and strengthen strategies to promote a healthier food environment for Asia's children. ",
doi="10.2196/63410",
url="https://pediatrics.jmir.org/2024/1/e63410",
url="http://www.ncbi.nlm.nih.gov/pubmed/39630493"
}


@Article{info:doi/10.2196/59545,
author="Wallenborn, T. Jordyn
and Sinantha-Hu, Miley
and Ouipoulikoune, Vattahanaphone
and Kounnavong, Sengchanh
and Siengsounthone, Latsamy
and Probst-Hensch, Nicole
and Odermatt, Peter
and Sayasone, Somphou
and Fink, G{\"u}nther",
title="Vientiane Multigenerational Birth Cohort Project in Lao People's Democratic Republic: Protocol for Establishing a Longitudinal Multigenerational Birth Cohort to Promote Population Health",
journal="JMIR Res Protoc",
year="2024",
month="Nov",
day="27",
volume="13",
pages="e59545",
keywords="Lao PDR",
keywords="birth cohort",
keywords="growth and development",
keywords="mental health",
keywords="dementia",
keywords="exercise",
keywords="behavior",
keywords="aging",
keywords="intergenerational",
keywords="noncommunicable disease",
keywords="hypertension",
keywords="longitudinal cohort",
keywords="low- and middle-income countries",
keywords="maternal health",
keywords="pregnancy",
keywords="antenatal care",
keywords="peripartum",
keywords="postpartum",
keywords="child health",
keywords="infant health",
abstract="Background: Rapid global population growth and urbanization have led to an increase in urban populations in low- and middle-income countries. Although these urban areas have generally better health outcomes than lower-income rural areas, many environmental, social, and health challenges remain. Vientiane, the capital of Lao People's Democratic Republic (Lao PDR), has approximately 1.5 of the 7.5 million Laotian population (2022) and provides a unique opportunity to examine health outcomes among socioeconomically diverse populations in the rapidly urbanizing context of the country. Objective: The aim of the Vientiane multigenerational birth cohort (VITERBI) project is to (1) establish a multigenerational birth cohort in Vientiane capital, Lao PDR, which is representative of the local population, (2) serve as the basis for additional observational (ie, cross-sectional) and intervention studies that promote population health in Vientiane province, and (3) investigate the social, epidemiological, and medical problems of public health importance to Lao PDR. Methods: VITERBI is a prospective multigenerational birth cohort. The study population is structured around children born between July 1, 2022, and June 30, 2023, who reside in Chanthabuly, Sikhottabong, Sangthong, or Mayparkngum districts of Vientiane. Whenever possible, children and their mothers are enrolled during pregnancy; nonreported pregnancies are enrolled after birth. The cohort plans to enroll 3000 pregnant women and their children and the infants' fathers, grandparents, and great-grandparents for a total study population of approximately 13,000 individuals. Participants will be followed throughout the life course with a range of data collected, including demographics, behavior, diet, physical activity, physiology, neurodevelopment, health history, quality of life, environmental exposures, depression, anxiety, stress, resilience, household characteristics, obstetric history, birth outcomes, and various living and dementia scales for older adults. Biomarkers collected include height, weight, blood pressure, and hemoglobin levels. Currently, no statistical analyses are planned. Results: As of April 2024, this study has enrolled 3500 pregnant women and 4579 family members. Study participation is ongoing until May 2025 at minimum, with the goal to extend follow-up until 2050. Conclusions: The study cohort will be used as a basis for further observational (cross-sectional, longitudinal) and intervention studies. It also serves as a tool to investigate social, epidemiological, and medical problems of public health importance to Lao PDR, which will contribute to broader understanding of regional and international contexts. International Registered Report Identifier (IRRID): DERR1-10.2196/59545 ",
doi="10.2196/59545",
url="https://www.researchprotocols.org/2024/1/e59545"
}


@Article{info:doi/10.2196/54275,
author="Li, Huilun
and Lu, Zhaohui
and Zhang, Erliang
and Zhang, Jie
and Cui, Shuheng
and Takahashi, Masaki
and Xiang, Mi",
title="Meal Timing and Depression Among Chinese Children and Adolescents: Cross-Sectional Study",
journal="JMIR Public Health Surveill",
year="2024",
month="Oct",
day="23",
volume="10",
pages="e54275",
keywords="mental health",
keywords="meal timing",
keywords="chrononutrition",
keywords="depression",
keywords="mhealth",
keywords="meal time",
keywords="children",
keywords="adolescent",
keywords="cross-sectional study",
keywords="China",
keywords="schedule of meal",
keywords="metabolic disorder",
keywords="correlation",
keywords="survey",
keywords="breakfast skipping",
keywords="food intake",
keywords="daily eating",
keywords="analysis",
keywords="logistic regression",
abstract="Background: Depression in children and adolescents is a rising concern in China. Dietary behavior is a critical determinant of mental health. Meal timing, or the schedule of meal consumption, has been related to several metabolic disorders. However, the effect of meal timing on mental health is scarce, particularly in children and adolescents who are in a critical period of physical and psychological development. Objective: This research examined the relationship between meal timing and depression in children and adolescents in China. Methods: Children and adolescents from grades 1 to 9 were recruited from 16 districts in Shanghai, China, from January 3 to January 21, 2020. Ten schools attended the study. A survey was distributed to the students and their parents to collect demographic and health-related information. Depression was measured by the Children's Depression Inventory-Short Form. Breakfast consumption was analyzed as a binary outcome. Participants were defined as breakfast consumers if they never skipped breakfast during the week. They were otherwise defined as breakfast skippers if they skipped breakfast at least once per week. A similar categorization was applied to analyze food intake proximal to bed. Daily eating windows were calculated using the last food intake time frame---the first food intake time frame. Participants were classified into eating window groups of less than 10 hours, 10-12 hours, and more than 12 hours. A logistic regression model was used to compute the odds ratio (OR) and 95\% CI. Results: A total of 6874 participants were included in the analysis. Participants who skipped breakfast were associated with a 2.70 times higher occurrence of depression (OR 2.70, 95\% CI 2.24?3.26; P<.001). The prevalence of depression was 1.28 times higher in participants who ate before bed than in those who never ate before bed (OR 1.28, 95\% CI 1.08?1.50; P<.001). The occurrence of depression was 1.37 times higher if the eating time window was shorter than 10 hours (OR 1.37, 95\% CI 1.08?1.73; P=.009) and 1.23 times higher if the eating time window was longer than 12 hours (OR 1.23, 95\% CI 1.01?1.50; P=.004). The lowest occurrence of depression was observed at 11.5 hours. Subgroup analysis showed that such relationships remained significant in adolescents aged 10 years or older. In children, only skipping breakfast was associated with a higher odds of depression (OR 2.77, 95\% CI 1.94?3.96; P<.001). Conclusions: Breakfast skipping and eating before bed significantly increase the occurrence of depression. The optimal daily eating window to lower the occurrence of depression is 11.5 hours in children and adolescents. Daily eating windows longer than 12 hours or shorter than 10 hours are associated with an elevated occurrence of depression. Current findings advocate evidence-based dietary strategies to prevent and treat depression in children and adolescents. ",
doi="10.2196/54275",
url="https://publichealth.jmir.org/2024/1/e54275"
}


@Article{info:doi/10.2196/58085,
author="Conderino, Sarah
and Anthopolos, Rebecca
and Albrecht, S. Sandra
and Farley, M. Shannon
and Divers, Jasmin
and Titus, R. Andrea
and Thorpe, E. Lorna",
title="Addressing Information Biases Within Electronic Health Record Data to Improve the Examination of Epidemiologic Associations With Diabetes Prevalence Among Young Adults: Cross-Sectional Study",
journal="JMIR Med Inform",
year="2024",
month="Oct",
day="1",
volume="12",
pages="e58085",
keywords="information bias",
keywords="electronic health record",
keywords="EHR",
keywords="epidemiologic method",
keywords="confounding factor",
keywords="diabetes",
keywords="epidemiology",
keywords="young adult",
keywords="cross-sectional study",
keywords="risk factor",
keywords="asthma",
keywords="race",
keywords="ethnicity",
keywords="diabetic",
keywords="diabetic adult",
abstract="Background: Electronic health records (EHRs) are increasingly used for epidemiologic research to advance public health practice. However, key variables are susceptible to missing data or misclassification within EHRs, including demographic information or disease status, which could affect the estimation of disease prevalence or risk factor associations. Objective: In this paper, we applied methods from the literature on missing data and causal inference to assess whether we could mitigate information biases when estimating measures of association between potential risk factors and diabetes among a patient population of New York City young adults. Methods: We estimated the odds ratio (OR) for diabetes by race or ethnicity and asthma status using EHR data from NYU Langone Health. Methods from the missing data and causal inference literature were then applied to assess the ability to control for misclassification of health outcomes in the EHR data. We compared EHR-based associations with associations observed from 2 national health surveys, the Behavioral Risk Factor Surveillance System (BRFSS) and the National Health and Nutrition Examination Survey, representing traditional public health surveillance systems. Results: Observed EHR-based associations between race or ethnicity and diabetes were comparable to health survey-based estimates, but the association between asthma and diabetes was significantly overestimated (OREHR 3.01, 95\% CI 2.86-3.18 vs ORBRFSS 1.23, 95\% CI 1.09-1.40). Missing data and causal inference methods reduced information biases in these estimates, yielding relative differences from traditional estimates below 50\% (ORMissingData 1.79, 95\% CI 1.67-1.92 and ORCausal 1.42, 95\% CI 1.34-1.51). Conclusions: Findings suggest that without bias adjustment, EHR analyses may yield biased measures of association, driven in part by subgroup differences in health care use. However, applying missing data or causal inference frameworks can help control for and, importantly, characterize residual information biases in these estimates. ",
doi="10.2196/58085",
url="https://medinform.jmir.org/2024/1/e58085"
}


