Accuracy of Parent-Measured Weight and Height of Preschool Children at Home With Increasing Levels of Instruction

Background: The purpose of this study was to determine how accurately parents measure their preschool child's weight and height with increasing levels of instruction. Methods: Parents measured their child's (n = 30 dyads) weight (own weight scale) and height (soft tape measure) using three levels of instruction: instructional guide (level 1); guide, demonstration video (level 2); and guide, video, and virtual monitoring (level 3), which were compared to researcher measurements (electronic weight scale, Stadiometer). Paired t-tests were used to determine differences between researcher and parent measurements and between the three parent levels. Inaccurate classifications were calculated using parent-measured values for the four categories (underweight, healthy, overweight, obese). Results: Raw mean parent-measured weights (17.4 ± 2.3 kg) differed from researcher by 0.2 kg (level 1), 0.3 kg (level 2), and 0.1 kg (level 3). Raw mean parent-measured heights (104.0 ± 5.9 cm) differed from researcher by 0.9 cm (level 1, p = 0.005), 0.4 cm (level 2, NS), and 0.3 cm (level 3, NS). Across all levels, 48.9% and 65.5% parents overmeasured their children's weights and heights, respectively. Using parent-measured values, 29.4% of children were classified high while 70.5% were classified low. Parents were more likely to make errors if their children were on the borderline between any of the two weight categories. Conclusion: Findings indicate that an instructional guide with demonstration video is helpful in improving the parents' accuracy of their children's weights and heights. More research is needed to determine accuracy in population other than White parents with high education levels and children under overweight and obese category.

Quality of Nutrition Environments, Menus and Foods Served, and Food Program Achievement in Oklahoma Family Child Care Homes

Child care environments foster children's healthy eating habits by providing exposure to healthy foods and feeding practices. We assessed the healthfulness of nutrition environments, menu/meal quality, and the achievement of Child and Adult Care Food Program (CACFP) guidelines and best practices in Oklahoma CACFP-enrolled family child care homes (FCCHs) (n = 51). Two-day classroom observations were conducted. Healthfulness of classroom nutrition environments was assessed using the Environment and Policy Assessment and Observation (EPAO). Foods served to and consumed by children were quantified using the Dietary Observations in Child Care (DOCC) tool. Nutrient analysis was performed to determine total energy for foods listed on menus, served to, and consumed by children. Menu and meal food variety and CACFP Guideline Achievement Scores were determined. Average nutrition environment score was 11.7 ± 1.2 (61.5% of maximum possible score). Energy (kcals) from menus and consumed by children was insufficient to meet two-thirds of their daily reference intake. Children were exposed to 1.7 vegetables and 1.3 fruits per meal. CACFP Guideline Achievement Scores were 66.3% ± 7.8 for menus and 59.3% ± 7.6 for mealtimes. Similar to previous research, our findings indicate a need for improved FCCH nutrition practices. Tailored interventions for FCCHs are needed.

Early-learners' expectations of and experience with IPE: A multi-institutional qualitative study

BACKGROUND

Multi-institutional qualitative studies are scarce within the interprofessional education (IPE) literature; such a report would provide comprehensive evidence for the application of interprofessional instruction among earlier learners.

OBJECTIVE

This investigation explored students' expectations of and barriers to introductory IPE across four institutions.

DESIGN

Qualitative inductive content analysis was utilized to interpret students' narrative responses to assigned pre- and post-survey questions.

SETTING

Health science schools of four U.S. institutions at Institution A, Institution B, Institution C, and Institution D.

PARTICIPANTS

Twenty-two percent (n = 385) of eligible participants completed both pre- and post-surveys. Nursing student participation was greatest (n = 113, 33%), followed by occupational therapy (n = 44, 13%), and physical therapy (n = 36, 10%). All other program participation was <10%. In total, students' narrative comments from 19 degree programs were a part of the data set.

METHODS

Responses from one pre-survey question on expectations of introductory IPE and two post-survey questions on IPE benefits and barriers were studied using qualitative inductive thematic analysis.

