JAMA Pediatrics最新文献_第8页

Accumulating Robust Evidence for Reducing Vaccine Hesitancy in Early Pregnancy-Reply. 积累可靠证据，减少孕早期对疫苗的犹豫不决--回复。

IF 24.7 1区医学

JAMA Pediatrics Pub Date : 2024-10-21 DOI: 10.1001/jamapediatrics.2024.4349

Elyse O Kharbanda, Malini B DeSilva, Gabriela Vazquez-Benitez

引用次数: 0

Levels of Satisfaction and Regret With Gender-Affirming Medical Care in Adolescence 青春期对性别确认医疗服务的满意度和遗憾度

IF 26.1 1区医学

JAMA Pediatrics Pub Date : 2024-10-21 DOI: 10.1001/jamapediatrics.2024.4527

Kristina R. Olson, G. F. Raber, Natalie M. Gallagher

{"title":"Levels of Satisfaction and Regret With Gender-Affirming Medical Care in Adolescence","authors":"Kristina R. Olson, G. F. Raber, Natalie M. Gallagher","doi":"10.1001/jamapediatrics.2024.4527","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.4527","url":null,"abstract":"ImportanceThere is a need to improve the evidence base for gender-affirming medical care provided to adolescents, including the experiences of those who have received this care.ObjectiveTo examine rates of satisfaction, regret, and continuity of care in adolescents who received puberty blockers and/or gender-affirming hormones as part of gender-affirming medical care.Design, Setting, and ParticipantsThis survey study used the 2023 online survey wave of an ongoing longitudinal study, the Trans Youth Project, among a community-based sample of transgender youth and their parents initially recruited throughout the US and Canada between 2013 and 2017. The satisfaction and regret data include responses from a youth or their parent representing 87% of the youth aged 12 years or older in the cohort who have received gender-affirming medical care (235 of 269 youths). Of these, 220 completed the 2023 survey (main sample); information about continuity of care was available for all youth. Data analysis was performed from April to August 2024.ExposureSatisfaction, regret, and continuity of care following puberty blockers or suppression and/or gender-affirming hormones.Main Outcomes and MeasuresSelf- or parent-reported satisfaction or regret with gender-affirming care and continuation of care.ResultsAmong the 220 youths in the main sample (mean [SD] age, 16.07 [2.40] years; 30 [14%] multiracial, non-Hispanic; 18 [8%] White, Hispanic; 155 [70%] White, non-Hispanic; 17 [8%] other race and ethnicity, including Asian, Black [Hispanic and non-Hispanic], Hispanic with unknown race, multiracial Hispanic, or Native American; gender at last interaction: 68 [31%] boys, 132 [60%] girls, 20 [9%] gender diverse, eg, nonbinary) and their parents, very high levels of satisfaction and low levels of regret with puberty blockers and gender-affirming hormones as well as high levels of continuation of care were reported. Of these 220 respondents in the main sample, 9 were regretful of having received blockers (n = 8) and/or hormones (n = 3; 2 of these individuals reported regret with both), of whom 4 have stopped all gender-affirming medical care and 1 has continued to receive blockers but plans to stop. The 4 others have continued care, suggesting that regret is not synonymous with stopping care.Conclusions and RelevanceThe findings suggest that youth accessing puberty blockers and hormones as part of gender-affirming care tend to be satisfied with and not regretful of that care several years later. While regret was rare, these experiences need to be better understood.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"110 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142452235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Future Directions for Screen Time Interventions for Sleep. 屏幕时间干预睡眠的未来方向。

IF 26.1 1区医学

JAMA Pediatrics Pub Date : 2024-10-21 DOI: 10.1001/jamapediatrics.2024.4009

Ariel A Williamson,Lauren Hale

引用次数: 0

Community Health Workers Linking Clinics and Schools and Asthma Control 社区保健工作者将诊所和学校与哮喘控制联系起来