@Article{info:doi/10.2196/53361,
author="Li, Juntong
and Zhang, Runxi
and Lan, Guanghua
and Lin, Mei
and Tan, Shengkui
and Zhu, Qiuying
and Chen, Huanhuan
and Huang, Jinghua
and Ding, Dongni
and Li, Chunying
and Ruan, Yuhua
and Wang, Na",
title="The Distribution and Associated Factors of HIV/AIDS Among Youths in Guangxi, China, From 2014 to 2021: Bayesian Spatiotemporal Analysis",
journal="JMIR Public Health Surveill",
year="2024",
month="Sep",
day="27",
volume="10",
pages="e53361",
keywords="HIV/AIDS",
keywords="acquired immunodeficiency syndrome",
keywords="youth",
keywords="reported incidence",
keywords="Bayesian model",
keywords="spatiotemporal distribution",
abstract="Background: In recent years, the number of HIV/AIDS cases among youth has increased year by year around the world. A spatial and temporal analysis of these AIDS cases is necessary for the development of youth AIDS prevention and control policies. Objective: This study aimed to analyze the spatial and temporal distribution and associated factors of HIV/AIDS among youth in Guangxi as an example. Methods: The reported HIV/AIDS cases of youths aged 15?24 years in Guangxi from January 2014 to December 2021 were extracted from the Chinese Comprehensive Response Information Management System of HIV/AIDS. Data on population, economy, and health resources were obtained from the Guangxi Statistical Yearbook. The ArcGIS (version 10.8; ESRI Inc) software was used to describe the spatial distribution of AIDS incidence among youths in Guangxi. A Bayesian spatiotemporal model was used to analyze the distribution and associated factors of HIV/AIDS, such as gross domestic product per capita, population density, number of health technicians, and road mileage per unit area. Results: From 2014 to 2021, a total of 4638 cases of HIV/AIDS infection among youths were reported in Guangxi. The reported incidence of HIV/AIDS cases among youths in Guangxi increased from 9.13/100,000 in 2014 to 11.15/100,000 in 2019 and then plummeted to a low of 8.37/100,000 in 2020, followed by a small increase to 9.66/100,000 in 2021. The districts (counties) with relatively high HIV/AIDS prevalence among youths were Xixiangtang, Xingning, Qingxiu, Chengzhong, and Diecai. The reported incidence of HIV/AIDS among youths was negatively significantly associated with road mileage per unit area (km) at a posterior mean of ?0.510 (95\% CI ?0.818 to 0.209). It was positively associated with population density (100 persons) at a posterior mean of 0.025 (95\% CI 0.012?0.038), with the number of health technicians (100 persons) having a posterior mean of 0.007 (95\% CI 0.004?0.009). Conclusions: In Guangxi, current HIV and AIDS prevention and control among young people should focus on areas with a high risk of disease. It is suggested to strengthen the allocation of AIDS health resources and balance urban development and AIDS prevention. In addition, AIDS awareness, detection, and intervention among Guangxi youths need to be strengthened. ",
doi="10.2196/53361",
url="https://publichealth.jmir.org/2024/1/e53361"
}


@Article{info:doi/10.2196/60319,
author="Gribbin, William
and Dejonge, Peter
and Rodseth, Jakob
and Hashikawa, Andrew",
title="Advancing Public Health Surveillance in Child Care Centers: Stakeholder-Informed Redesign and User Satisfaction Evaluation of the MCRISP Network",
journal="JMIR Public Health Surveill",
year="2024",
month="Sep",
day="24",
volume="10",
pages="e60319",
keywords="public health",
keywords="disease surveillance",
keywords="data collection",
keywords="dashboard",
keywords="child care",
keywords="child",
keywords="children",
keywords="care center",
keywords="user satisfaction",
keywords="ill",
keywords="illness",
keywords="transmission",
keywords="tracking",
keywords="tracker",
keywords="COVID-19",
keywords="SARS-CoV-2",
keywords="pandemic",
keywords="disease monitoring",
keywords="technology",
keywords="respiratory",
keywords="gastrointestinal",
keywords="user-centered design",
keywords="infectious disease",
keywords="visualization",
doi="10.2196/60319",
url="https://publichealth.jmir.org/2024/1/e60319"
}


@Article{info:doi/10.2196/60330,
author="Wang, Xiaoling
and Rao, Rui
and Li, Hua
and Lei, Xiaoping
and Dong, Wenbin",
title="Red Blood Cell Transfusion for Incidence of Retinopathy of Prematurity: Prospective Multicenter Cohort Study",
journal="JMIR Pediatr Parent",
year="2024",
month="Sep",
day="18",
volume="7",
pages="e60330",
keywords="red blood cell transfusion",
keywords="retinopathy of prematurity",
keywords="VPI",
keywords="very preterm infants",
keywords="ROP",
keywords="visual impairment",
keywords="blindness",
keywords="RBC",
keywords="red blood cell",
abstract="Background: Retinopathy of prematurity (ROP) is a leading cause of visual impairment and blindness in preterm infants. Objective: This study sought to investigate the association between red blood cell (RBC) transfusion and ROP in very preterm infants (VPIs) to inform clinical strategies for ROP prevention and treatment. Methods: We designed a prospective multicenter cohort study that included VPIs and follow-up data from January 2017 to December 2022 at 3 neonatal clinical medicine centers. They were categorized into a transfusion group (infants who received an RBC transfusion within 4 wk) and a nontransfusion group. The relationship between RBC transfusion and ROP incidence was assessed using binary logistic regression, with subgroup analyses based on gestational age, birth weight, sex, and sepsis status. Inverse probability of treatment weighting and propensity score matching were applied to account for all potential confounding factors that could affect ROP development, followed by sensitivity analysis. Results: The study included 832 VPIs, including 327 in the nontransfusion group and 505 in the transfusion group. The transfusion group had a lower average birth weight and gestational age and a greater incidence of ROP, ?stage 2 ROP, and severe ROP. Logistic regression analysis revealed that the transfusion group had a significantly greater risk of ROP (adjusted odds ratio [aOR] 1.70, 95\% CI 1.14?2.53, P=.009) and ?stage 2 ROP (aOR 1.68, 95\% CI 1.02?2.78, P=.04) but not severe ROP (aOR 1.75, 95\% CI 0.61?5.02, P=.30). The trend analysis also revealed an increased risk of ROP with an increasing number of transfusions and a larger volume of blood transfused (P for trend<.001). Subgroup analyses confirmed a consistent trend, with the transfusion group at a higher risk for ROP across all subgroups. Inverse probability of treatment weighting and propensity score matching analyses supported the initial findings. Conclusions: For VPIs, RBC transfusion significantly increases the risk of ROP, and the risk increases with an increasing number of transfusions and volume of blood transfused. ",
doi="10.2196/60330",
url="https://pediatrics.jmir.org/2024/1/e60330"
}