RESULTS

Four themes emerged as IPE learning expectations and benefits: my own professional role, professional role of others, teamwork, and communication. The theme of interacting with peers surfaced as an additional IPE benefit. There were four themes noted as IPE barriers: course logistics, lack of context, course content, and social dynamics.

CONCLUSION

This multi-institutional qualitative study adds to the literature by providing empirical evidence regarding early learner perceptions of IPE experiences. Student expectations and benefits of their introductory IPE course/curriculum aligned. Perceived barriers are useful in informing future IPE implementation and research.

An exploratory, cross-sectional and multi-institutional study using three instruments to examine student perceptions of interprofessional education

Interprofessional education (IPE) research needs to expand beyond single site, single event inquiry. Multi-institutional studies increase methodologic rigor and generalizability, advancing the pedagogical science of IPE. Four U.S. institutions used three different validated measures to examine early learner interprofessional outcomes. The three assessment tools included the Communication and Teamwork subscale of the University of West England Entry Level Interprofessional Questionnaire (UWE-ELIQ), the Self-Assessed Collaboration Skills (SACS), and the Interprofessional Teamwork and Team-based Practice factor of the Student Perceptions of Interprofessional Clinical Education-Revised, version 2 (SPICE-R2). Across the four institutions, 659 eligible participants, representing 19 programs completed the pre-survey, and 385 completed the post-survey. The UWE-ELIQ showed a statistically significant difference between the pre- and post-survey overall, but the effect size was small. One institution demonstrated a positive change in scores on the UWE-ELIQ with a small effect size, while the other institutions saw no significant change. Two institutions observed lower post-survey scores on the SPICE-R2. Cumulative results from the study indicated no statistically significant change from pre- to post- in total SACS or SPICE-R2 scores. Additional multi-site longitudinal research is needed to investigate use of validated instruments, as well as the impact of curricula and learning environment on educational outcomes.

Utilizing Shared Expertise Across Contexts to Engage in Multi-institutional Interprofessional Scholarship

Interprofessional education (IPE) research has grown dramatically, but it has primarily occurred at single institutions/contexts with unique assessment tools. Comparing pedagogical approaches and assessment tools across contexts and learner levels is necessary to advance the educational preparation of "collaborative-ready" health professionals. One common thread through IPE initiatives is a learning experience that introduces students to the basic tenets of professional roles, communication and collaboration. Commonly accepted objectives focus on competencies such as those defined by the Interprofessional Education Collaborative (IPEC). The IPE Research Collaborative (IPE-RC) brings together researchers from four universities that deliver introductory interprofessional learning experiences seeking to leverage this relationship to improve IPE research in support of collaborative person-centered quality healthcare. Donabedian's quality improvement (QI) model provides a framework of structure, process and outcomes for assessing and improving the quality of healthcare. The IPE-RC operationalized the IPEC competencies in their collaboration using Donabedian's QI model. They demonstrate, using a systematic approach that mirrors interprofessional practice, how researchers from multiple institutions can study learning experiences across different contexts and learner levels to inform best practice for an introductory interprofessional learning experience.

Student Perceptions of Collaboration Skills in an Interprofessional Context: Development and Initial Validation of the Self-Assessed Collaboration Skills Instrument

An integral component of interprofessional education (IPE) is the development of a collaboration-ready health-care workforce. While collaboration is a fundamental element of IPE, there is no existing measure of collaboration skills that is not context specific. This article describes the development and initial validation of the Self-Assessed Collaboration Skills (SACS) measure. Items were initially drawn from the Collaboration Skills Assessment Tool rubric, an educational assessment tool. The SACS measure was piloted in a sample of students in an introductory IPE course. Following scale revision, the SACS was piloted a second time in a sample of students in an IPE health systems course and then validated in a sample of students in an introductory IPE course. Exploratory factor analysis was used to assess scale factor structure in Pilots 1 and 2 and confirmatory factor analysis to confirm factor structure in the validation sample. Convergent and discriminant validity were also assessed. The final SACS measure is an 11-item scale consisting of three dimensions of collaboration: information sharing, learning, and team support. The SACS measure demonstrates high internal consistency and both convergent and discriminant validity as a measure of collaboration. The SACS can be implemented in any setting for assessing collaboration in clinical and nonclinical contexts.

