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Newark, DE, United States

McAuliffe M.L.,DuPont Company | Tynan W.D.,DuPont Company | Angalet G.B.,Nemours Health and Prevention Services | Shroff Pendley J.,DuPont Company
Journal of Pediatric Psychology

This article focuses on the current status of the use of Health and Behavior (H&B) codes by pediatric psychologists. We address the rationale for the use of these codes in a pediatric psychology setting, practice updates since the codes were initiated, and our experience with utilizing these codes in one pediatric hospital. We conclude with a summary of our assertions and future directions for policy and practice. © The Author 2011 . Published by Oxford University Press on behalf of the Society of Pediatric Psychology. Source

Chang D.I.,Policy and Prevention | Gertel-Rosenberg A.,Policy and Prevention | Drayton V.L.,Policy | Schmidt S.,Policy | Angalet G.B.,Nemours Health and Prevention Services
Health Affairs

In 2006, approximately 37 percent of Delaware's children were overweight or obese. To combat Delaware's childhood obesity epidemic, Nemours, a leading child health care provider, launched a statewide program to improve child health. The "social-ecological" strategy reaches beyond clinical encounters to promote better health and behavior at multiple levels. Early results show that the initiative halted the increase in the prevalence of overweight and obese children, since no statistically significant change occurred during the two-year span between administrations of the Delaware Survey on Children's Health. The initiative also spurred increased knowledge of healthy eating and awareness of the need for increased physical activity in school, child care, and primary care settings. © 2010 Project HOPE-The People-to-People Health Foundation, Inc. Source

Feinson J.,Nemours Health and Prevention Services
Delaware medical journal

This article briefly describes the Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity and explains how the Delaware Primary Care Initiative on Childhood Overweight, a quality improvement initiative, trains primary care practices to implement them. It includes a Delaware pediatrician's first-hand description of how she incorporates the recommendations into her daily practice using motivational interviewing and the 5-2-1-Almost None healthy lifestyle message. Source

Lessard L.,Arcadia University | Leng S.W.,Nemours Health and Prevention Services | Brennan R.,Nemours Health and Prevention Services
Childhood Obesity

Background: As more calls are made in the literature for nutrition interventions to be delivered in child care settings, research on the implementation of these interventions becomes more important. This study examined compliance with Delaware's regulations related to nutrition in child care settings, which are designed to improve the nutrition-related environment in these settings. Methods: A stratified random sample of licensed child care centers (n=233) was created from the total population of eligible centers in Delaware (N=450). Study staff visited each center and distributed self-administered surveys to the director and two randomly selected teachers. Surveys contained items about classroom-level compliance with the regulations along with center-level characteristics. Bivariate analyses were conducted to explore relationships between consistent compliance with each regulation component and center-level characteristics. Results: A total of 179 of the 233 centers in the selected sample participated in the study. Compliance with the regulations varied within centers and across components; the highest levels of consistent compliance were reported for juice type (88.3%) and the lowest levels for whole grains (18.6%). Center characteristics, such as participation in the Child and Adult Care Food Program, were associated with consistent compliance for certain regulations components. Conclusions: Our results suggest that these types of regulations can be implemented across a diversity of centers, but that certain components (e.g., those relating to whole grains and water) may need further clarification. Our results also suggest that there are certain types of centers on which to focus training efforts to maximize compliance. © Copyright 2013, Mary Ann Liebert, Inc. 2013. Source

Van Stan S.,Nemours Health and Prevention Services | Lessard L.,Nemours Health and Prevention Services | Lessard L.,Arcadia University | Dupont Phillips K.,Nemours Health and Prevention Services
Childhood Obesity

Background: Childhood obesity has been recognized as a national problem of epidemic proportions. Child care represents an ideal venue in which to address this problem, as many young children spend a significant amount of time and consume the majority of their meals in this setting. Recognizing this opportunity, Delaware recently enacted reforms to statewide licensing regulations designed to improve the quality of the nutrition-, physical activity-, and screen viewing-related environments in child care settings. Methods: To facilitate the translation of these regulations into practices, a series of broad-scale trainings was held throughout the state. Attendance was required for all Child & Adult Care Food Program (CACFP)-participating facilities, although child care providers from non-CACFP facilities also attended. Pre- and posttraining surveys were used to assess changes in providers' knowledge of the regulations and satisfaction with the training. Results: In total 1094 presurveys and 1076 postsurveys were received. Participants were highly satisfied with the training format and content, including the instructors, materials, and schedule. Data analysis demonstrates improved knowledge of all 26 regulation components from presurvey to postsurvey. Family child care providers, providers with more years of experience, CACFP-participating facilities, and facilities with food service personnel scored significantly higher than their center staff, less experienced and non-CACFP counterparts, as well as those without food service personnel. Conclusions: Broad-scale, in-person training can effectively increase child care providers' knowledge of the regulations and is well received by this audience. Other states and jurisdictions seeking to improve nutrition, physical activity, and screen-viewing practices in child care settings should consider this model of quality improvement. © Copyright 2013, Mary Ann Liebert, Inc. Source

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