@Article{info:doi/10.2196/60039,
author="Bergh, Eric
and Rennie, Kimberly
and Espinoza, Jimmy
and Johnson, Anthony
and Papanna, Ramesha",
title="Use of Web-Based Surveys to Collect Long-Term Pediatric Outcomes in Patients With Twin-Twin Transfusion Syndrome Treated With Fetoscopic Laser Photocoagulation: Observational Study",
journal="JMIR Pediatr Parent",
year="2024",
month="Sep",
day="11",
volume="7",
pages="e60039",
keywords="automation",
keywords="REDCap",
keywords="data collection",
keywords="reporting",
keywords="response rate",
keywords="response rates",
keywords="survey",
keywords="surveys",
keywords="questionnaire",
keywords="questionnaires",
keywords="fetal medicine",
keywords="pediatric outcomes",
keywords="long-term outcomes",
keywords="photocoagulation",
keywords="twin",
keywords="twins",
keywords="blood",
keywords="pregnant",
keywords="pregnancy",
keywords="pediatric",
keywords="pediatrics",
keywords="infant",
keywords="infants",
keywords="infancy",
keywords="baby",
keywords="babies",
keywords="neonate",
keywords="neonates",
keywords="neonatal",
keywords="newborn",
keywords="newborns",
keywords="maternal",
keywords="in utero",
keywords="TTTS",
keywords="fetus",
keywords="fetal",
keywords="twin-twin transfusion syndrome",
abstract="Background: In the United States, patients with monochorionic diamniotic twins who undergo in utero fetoscopic laser photocoagulation (FLP) for twin-twin transfusion syndrome (TTTS) may travel great distances for care. After delivery, many parents cannot return to study sites for formal pediatric evaluation due to geographic location and cost. Objective: The aim of this study was to collect long-term pediatric outcomes in patients who underwent FLP for TTTS. Methods: We assessed the feasibility of using a web-based survey designed in REDCap (Research Electronic Data Capture; Vanderbilt University) to collect parent-reported outcomes in children treated for TTTS at a single center during 2011?2019. Patients with ?1 neonatal survivor were invited via email to complete 5 possible questionnaires: the child status questionnaire (CSQ); fetal center questionnaire (FCQ); Ages \& Stages Questionnaires, Third Edition (ASQ-3); Modified Checklist for Autism in Toddlers, Revised With Follow-Up (M-CHAT-R/F); and thank you questionnaire (TYQ). The R programming language (R Foundation for Statistical Computing) was used to automate survey distribution, scoring, and creation of customized reports. The survey was performed in 2019 and repeated after 12 months in the same study population in 2020. Results: A total of 389 patients in 26 different states and 2 international locations had an email address on file and received an invitation in 2019 to complete the survey (median pediatric age 48.9, IQR 1.0?93.6 months). Among surveyed mothers in 2019, the overall response rate was 37.3\% (145/389), and the questionnaire completion rate was 98\% (145/148), 87.8\% (130/148), 71.1\% (81/100), 86.4\% (19/22), and 74.3\% (110/148) for the CSQ, FCQ, ASQ-3, M-CHAT-R/F, and TYQ, respectively. In 2020, the overall response rate was 57.8\% (56/97), and the questionnaire completion rate was 96.4\% (54/56), 91.1\% (51/56), 86.1\% (31/36), 91.7\% (11/12), and 80.4\% (45/56) for the CSQ, FCQ, ASQ-3, M-CHAT-R/F, and TYQ, respectively. Conclusions: This is the first study to use both REDCap and computer automation to aid in the dissemination, collection, and reporting of surveys to collect long-term pediatric outcomes in the field of fetal medicine. ",
doi="10.2196/60039",
url="https://pediatrics.jmir.org/2024/1/e60039"
}


@Article{info:doi/10.2196/57340,
author="Jimenez-Garcia, Rodrigo
and Lopez-de-Andres, Ana
and Hernandez-Barrera, Valentin
and Zamorano-Leon, J. Jose
and Cuadrado-Corrales, Natividad
and de Miguel-Diez, Javier
and del-Barrio, L. Jose
and Jimenez-Sierra, Ana
and Carabantes-Alarcon, David",
title="Hospitalizations for Food-Induced Anaphylaxis Between 2016 and 2021: Population-Based Epidemiologic Study",
journal="JMIR Public Health Surveill",
year="2024",
month="Aug",
day="27",
volume="10",
pages="e57340",
keywords="food-induced anaphylaxis",
keywords="epidemiology",
keywords="hospitalizations",
keywords="in-hospital mortality",
abstract="Background: Food-induced anaphylaxis (FIA) is a major public health problem resulting in serious clinical complications, emergency department visits, hospitalization, and death. Objective: This study aims to assess the epidemiology and the trends in hospitalizations because of FIA in Spain between 2016 and 2021. Methods: An observational descriptive study was conducted using data from the Spanish National Hospital discharge database. Information was coded based on the International Classification of Diseases, Tenth Revision. The study population was analyzed by gender and age group and according to food triggers, clinical characteristics, admission to the intensive care unit, severity, and in-hospital mortality. The annual incidence of hospitalizations because of FIA per 100,000 person-years was estimated and analyzed using Poisson regression models. Multivariable logistic regression models were constructed to identify which variables were associated with severe FIA. Results: A total of 2161 hospital admissions for FIA were recorded in Spain from 2016 to 2021. The overall incidence rate was 0.77 cases per 100,000 person-years. The highest incidence was found in those aged <15 years (3.68), with lower figures among those aged 15 to 59 years (0.25) and ?60 years (0.29). Poisson regression showed a significant increase in incidence from 2016 to 2021 only among children (3.78 per 100,000 person-years vs 5.02 per 100,000 person-years; P=.04). The most frequent food triggers were ``milk and dairy products'' (419/2161, 19.39\% of cases) and ``peanuts or tree nuts and seeds'' (409/2161, 18.93\%). Of the 2161 patients, 256 (11.85\%) were hospitalized because FIA required admission to the intensive care unit, and 11 (0.51\%) patients died in the hospital. Among children, the most severe cases of FIA appeared in patients aged 0 to 4 years (40/99, 40\%). Among adults, 69.4\% (111/160) of cases occurred in those aged 15 to 59 years. Multivariable logistic regression showed the variables associated with severe FIA to be age 15 to 59 years (odds ratio 5.1, 95\% CI 3.11-8.36), age ?60 years (odds ratio 3.87, 95\% CI 1.99-7.53), and asthma (odds ratio 1.71,95\% CI 1.12-2.58). Conclusions: In Spain, the incidence of hospitalization because of FIA increased slightly, although the only significant increase (P=.04) was among children. Even if in-hospital mortality remains low and stable, the proportion of severe cases is high and has not improved from 2016 to 2021, with older age and asthma being risk factors for severity. Surveillance must be improved, and preventive strategies must be implemented to reduce the burden of FIA. ",
doi="10.2196/57340",
url="https://publichealth.jmir.org/2024/1/e57340",
url="http://www.ncbi.nlm.nih.gov/pubmed/38940759"
}


@Article{info:doi/10.2196/57584,
author="Motreff, Yvon
and Marillier, Maude
and Saoudi, Abdessattar
and Verdot, Charlotte
and Seconda, Louise
and Pognon, Damien
and Khireddine-Medouni, Imane
and Richard, Jean-Baptiste
and Kovess-Masfety, Viviane
and Delorme, Richard
and Decio, Valentina
and Perrine, Anne-Laure
and El Haddad, Maria
and Gallay, Anne
and Monnier-Besnard, St{\'e}phanie
and Regnault, Nolwenn
and ",
title="Implementation of a Novel Epidemiological Surveillance System for Children's Mental Health and Well-Being in France: Protocol for the National ``Enabee'' Cross-Sectional Study",
journal="JMIR Public Health Surveill",
year="2024",
month="Aug",
day="13",
volume="10",
pages="e57584",
keywords="child",
keywords="mental health",
keywords="epidemiological surveillance",
keywords="well-being",
abstract="Background: Children's mental health, including their well-being, is a major public health concern, as the burden of related disorders may last throughout one's life. Although epidemiological mental health surveillance systems for children and adolescents have been implemented in several countries, they are sorely lacking in France. Objective: This study aims to describe the first step of the implementation of a novel surveillance system in France called Enabee (Etude nationale sur le bien-{\^e}tre des enfants), which focuses on the issue of mental health in children. The system aims to (1) describe the temporal trends in the population-based prevalence of the main mental health disorders and well-being in children aged 3 to 11 years, (2) explore their major determinants, and (3) assess mental health care use by this population. To do this, Enabee will rely on results from a recurrent national cross-sectional homonymous study. This paper presents the protocol for the first edition of this study (called Enabee 2022), as well as initial results regarding participation. Methods: Enabee 2022 is a national cross-sectional study that was implemented in French schools in 2022. It used a probabilistic, multistage, stratified, and balanced sampling plan as follows: first, schools were randomly drawn and stratified according to the type of school. Up to 4 classes per school were then randomly drawn, and finally, all the pupils within each class were selected. The study covered children from preschool and kindergarten (aged 3 to 6 years, US grading system) to fifth grade (aged 6 to 11 years). Children from first to fifth grades provided a self-assessment of their mental health using 2 validated self-administered questionnaires: the Dominic Interactive (DI) and the KINDL. Parents and teachers completed a web-based questionnaire, including the Strengths and Difficulties Questionnaire. Parents also answered additional questions about their parenting attitudes; their own mental health; known social, economic, and environmental determinants of mental health in children; and their child's life habits. Health, education, and family stakeholders were involved in designing and implementing the study as part of a large consultation group. Results: Data were collected from May 2, 2022, to July 31, 2022, in 399 schools across metropolitan France. Teachers completed questionnaires for 5721 pupils in preschool and kindergarten and for 15,263 pupils from first to fifth grades. Parents completed questionnaires for 3785 children in preschool and kindergarten and for 9227 children from first to fifth grades. Finally, 15,206 children from first to fifth grades completed the self-administered questionnaire. Conclusions: Enabee 2022 constitutes the first milestone in the development of a novel national epidemiological surveillance system, paving the way for improved children's mental health policies in France. ",
doi="10.2196/57584",
url="https://publichealth.jmir.org/2024/1/e57584",
url="http://www.ncbi.nlm.nih.gov/pubmed/39137010"
}