IF 26.1 1区医学

JAMA Pediatrics Pub Date : 2024-10-21 DOI: 10.1001/jamapediatrics.2024.3967

Tyra Bryant-Stephens, Chen C. Kenyon, Colleen Tingey, Andrea Apter, Julie Pappas, Natalie Minto, Yvonne S. Stewart, Justine Shults

{"title":"Community Health Workers Linking Clinics and Schools and Asthma Control","authors":"Tyra Bryant-Stephens, Chen C. Kenyon, Colleen Tingey, Andrea Apter, Julie Pappas, Natalie Minto, Yvonne S. Stewart, Justine Shults","doi":"10.1001/jamapediatrics.2024.3967","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.3967","url":null,"abstract":"ImportanceChildhood asthma is characterized by pervasive disparities, including 3-fold higher hospitalization rates and 7-fold higher death rates for Black children compared with White children. To address asthma disparities, one must intervene in all lived environments.ObjectiveTo determine if a community health worker (CHW) intervention to connect the primary care, home, and school for low-income minoritized school-aged children with asthma and their caregivers improves asthma control.Design, Setting, and ParticipantsThis study was a hybrid effectiveness/implementation trial using a 2 × 2 factorial, cluster randomized clinical trial design of 36 schools crossed with participant-level randomization into a clinic-based CHW intervention. The study was conducted from May 2018 to June 2022. The intervention took place in primary care offices, homes, and 36 West Philadelphia, Pennsylvania, public and charter schools. Children aged 5 to 13 years with uncontrolled asthma were recruited from local primary care practices.InterventionsAsthma management, trigger remediation, and care coordination occurred in school, home, and primary care settings. Children were followed up for 12 months. The Yes We Can Children’s Asthma Program, Open Airways For Schools Plus, and school-based asthma therapy were implemented.Main Outcomes and MeasuresImprovement in asthma control, as measured by the Asthma Control Questionnaire, comparing the mean difference between groups 1 year after randomization with their baseline (difference in differences). Both primary care and school interventions were dramatically disrupted by the COVID-19 pandemic; therefore, stratified analyses were performed to assess per-protocol intervention efficacy before the pandemic disruptions.ResultsA total of 1875 participants were approached, 1248 were excluded, and 1 was withdrawn. The 626 analyzed study participants (mean [SD] age, 8.7 [2.4] years; 363 male [58%]) self-identified as Black race (96%) and non-Hispanic ethnicity (98%). Although all groups had statistically significant improvements in asthma control from baseline to 12 months (P− group: −0.46; 95% CI, −0.58 to −0.33; P+ group: −0.57; 95% CI, −0.74 to −0.44; S− group: −0.47; 95% CI, −0.58 to −0.35; S+ group: −0.59; 95% CI, −0.74 to −0.44), none of the difference-in-differences estimates from the primary prespecified models showed a clinically meaningful improvement in asthma control. Analysis from the prepandemic interval, however, demonstrated that children in the combined clinic-school intervention had a statistically significant improvement in asthma control scores compared with control (−0.79; 95% CI, −1.40 to −0.18).Conclusions and RelevanceThis randomized clinical trial provides preliminary evidence that connecting all lived environments for care of children can be accomplished through linkages with CHWs.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"84 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142452234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Future Directions for Screen Time Interventions for Sleep. 屏幕时间干预睡眠的未来方向。

IF 24.7 1区医学

JAMA Pediatrics Pub Date : 2024-10-21 DOI: 10.1001/jamapediatrics.2024.4009

Ariel A Williamson, Lauren Hale

引用次数: 0

Guiding Child Health Policy With Science: The JAMA Pediatrics Health and the 2024 US Election Theme. 用科学指导儿童健康政策：JAMA 儿科健康与 2024 年美国大选主题》。

IF 26.1 1区医学

JAMA Pediatrics Pub Date : 2024-10-21 DOI: 10.1001/jamapediatrics.2024.4463

Alison A Galbraith,Aaron E Carroll

引用次数: 0

Recurrent Respiratory Papillomatosis in the Post–Human Papillomavirus Vaccination Era 后人类乳头瘤病毒疫苗时代的复发性呼吸道乳头状瘤病