Findings suggest that this intervention is effective in increasing the knowledge of safety behaviors for children receiving the curriculum during the summer months. Further research should focus on long-term behavior changes in these youth.
As hospitals are being asked to justify community benefit and make meaningful contributions to population health, impact evaluations can be utilized to demonstrate the cumulative community benefit of programs and assess population health impact of community benefit programs.
Population health includes medical conditions and social determinants of health, and it can be measured through community health needs assessments (CHNAs). A pediatric hospital utilized a survey to ask parents to rank different health topics based on the severity they present to children in the St. Louis Metropolitan for 2 installments of a CHNA (2016 and 2019). Between November 2015 and April 2016, 1156 parents and, between May 2018 and September 2018, 1022 parents responded to the Parent Health Concerns Survey. Respondents were most likely to be 25 to 44 years old, white, educated, have an income of at least $60 000, and work-related insurance. The top needs identified in 2016 and 2018 were lack of exercise and bullying, respectively. Depression saw the largest increase. Emerging topics in 2018 include tobacco/smoking, depression, and health insurance access. Our findings suggests that pediatricians should be prepared to address concerns across a wide variety of topics.
The prevalence of childhood obesity is a growing epidemic in the United States and as of 2014 its prevalence among children ages two to 19 was 17.0%. Without intervention, obese children are at risk for negative health consequences and for the increased likelihood of staying obese through adulthood. St. Louis Children's Hospital provides HTT (Head to Toe), an interactive 12-session fitness, nutrition, and social well-being class focuses on adopting healthier lifestyles through daily exercise, and proper nutrition. One program referral method is through a partnership with the hospital's HSC (Healthy Start Clinic), a multi-disciplinary obesity clinic. Pretest and posttest assessments are used to measure changes in body metrics, health behaviors, knowledge, readiness to change, and self-concept. Between August 2011 and May 2016, 485 children and at least one parent or guardian with them were enrolled in the program, and up to 235 children completed at least one pretest-or post-assessment. Analysis determined multiple statistically significant improvements in body metrics, health behaviors, knowledge, including questions related to nutrition and food guidelines, readiness to change assessment, and self-concept. Total knowledge increased by 22%; questions related to nutrition increased by 28.2%, social emotional by 18.9% and physical activity by 17.8%. Findings suggest that the Head to Toe program is effective in improving nutrition, physical activity, social emotional knowledge and behaviors among participants. Childhood obesity is a growing epidemic and creating a relationship with a pediatric obesity clinic can increase the total number of children and teens that are introduced to weight management programs.
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