@Article{info:doi/10.2196/41567,
author="Jain, Lovely
and Pradhan, Sreya
and Aggarwal, Arun
and Padhi, Kumar Bijaya
and Itumalla, Ramaiah
and Khatib, Nazli Mahalaqua
and Gaidhane, Shilpa
and Zahiruddin, Syed Quazi
and Santos, Guimar{\~a}es Celso Augusto
and AL-Mugheed, Khalid
and Alrahbeni, Tahani
and Kukreti, Neelima
and Satapathy, Prakasini
and Rustagi, Sarvesh
and Heidler, Petra
and Marzo, Rillera Roy",
title="Association of Child Growth Failure Indicators With Household Sanitation Practices in India (1998-2021): Spatiotemporal Observational Study",
journal="JMIR Public Health Surveill",
year="2024",
month="May",
day="24",
volume="10",
pages="e41567",
keywords="undernutrition",
keywords="malnutrition",
keywords="stunting",
keywords="wasting",
keywords="underweight",
keywords="sanitation",
keywords="WaSH",
keywords="LISA",
keywords="NFHS",
keywords="DHS",
keywords="spatial epidemiology",
keywords="epidemiology",
keywords="children",
keywords="child",
keywords="India",
keywords="intervention",
abstract="Background: Undernutrition among children younger than 5 years is a subtle indicator of a country's health and economic status. Despite substantial macroeconomic progress in India, undernutrition remains a significant burden with geographical variations, compounded by poor access to water, sanitation, and hygiene services. Objective: This study aimed to explore the spatial trends of child growth failure (CGF) indicators and their association with household sanitation practices in India. Methods: We used data from the Indian Demographic and Health Surveys spanning 1998-2021. District-level CGF indicators (stunting, wasting, and underweight) were cross-referenced with sanitation and sociodemographic characteristics. Global Moran I and Local Indicator of Spatial Association were used to detect spatial clustering of the indicators. Spatial regression models were used to evaluate the significant determinants of CGF indicators. Results: Our study showed a decreasing trend in stunting (44.9\%-38.4\%) and underweight (46.7\%-35.7\%) but an increasing prevalence of wasting (15.7\%-21.0\%) over 15 years. The positive values of Moran I between 1998 and 2021 indicate the presence of spatial autocorrelation. Geographic clustering was consistently observed in the states of Madhya Pradesh, Jharkhand, Odisha, Uttar Pradesh, Chhattisgarh, West Bengal, Rajasthan, Bihar, and Gujarat. Improved sanitation facilities, a higher wealth index, and advanced maternal education status showed a significant association in reducing stunting. Relative risk maps identified hotspots of CGF health outcomes, which could be targeted for future interventions. Conclusions: Despite numerous policies and programs, malnutrition remains a concern. Its multifaceted causes demand coordinated and sustained interventions that go above and beyond the usual. Identifying hotspot locations will aid in developing control methods for achieving objectives in target areas. ",
doi="10.2196/41567",
url="https://publichealth.jmir.org/2024/1/e41567",
url="http://www.ncbi.nlm.nih.gov/pubmed/38787607"
}


@Article{info:doi/10.2196/51429,
author="Matthes, J{\"o}rg
and Binder, Alice
and Naderer, Brigitte
and Forrai, Michaela
and Spielvogel, Ines
and Knupfer, Helena
and Saumer, Melanie",
title="Effects of Food Depictions in Entertainment Media on Children's Unhealthy Food Preferences: Content Analysis Linked With Panel Data",
journal="JMIR Pediatr Parent",
year="2024",
month="May",
day="22",
volume="7",
pages="e51429",
keywords="children",
keywords="health",
keywords="unhealthy food preferences",
keywords="food depictions",
keywords="centrality",
keywords="coviewing",
keywords="longitudinal linkage study",
keywords="child",
keywords="food",
keywords="eating",
keywords="diet",
keywords="dietary",
keywords="preference",
keywords="preferences",
keywords="nutrition",
keywords="nutritional",
keywords="media",
keywords="entertainment",
keywords="panel",
keywords="foods",
keywords="pediatric",
keywords="pediatrics",
keywords="food preference",
keywords="food preferences",
abstract="Background: Entertainment media content is often mentioned as one of the roots of children's unhealthy food consumption. This might be due to the high quantity of unhealthy foods presented in children's media environments. However, less is known about the role of the centrality of food placement, that is, whether foods are interacted with, consumed, verbally mentioned, or appear unobtrusively. We also lack longitudinal research measuring both children's unhealthy and healthy food consumption behaviors as outcomes. Objective: The aim is to connect content analytical data based on children's actual media diet with panel data in order to explain children's food preferences. Moreover, this study not only focuses on the amount of healthy and unhealthy foods children are exposed to, but also on how these foods are presented (ie, centrally or not). Furthermore, we looked at the question of how parental coviewing can diminish (or enhance) the effects of unhealthy (or healthy) food depictions, and we measured healthy and unhealthy consumption as dependent variables. Methods: We conducted a 2-wave panel study with children and one of their parents (of 2250 parents contacted, 829 responded, for a response rate of 36.84\%; 648 valid cases, ie, parent-child pairs, were used for analysis), with 6 months between the 2 panel waves. We linked the 2-wave panel data for the children and their parents to content analytical data for movies (n=113) and TV series (n=134; 3 randomly chosen episodes per TV series were used) that children were exposed to over the course of 6 months. Results: There was no significant relationship between exposure to unhealthy food presentation and unhealthy (b=0.008; P=.07) or healthy (b=?0.003; P=.57) food consumption over time. Also, healthy food presentation was unrelated to unhealthy (b=0.009; P=.18) or healthy (b=0.000; P=.99) food consumption over time. However, there was a significant, positive interaction between unhealthy food presentation and presentation centrality on unhealthy food consumption (b=0.000; P=.03), suggesting that the effects of unhealthy food presentation rise with increasing levels of centrality. There was no interaction between unhealthy food presentation and presentation centrality on the consumption of healthy foods (b=0.000; P=.10). Also, exposure to healthy food presentation interacted with centrality (b=?0.001; P=.003). That is, when a healthy product was presented at maximum centrality, it led to less unhealthy food consumption in children. Coviewing did not interact with exposure to unhealthy foods when explaining unhealthy (b=0.003; P=.08) or healthy (b=?0.001; P=.70) food consumption. Conclusions: We conclude that simply presenting more healthy foods is not sufficient to combat children's unhealthy food preferences. Further regulations may be necessary with respect to representations of unhealthy foods in children's media. ",
doi="10.2196/51429",
url="https://pediatrics.jmir.org/2024/1/e51429"
}


@Article{info:doi/10.2196/52456,
author="Tian, Fenglin
and Zhong, Xinqi
and Ye, Yufeng
and Liu, Xiaohan
and He, Guanhao
and Wu, Cuiling
and Chen, Zhiqing
and Zhu, Qijiong
and Yu, Siwen
and Fan, Jingjie
and Yao, Huan
and Ma, Wenjun
and Dong, Xiaomei
and Liu, Tao",
title="Mutual Associations of Exposure to Ambient Air Pollutants in the First 1000 Days of Life With Asthma/Wheezing in Children: Prospective Cohort Study in Guangzhou, China",
journal="JMIR Public Health Surveill",
year="2024",
month="Apr",
day="17",
volume="10",
pages="e52456",
keywords="pregnancy",
keywords="air pollution",
keywords="asthma",
keywords="wheezing",
keywords="birth cohort",
keywords="children",
abstract="Background: The first 1000 days of life, encompassing pregnancy and the first 2 years after birth, represent a critical period for human health development. Despite this significance, there has been limited research into the associations between mixed exposure to air pollutants during this period and the development of asthma/wheezing in children. Furthermore, the finer sensitivity window of exposure during this crucial developmental phase remains unclear. Objective: This study aims to assess the relationships between prenatal and postnatal exposures to various ambient air pollutants (particulate matter 2.5 [PM2.5], carbon monoxide [CO], sulfur dioxide [SO2], nitrogen dioxide [NO2], and ozone [O3]) and the incidence of childhood asthma/wheezing. In addition, we aimed to pinpoint the potential sensitivity window during which air pollution exerts its effects. Methods: We conducted a prospective birth cohort study wherein pregnant women were recruited during early pregnancy and followed up along with their children. Information regarding maternal and child characteristics was collected through questionnaires during each round of investigation. Diagnosis of asthma/wheezing was obtained from children's medical records. In addition, maternal and child exposures to air pollutants (PM2.5 CO, SO2, NO2, and O3) were evaluated using a spatiotemporal land use regression model. To estimate the mutual associations of exposure to mixed air pollutants with the risk of asthma/wheezing in children, we used the quantile g-computation model. Results: In our study cohort of 3725 children, 392 (10.52\%) were diagnosed with asthma/wheezing. After the follow-up period, the mean age of the children was 3.2 (SD 0.8) years, and a total of 14,982 person-years were successfully followed up for all study participants. We found that each quartile increase in exposure to mixed air pollutants (PM2.5, CO, SO2, NO2, and O3) during the second trimester of pregnancy was associated with an adjusted hazard ratio (HR) of 1.24 (95\% CI 1.04-1.47). Notably, CO made the largest positive contribution (64.28\%) to the mutual effect. After categorizing the exposure according to the embryonic respiratory development stages, we observed that each additional quartile of mixed exposure to air pollutants during the pseudoglandular and canalicular stages was associated with HRs of 1.24 (95\% CI 1.03-1.51) and 1.23 (95\% CI 1.01-1.51), respectively. Moreover, for the first year and first 2 years after birth, each quartile increment of exposure to mixed air pollutants was associated with HRs of 1.65 (95\% CI 1.30-2.10) and 2.53 (95\% CI 2.16-2.97), respectively. Notably, SO2 made the largest positive contribution in both phases, accounting for 50.30\% and 74.70\% of the association, respectively. Conclusions: Exposure to elevated levels of mixed air pollutants during the first 1000 days of life appears to elevate the risk of childhood asthma/wheezing. Specifically, the second trimester, especially during the pseudoglandular and canalicular stages, and the initial 2 years after birth emerge as crucial susceptibility windows. Trial Registration: Chinese Clinical Trial Registry ChiCTR-ROC-17013496; https://tinyurl.com/2ctufw8n ",
doi="10.2196/52456",
url="https://publichealth.jmir.org/2024/1/e52456",
url="http://www.ncbi.nlm.nih.gov/pubmed/38631029"
}


@Article{info:doi/10.2196/48060,
author="Rieckmann, Andreas
and Nielsen, Sebastian
and Dworzynski, Piotr
and Amini, Heresh
and Mogensen, Wengel S{\o}ren
and Silva, Bartolomeu Isaquel
and Chang, Y. Angela
and Arah, A. Onyebuchi
and Samek, Wojciech
and Rod, Hulvej Naja
and Ekstr{\o}m, Thorn Claus
and Benn, Stabell Christine
and Aaby, Peter
and Fisker, B{\ae}rent Ane",
title="Discovering Subgroups of Children With High Mortality in Urban Guinea-Bissau: Exploratory and Validation Cohort Study",
journal="JMIR Public Health Surveill",
year="2024",
month="Apr",
day="9",
volume="10",
pages="e48060",
keywords="child mortality",
keywords="causal discovery",
keywords="Guinea-Bissau",
keywords="inductive-deductive",
keywords="machine learning",
keywords="targeted preventive and risk-mitigating interventions",
abstract="Background: The decline in global child mortality is an important public health achievement, yet child mortality remains disproportionally high in many low-income countries like Guinea-Bissau. The persisting high mortality rates necessitate targeted research to identify vulnerable subgroups of children and formulate effective interventions. Objective: This study aimed to discover subgroups of children at an elevated risk of mortality in the urban setting of Bissau, Guinea-Bissau, West Africa. By identifying these groups, we intend to provide a foundation for developing targeted health interventions and inform public health policy. Methods: We used data from the health and demographic surveillance site, Bandim Health Project, covering 2003 to 2019. We identified baseline variables recorded before children reached the age of 6 weeks. The focus was on determining factors consistently linked with increased mortality up to the age of 3 years. Our multifaceted methodological approach incorporated spatial analysis for visualizing geographical variations in mortality risk, causally adjusted regression analysis to single out specific risk factors, and machine learning techniques for identifying clusters of multifactorial risk factors. To ensure robustness and validity, we divided the data set temporally, assessing the persistence of identified subgroups over different periods. The reassessment of mortality risk used the targeted maximum likelihood estimation (TMLE) method to achieve more robust causal modeling. Results: We analyzed data from 21,005 children. The mortality risk (6 weeks to 3 years of age) was 5.2\% (95\% CI 4.8\%-5.6\%) for children born between 2003 and 2011, and 2.9\% (95\% CI 2.5\%-3.3\%) for children born between 2012 and 2016. Our findings revealed 3 distinct high-risk subgroups with notably higher mortality rates, children residing in a specific urban area (adjusted mortality risk difference of 3.4\%, 95\% CI 0.3\%-6.5\%), children born to mothers with no prenatal consultations (adjusted mortality risk difference of 5.8\%, 95\% CI 2.6\%-8.9\%), and children from polygamous families born during the dry season (adjusted mortality risk difference of 1.7\%, 95\% CI 0.4\%-2.9\%). These subgroups, though small, showed a consistent pattern of higher mortality risk over time. Common social and economic factors were linked to a larger share of the total child deaths. Conclusions: The study's results underscore the need for targeted interventions to address the specific risks faced by these identified high-risk subgroups. These interventions should be designed to work to complement broader public health strategies, creating a comprehensive approach to reducing child mortality. We suggest future research that focuses on developing, testing, and comparing targeted intervention strategies unraveling the proposed hypotheses found in this study. The ultimate aim is to optimize health outcomes for all children in high-mortality settings, leveraging a strategic mix of targeted and general health interventions to address the varied needs of different child subgroups. ",
doi="10.2196/48060",
url="https://publichealth.jmir.org/2024/1/e48060",
url="http://www.ncbi.nlm.nih.gov/pubmed/38592761"
}


@Article{info:doi/10.2196/51581,
author="Lim, Heemoon
and Lee, Hyejung",
title="Eating Habits and Lifestyle Factors Related to Childhood Obesity Among Children Aged 5-6 Years: Cluster Analysis of Panel Survey Data in Korea",
journal="JMIR Public Health Surveill",
year="2024",
month="Apr",
day="5",
volume="10",
pages="e51581",
keywords="BMI",
keywords="body mass index",
keywords="childhood obesity",
keywords="cluster analysis",
keywords="healthy eating",
keywords="healthy lifestyle",
keywords="pediatric obesity",
keywords="preschool child",
keywords="prevention",
keywords="unsupervised machine learning",
abstract="Background: Childhood obesity has emerged as a major health issue due to the rapid growth in the prevalence of obesity among young children worldwide. Establishing healthy eating habits and lifestyles in early childhood may help children gain appropriate weight and further improve their health outcomes later in life. Objective: This study aims to classify clusters of young children according to their eating habits and identify the features of each cluster as they relate to childhood obesity. Methods: A total of 1280 children were selected from the Panel Study on Korean Children. Data on their eating habits (eating speed, mealtime regularity, consistency of food amount, and balanced eating), sleep hours per day, outdoor activity hours per day, and BMI were obtained. We performed a cluster analysis on the children's eating habits using k-means methods. We conducted ANOVA and chi-square analyses to identify differences in the children's BMI, sleep hours, physical activity, and the characteristics of their parents and family by cluster. Results: At both ages (ages 5 and 6 years), we identified 4 clusters based on the children's eating habits. Cluster 1 was characterized by a fast eating speed (fast eaters); cluster 2 by a slow eating speed (slow eaters); cluster 3 by irregular eating habits (poor eaters); and cluster 4 by a balanced diet, regular mealtimes, and consistent food amounts (healthy eaters). Slow eaters tended to have the lowest BMI (P<.001), and a low proportion had overweight and obesity at the age of 5 years (P=.03) and 1 year later (P=.005). There was a significant difference in sleep time (P=.01) and mother's education level (P=.03) at the age of 5 years. Moreover, there was a significant difference in sleep time (P=.03) and the father's education level (P=.02) at the age of 6 years. Conclusions: Efforts to establish healthy eating habits in early childhood may contribute to the prevention of obesity in children. Specifically, providing dietary guidance on a child's eating speed can help prevent childhood obesity. This research suggests that lifestyle modification could be a viable target to decrease the risk of childhood obesity and promote the development of healthy children. Additionally, we propose that future studies examine long-term changes in obesity resulting from lifestyle modifications in children from families with low educational levels. ",
doi="10.2196/51581",
url="https://publichealth.jmir.org/2024/1/e51581",
url="http://www.ncbi.nlm.nih.gov/pubmed/38578687"
}


@Article{info:doi/10.2196/29049,
author="Ennab, Farah
and ElSaban, Mariam
and Khalaf, Eman
and Tabatabaei, Hanieh
and Khamis, Hassan Amar
and Devi, Radha Bindu
and Hanif, Kashif
and Elhassan, Hiba
and Saravanan, Ketharanathan
and Cremonesini, David
and Popatia, Rizwana
and Malik, Zainab
and Ho, B. Samuel
and Abusamra, Rania",
title="Clinical Characteristics of Children With COVID-19 in the United Arab Emirates: Cross-sectional Multicenter Study",
journal="JMIR Pediatr Parent",
year="2021",
month="Nov",
day="5",
volume="4",
number="4",
pages="e29049",
keywords="pediatrics",
keywords="children",
keywords="COVID-19",
keywords="SARS-CoV-2",
keywords="United Arab Emirates",
keywords="viral shedding",
keywords="pandemic",
keywords="treatment",
keywords="outcomes",
keywords="clinical",
keywords="public heath",
abstract="Background: COVID-19 has infected over 123 million people globally. The first confirmed case in the United Arab Emirates (UAE)\thinspacewas reported on January 29, 2020. According to studies conducted in the early epicenters of the pandemic, COVID-19 has fared mildly in the pediatric population. To date, there is a lack of published data about COVID-19 infection among children in the Arabian region. Objective: This study aims to investigate the clinical characteristics, laboratory findings, treatment, and outcomes of children with COVID-19. Methods: This cross-sectional, multicenter study included children with confirmed COVID-19 infection admitted to 3 large hospitals in Dubai, UAE, between March 1 and June 15, 2020. Serial COVID-19 polymerase chain reaction (PCR) testing data were collected, and patients' demographics, premorbid clinical characteristics, and inpatient hospital courses were examined. Results: In all, 111 children were included in our study and represented 22 nationalities. Of these, 59 (53.2\%) were boys. The mean age of the participants was 7 (SD 5.3) years. About 15.3\% of children were younger than 1 year. Only 4 (3.6\%) of them had pre-existing asthma, all of whom had uneventful courses. At presentation, of the 111 children, 43 (38.7\%) were asymptomatic, 68 (61.2\%) had mild or moderate symptoms, and none (0\%) had severe illness requiring intensive care. Fever (23/111, 20.7\%), cough (22/111, 19.8\%), and rhinorrhea (17/111, 15.3\%) were the most common presenting symptoms, and most reported symptoms resolved by day 5 of hospitalization. Most patients had no abnormality on chest x-ray. The most common laboratory abnormalities on admission included variations in neutrophil count (22/111, 24.7\%), aspartate transaminase (18/111, 22.5\%), alkaline phosphatase (29/111, 36.7\%), and lactate dehydrogenase (31/111, 42.5\%). Children were infrequently prescribed targeted medications, with only 4 (3.6\%) receiving antibiotics. None of the 52 patients tested for viral coinfections were positive. COVID-19 PCR testing turned negative at a median of 10 days (IQR: 6-14) after the first positive test. Overall, there was no significant difference of time to negative PCR results between symptomatic and asymptomatic children. Conclusions: This study of COVID-19 presentations and characteristics presents a first look into the burden of COVID-19 infection in the pediatric population in the UAE. We conclude that a large percentage of children experienced no symptoms and that severe COVID-19 disease is uncommon in the UAE. Various laboratory abnormalities were observed despite clinical stability. Ongoing surveillance, contact tracing, and public health measures will be important to contain future outbreaks. ",
doi="10.2196/29049",
url="https://pediatrics.jmir.org/2021/4/e29049",
url="http://www.ncbi.nlm.nih.gov/pubmed/34643535"
}


@Article{info:doi/10.2196/27739,
author="Pinilla, T. Yudi
and Friessinger, Evelyn
and Griesbaum, Marie Johanna
and Berner, Lilith
and Heinzel, Constanze
and Elsner, K{\"a}the
and Fendel, Rolf
and Held, Jana
and Kreidenweiss, Andrea",
title="Prevalence of SARS-CoV-2 Infection in Children by Antibody Detection in Saliva: Protocol for a Prospective Longitudinal Study (Coro-Buddy)",
journal="JMIR Res Protoc",
year="2021",
month="Oct",
day="8",
volume="10",
number="10",
pages="e27739",
keywords="SARS-CoV-2",
keywords="COVID-19",
keywords="antibody",
keywords="saliva",
keywords="children",
keywords="epidemiology",
abstract="Background: The world has been confronted with the COVID-19 pandemic for more than one year. Severe disease is more often found among elderly people, whereas most young children and adolescents show mild symptoms or even remain asymptomatic, so that infection might be undiagnosed. Therefore, only limited epidemiological data on SARS-CoV-2 infection in children and young adults are available. Objective: This study aims to determine the prevalence of SARS-CoV-2 antibodies in children from the city of T{\"u}bingen, Germany, and to measure the incidence of new cases over 12 months. Methods: SARS-CoV-2 antibodies will be measured in saliva as a surrogate for a previous SARS-CoV-2 infection. Children will be sampled at their preschools, primary schools, and secondary schools at three time points: July 2020, October to December 2020, and April to July 2021. An adult cohort will be sampled at the same time points (ie, adult comparator group). The saliva-based SARS-CoV-2--antibody enzyme-linked immunosorbent assay will be validated using blood and saliva samples from adults with confirmed previous SARS-CoV-2 infections (ie, adult validation group). Results: The first study participant was enrolled in July 2020, and recruitment and enrollment continued until July 2021. We have recruited and enrolled 1850 children, 560 adults for the comparator group, and 83 adults for the validation group. We have collected samples from the children and the adults for the comparator group at the three time points. We followed up with participants in the adult validation group every 2 months and, as of the writing of this paper, we were at time point 7. We will conduct data analysis after the data collection period. Conclusions: Infection rates in children are commonly underreported due to a lack of polymerase chain reaction testing. This study will report on the prevalence of SARS-CoV-2 infections in infants, school children, and adolescents as well as the incidence change over 12 months in the city of T{\"u}bingen, Germany. The saliva sampling approach for SARS-CoV-2--antibody measurement allows for a unique, representative, population-based sample collection process. Trial Registration: ClinicalTrials.gov NCT04581889; https://clinicaltrials.gov/ct2/show/NCT04581889 International Registered Report Identifier (IRRID): DERR1-10.2196/27739 ",
doi="10.2196/27739",
url="https://www.researchprotocols.org/2021/10/e27739",
url="http://www.ncbi.nlm.nih.gov/pubmed/34533472"
}


@Article{info:doi/10.2196/28619,
author="Alsafadi, Danyah
and Ezzat, Aly
and Altamimi, Fatima
and ElBagoury, Marwan
and Olfat, Mohammed
and Saleh, Mohammed
and Roushdy, Sherif
and Aktham, Yahia",
title="Mucopolysaccharidosis Type I Disease Prevalence Among Patients With Idiopathic Short Stature in Saudi Arabia: Protocol for a Multicenter Cross-sectional Study",
journal="JMIR Res Protoc",
year="2021",
month="Aug",
day="31",
volume="10",
number="8",
pages="e28619",
keywords="mucopolysaccharidosis",
keywords="lysosomal storage disorders",
keywords="epidemiology",
keywords="Saudi Arabia",
abstract="Background: Since the underlying cause of idiopathic short stature can indeed be undiagnosed mucopolysaccharidosis type I, it is critical to identify patients with mucopolysaccharidosis type I among screened patients with idiopathic short stature. Objective: The primary objective of this study is to determine the prevalence of mucopolysaccharidosis type I disease in a high-risk group (ie, patients with idiopathic short stature). Methods: We plan to perform a multicenter, cross-sectional screening study to primarily assess the prevalence of mucopolysaccharidosis type I disease in patients with idiopathic short stature. All eligible patients will be tested after obtaining written informed consent from their parents and guardians. Eligible patients will be recruited over 18 months from specialty care centers for pediatrics and genetics. Results: This protocol was approved by the Institutional Review Board of King Fahd Medical City and funded by Sanofi Genzyme Saudi Arabia. We expect to collect data from ?800 patients, as determined by our sample size calculation. Conclusions: Saudi Arabia is the largest country in the Arabian Peninsula; it has a population of more than 28 million people. To date, there are no reliable data regarding the incidence and prevalence of mucopolysaccharidosis type I in Saudi Arabia; therefore, future multicenter studies will be needed. Further, the prevalence of an attenuated form of mucopolysaccharidosis type I is largely underestimated in Saudi Arabia due to the absence of an effective newborn screening program. Therefore, the implementation of a nationwide newborn screening program is essential for the accurate estimation of the burden of mucopolysaccharidosis and the early diagnosis of patients. International Registered Report Identifier (IRRID): PRR1-10.2196/28619 ",
doi="10.2196/28619",
url="https://www.researchprotocols.org/2021/8/e28619",
url="http://www.ncbi.nlm.nih.gov/pubmed/34463634"
}


@Article{info:doi/10.2196/27581,
author="Katayama, Yusuke
and Kiyohara, Kosuke
and Hirose, Tomoya
and Matsuyama, Tasuku
and Ishida, Kenichiro
and Nakao, Shunichiro
and Tachino, Jotaro
and Ojima, Masahiro
and Noda, Tomohiro
and Kiguchi, Takeyuki
and Hayashida, Sumito
and Kitamura, Tetsuhisa
and Mizobata, Yasumitsu
and Shimazu, Takeshi",
title="A Mobile App for Self-Triage for Pediatric Emergency Patients in Japan: 4 Year Descriptive Epidemiological Study",
journal="JMIR Pediatr Parent",
year="2021",
month="Jun",
day="30",
volume="4",
number="2",
pages="e27581",
keywords="emergency medicine",
keywords="self-triage",
keywords="mobile app",
keywords="children",
keywords="telemedicine",
keywords="app",
keywords="mobile health",
keywords="mHealth",
keywords="epidemiology",
abstract="Background: When children suffer sudden illness or injury, many parents wonder whether they should go to the hospital immediately or call an ambulance. In 2015, we developed a mobile app that allows parents or guardians to determine the urgency of their child's condition or call an ambulance and that indicates available hospitals and clinics when their child is suddenly sick or injured by simple selection of the child's chief complaints and symptoms. However, the effectiveness of medical apps used by the general public has not been well evaluated. Objective: The purpose of this study was to clarify the use profile of this mobile app based on data usage in the app. Methods: This study was a descriptive epidemiological study with a 4-year study period running from January 2016 to December 2019. We included cases in which the app was used either by the children themselves or by their parents and other guardians. Cases in which the app was downloaded but never actually used were excluded from this study. Continuous variables are presented as median and IQR, and categorical variables are presented as actual number and percentages. Results: The app was used during the study period for 59,375 children whose median age was 1 year (IQR 0-3 years). The app was used for 33,874 (57.05\%) infants, 16,228 (27.33\%) toddlers, 8102 (13.65\%) elementary school students, and 1117 (1.88\%) junior high school students, with 54 (0.09\%) having an unknown status. Furthermore, 31,519 (53.08\%) were male and 27,329 (46.03\%) were female, with sex being unknown for 527 (0.89\%) children. ``Sickness'' was chosen for 49,101 (78.51\%) patients, and ``injury, poisoning, foreign, substances and others'' was chosen for 13,441 (21.49\%). For ``sickness,'' ``fever'' was the most commonly selected option (22,773, 36.41\%), followed by ``cough'' (4054, 6.48\%), and ``nausea/vomiting'' (3528, 5.64\%), whereas for ``injury, poisoning, foreign substances and others,'' ``head and neck injury'' was the most commonly selected option (3887, 6.22\%), followed by ``face and extremities injury'' (1493, 2.39\%) and ``injury and foreign substances in eyes'' (1255, 2.01\%). Conclusions: This study clarified the profile of use of a self-triage app for pediatric emergency patients in Japan. ",
doi="10.2196/27581",
url="https://pediatrics.jmir.org/2021/2/e27581",
url="http://www.ncbi.nlm.nih.gov/pubmed/34255709"
}


@Article{info:doi/10.2196/22541,
author="Tate, Allan
and Trofholz, Amanda
and Miner, Michael
and Berge, Jerica",
title="Days Needed to Characterize the Healthfulness of a Typical Dinner Meal in Direct Observational Research: Mixed Methods Study",
journal="JMIR Pediatr Parent",
year="2021",
month="Mar",
day="24",
volume="4",
number="1",
pages="e22541",
keywords="meal healthfulness",
keywords="direct observation",
keywords="family meals",
keywords="well-being",
keywords="diet",
keywords="food",
abstract="Background: Prior research around the home meal environment has demonstrated that family meals are associated with positive health outcomes for children and adolescents. Researchers have begun using direct observational methods to understand key aspects of family meals such as meal healthfulness and family meal frequency to explain the protective nature of family meals. Direct observational research, however, can be resource intensive and also burdensome for participants. Information about the number of days needed to sufficiently characterize typical meal healthfulness using direct observational research methods is needed. Objective: The current study aimed to produce guidance about the number of meals necessary to approximate typical meal healthfulness at the family dinner meal occasion in a direct observational, mixed methods study of the home food environment. Methods: Families were recruited between 2012-2013 from primary care clinics in the Minneapolis--St Paul metropolitan area (N=120). A total of 800 meals were collected as part of the Family Meals LIVE! mixed methods study. The Healthfulness of Meal Index was used to evaluate meal dietary healthfulness of foods served at 8 family meal occasions. Participating families were provided an iPad (Apple Inc) and asked to video-record 8 consecutive days of family dinner meals with a minimum of two weekend meals. After the meal, families completed a meal screener, which is a self-reported, open-ended measure of the foods served at the meal. Results: Weekend and weekday meals differed in their measurement of meal healthfulness, indicating that at least one weekday and one weekend day are necessary to approximate meal healthfulness. Single-day measurement mischaracterized the strength of the relationship between the quality of what was served and intake by almost 50\%, and 3 to 4 observation days were sufficient to characterize typical weekly meal healthfulness (r=0.94; P<.001). Conclusions: Relatively few direct observational days of family meals data appear to be needed to approximate the healthfulness of meals across 1 week. Specifically, 1 weekday and 1 weekend observation are needed, including a total of 3 to 4 days of direct observational meal data. These findings may inform future direct observational study designs to reduce both research costs and participant burden in assessing features of the meal environment. ",
doi="10.2196/22541",
url="https://pediatrics.jmir.org/2021/1/e22541",
url="http://www.ncbi.nlm.nih.gov/pubmed/33759788"
}


@Article{info:doi/10.2196/21851,
author="Calaminus, Gabriele
and Baust, Katja
and Berger, Claire
and Byrne, Julianne
and Binder, Harald
and Casagranda, Leonie
and Grabow, Desiree
and Grootenhuis, Martha
and Kaatsch, Peter
and Kaiser, Melanie
and Kepak, Tomas
and Kep{\'a}kov{\'a}, Kate?ina
and Kremer, M. Leontien C.
and Kruseova, Jarmila
and Luks, Ales
and Spix, Claudia
and van den Berg, Marleen
and van den Heuvel-Eibrink, M. Marry M.
and van Dulmen-den Broeder, Eline
and Kuonen, Rahel
and Sommer, Grit
and Kuehni, Claudia",
title="Health-Related Quality of Life in European Childhood Cancer Survivors: Protocol for a Study Within PanCareLIFE",
journal="JMIR Res Protoc",
year="2021",
month="Jan",
day="25",
volume="10",
number="1",
pages="e21851",
keywords="children",
keywords="adolescents",
keywords="neoplasms",
keywords="quality of life",
keywords="health status",
keywords="Europe",
keywords="epidemiology",
keywords="survivors of childhood cancer",
abstract="Background: Survival after childhood cancer has improved to more than 80\% during the last few years, leading to an increased number of childhood cancer survivors. Cancer itself, or its treatment, may cause chronic health conditions, including somatic and mental sequelae, which may affect survivors' health-related quality of life (HRQoL). Objective: The project PanCareLIFE aims to establish a large database with comprehensive data on childhood cancer survivors from different European countries, including data on HRQoL. Within PanCareLIFE, this study aims to describe HRQoL in survivors, investigate predictors of HRQoL, and describe the association of HRQoL with hearing and female fertility impairment. This paper describes the design of the HRQoL study, the origin of data, strategies for data collection, and sampling characteristics of survivors from each contributing country. Methods: A total of 6 institutions from 5 European countries (the Czech Republic, France, Germany, the Netherlands, and Switzerland) provided data on HRQoL assessed with the Short Form 36 and on relevant predictors. The central PanCareLIFE data center aggregated the data and harmonized the variables between the institutions. Survivors were eligible if they received a diagnosis of cancer according to the 12 main groups of the International Classification of Childhood Cancer, 3rd edition, or Langerhans cell histiocytosis; were aged ?18 years at the time of diagnosis; were residents of the respective country at the time of diagnosis; had survived ?5 years after cancer diagnosis; were aged ?18 years at the time of the questionnaire survey; and did not refuse to registration in the national or local childhood cancer cohort. Results: We identified 24,993 eligible survivors. Of those, 19,268 survivors received a questionnaire and 9871 survivors participated, resulting in response rates of 9871/24,993 (39.50\%) of eligible survivors and of 9871/19,268 (51.23\%) invited survivors. Most participants were diagnosed with cancer between the ages of 10 and 14 years (3448/9871, 34.93\%) or <5 years (3201/9871, 32.43\%). The median age was 8 years. Of the 9871 participants, 3157 (31.97\%) were survivors of leukemia, 2075 (21.02\%) lymphoma, and 1356 (13.7\%) central nervous system (CNS) tumors. Most participants (9225/9871, 93.46\%) had no history of a subsequent tumor; 77.45\% (7645/9871) received chemotherapy with or without other treatments. More than half (5460/9871, 55.31\%) were aged 25 to 34 years at the time of the HRQoL study. Participating survivors differed from nonparticipants; participants were more often women, survivors of leukemia or lymphoma, and less frequently, survivors of CNS tumors than nonparticipants. Conclusions: PanCareLIFE successfully assessed HRQoL and its predictors in 9871 European survivors of childhood cancer. This large population will permit detailed investigations of HRQoL after childhood cancer, particularly the impact of hearing and female fertility impairment on HRQoL. International Registered Report Identifier (IRRID): RR1-10.2196/21851 ",
doi="10.2196/21851",
url="http://www.researchprotocols.org/2021/1/e21851/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33492237"
}


@Article{info:doi/10.2196/10320,
author="Quick, Virginia",
title="Clustering of Obesity-Related Risk Behaviors Among Families With Preschool Children Using a Socioecological Approach: Cross-Sectional Study",
journal="JMIR Pediatr Parent",
year="2018",
month="Apr",
day="25",
volume="1",
number="1",
pages="e10320",
keywords="obesity",
keywords="family",
keywords="preschool children",
keywords="socioecological",
keywords="risk factors",
keywords="environment",
keywords="home",
keywords="physical activity",
keywords="screen time",
abstract="Background: Limited attention has been given to assessing home environments of parents with preschool-aged children using a socioecological approach to better understand potential influencers of obesity risk. Objective: The purpose of this cross-sectional study was to examine the clustering of obesity-related risk behaviors among mothers with preschool children. Methods: Mothers with preschool-aged children (ages 2 to 5 years) who participated in the online Home Obesogenic Measure of Environments (HOMES) survey were examined in clustering of four healthy recommended behaviors (ie, mother's fruit and vegetable intake ?5 per day, sedentary screen time <4 hours per day, sugar-sweetened beverage intake <1 time/day, and increased physical activity level). Frequencies and percents of the clustering variables were conducted along with Spearman rank order correlations to determine significant associations. Ward's method with squared Euclidean distances were performed for the cluster analysis using the four standardized continuous variables. Identification of total cluster number was determined by visually inspecting the dendogram. Sociodemographic, intrapersonal, social environment, and home physical environment characteristic differences between cluster groups were further examined by independent t tests and chi-square analysis to validate findings. Results: Of the 496 participants (72.6\%, 360/496 white; age mean 32.36, SD 5.68 years), only a third (37.1\%, 184/496) consumed five or more servings of fruits/vegetables daily, had low sedentary screen time of <4 hours/day, and reported moderate to high levels of physical activity (34.1\%, 169/496). More than half (57.7\%, 286/496) consumed <1 sugar-sweetened beverage serving daily. A positive correlation (r=.34, P<.001) between physical activity level and fruit/vegetable intake (?5 servings/day), and a positive correlation (r=.15, P=.001) between low sedentary screen time (<4 hours/day) and low sugar-sweetened beverage intake (<1 serving/day) were found. Ward's hierarchical analysis revealed a two-cluster solution: less healthy/inactive moms (n=280) and health conscious/active moms (n=216). Health conscious/active moms were significantly (P<.010) likely to be more physically active, have lower sedentary screen time, lower daily intake of sugar-sweetened beverages, and greater daily intake of fruits and vegetables compared to less healthy/inactive moms. Less healthy/inactive moms were significantly more likely to have a higher body mass index and waist circumference compared to the other cluster; however, there were no significant sociodemographic differences. There were many intrapersonal (eg, importance of physical activity for child and self) and home physical environment (eg, home availability of fruits/vegetables and salty/fatty snacks) characteristic differences between clusters, but few significant differences emerged for social environment characteristics (eg, family meals, family cohesion). Conclusions: Findings may have implications in tailoring future obesity prevention interventions among families with young children. ",
doi="10.2196/10320",
url="http://pediatrics.jmir.org/2018/1/e10320/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31518289"
}


@Article{info:doi/10.2196/jmir.7802,
author="Mauz, Elvira
and Hoffmann, Robert
and Houben, Robin
and Krause, Laura
and Kamtsiuris, Panagiotis
and G{\"o}{\ss}wald, Antje",
title="Mode Equivalence of Health Indicators Between Data Collection Modes and Mixed-Mode Survey Designs in Population-Based Health Interview Surveys for Children and Adolescents: Methodological Study",
journal="J Med Internet Res",
year="2018",
month="Mar",
day="05",
volume="20",
number="3",
pages="e64",
keywords="public health",
keywords="child and adolescent health",
keywords="health surveys",
keywords="survey methods",
keywords="mixed-mode survey",
keywords="paper-and-pencil questionnaire",
keywords="online questionnaire",
keywords="mode effects",
abstract="Background: The implementation of an Internet option in an existing public health interview survey using a mixed-mode design is attractive because of lower costs and faster data availability. Additionally, mixed-mode surveys can increase response rates and improve sample composition. However, mixed-mode designs can increase the risk of measurement error (mode effects). Objective: This study aimed to determine whether the prevalence rates or mean values of self- and parent-reported health indicators for children and adolescents aged 0-17 years differ between self-administered paper-based questionnaires (SAQ-paper) and self-administered Web-based questionnaires (SAQ-Web), as well as between a single-mode control group and different mixed-mode groups. Methods: Data were collected for a methodological pilot of the third wave of the ``German Health Interview and Examination Survey for Children and Adolescents''. Questionnaires were completed by parents or adolescents. A population-based sample of 11,140 children and adolescents aged 0-17 years was randomly allocated to 4 survey designs---a single-mode control group with paper-and-pencil questionnaires only (n=970 parents, n=343 adolescents)---and 3 mixed-mode designs, all of which offered Web-based questionnaire options. In the concurrent mixed-mode design, both questionnaires were offered at the same time (n=946 parents, n=290 adolescents); in the sequential mixed-mode design, the SAQ-Web was sent first, followed by the paper questionnaire along with a reminder (n=854 parents, n=269 adolescents); and in the preselect mixed-mode design, both options were offered and the respondents were asked to request the desired type of questionnaire (n=698 parents, n=292 adolescents). In total, 3468 questionnaires of parents of children aged 0-17 years (SAQ-Web: n=708; SAQ-paper: n=2760) and 1194 questionnaires of adolescents aged 11-17 years (SAQ-Web: n=299; SAQ-paper: n=895) were analyzed. Sociodemographic characteristics and a broad range of health indicators for children and adolescents were compared by survey design and data collection mode by calculating predictive margins from regression models. Results: There were no statistically significant differences in sociodemographic characteristics or health indicators between the single-mode control group and any of the mixed-mode survey designs. Differences in sociodemographic characteristics between SAQ-Web and SAQ-paper were found. Web respondents were more likely to be male, have higher levels of education, and higher household income compared with paper respondents. After adjusting for sociodemographic characteristics, only one of the 38 analyzed health indicators showed different prevalence rates between the data collection modes, with a higher prevalence rate for lifetime alcohol consumption among the online-responding adolescents (P<.001). Conclusions: These results suggest that mode bias is limited in health interview surveys for children and adolescents using a mixed-mode design with Web-based and paper questionnaires. ",
doi="10.2196/jmir.7802",
url="http://www.jmir.org/2018/3/e64/",
url="http://www.ncbi.nlm.nih.gov/pubmed/29506967"
}


@Article{info:doi/10.5210/ojphi.v7i1.5848,
title="Roles of Health Literacy in Relation to Social Determinants of Health and Recommendations for Informatics-Based Interventions: Systematic Review",
journal="Online J Public Health Inform",
year="2015",
volume="7",
number="1",
pages="e5848",
doi="10.5210/ojphi.v7i1.5848",
url=""
}