The Progress and Promise of Interprofessional Education in Athletic Training Programs

Context:

Interprofessional education (IPE), an emerging theme in health professional education programs, intends to prepare students for collaborative practice in order to improve patient outcomes. In 2012, the profession of athletic training strategically began to increase program participation in IPE.

Objective:

This article compares 2 studies that examined the presence of IPE in athletic training.

Design:

Cross-sectional design utilizing similar surveys regarding athletic training program participation in, and readiness for, IPE initiatives were administered via Qualtrics in 2012 and 2015.

Patients and Other Participants:

Program directors of Commission on Accreditation of Athletic Training Education–accredited athletic training programs were surveyed in 2012 and 2015 using the “Interprofessional Education Assessment and Planning Instrument for Academic Institutions” in addition to program demographic information and IPE participation.

Data Collection and Analysis:

The participants involved included 160 of 367 surveyed (43.6%) in 2012 and 162 of 380 surveyed (42.6%) in 2015.

Results:

Data were analyzed, and χ2 analysis revealed a significant relationship between level of accreditation and academic unit housing the program in both studies. Significant change was also shown in program participation in IPE from 2012 to 2015. However, institutional readiness and infrastructure for IPE was low in nearly all categories.

Conclusions:

Interprofessional education has a greater presence in Commission on Accreditation of Athletic Training Education professional programs that reside in health science–related academic units and are accredited at the master's level. However, less than 50% of the programs participate in IPE. There is also a need for greater institutional infrastructure and readiness for IPE.

Institutional Readiness for Interprofessional Education Among Nutrition and Dietetics and Athletic Training Education Programs

Organizations recommend interprofessional education (IPE) as a means of promoting collaborative patient-centered care. In turn, various external accreditors in the health professions have integrated IPE competencies into their standards. However, little is known about how athletic training (AT) and nutrition and dietetics (ND) have incorporated IPE into their educational programs. This study examined institutional factors that affect the level of IPE participation within ND and AT programs in the United States. The Interprofessional Education Assessment and Planning Instrument for Academic Institutions was distributed electronically to directors of accredited programs in ND and AT. In addition to gathering demographic information, survey questions addressed the institutions' level of involvement and commitment to IPE. Differences emerged between ND and AT programs for several items in the instrument. Factors that affected the differences included program level and academic unit in which the program resides. Results also suggest that ND and AT programs have similar levels of IPE participation, but there are great opportunities for growth. Institutional factors such resource commitment, academic unit type, and level of program may affect implementation and contribute to the development and success of IPE initiatives.

Dicarboxylic Acid Excretion in Normal Formula-Fed and Breastfed Infants

PURPOSE

Infant formulas are often supplemented with medium-chain triglycerides (MCTs) to optimize calories for small for gestational age or preterm infants. High amounts of MCTs have been associated with an increase in dicarboxylic acid (DCA) in the urine. Elevated DCA in the urine is also a clinical indicator for fatty acid metabolism disorders. The purpose of this study was to identify if there is an amount of MCTs that can be provided without elevating urinary DCA excretion.

METHODS

A metabolic screening laboratory provided urinary DCA excretion data for 175 infants. It was verified that no infants were diagnosed with metabolic disorders and therefore were considered "metabolically normal." All infants were either formula fed or breastfed at the time of screening. The type and volume of formula provided at the time of urine screening was documented. The exact amount of MCTs provided to each infant was calculated.

RESULTS

The mean age of the infants was 3.09 months. The mean total DCA was determined for both the breastfeeding and formula groups. Within the formula group, the means were 32.07, 13.36, and 5.77 mmol/mol creatinine for adipic, suberic, and sebacic acids, respectively. Spearman correlation coefficient indicated correlations of r = 0.0693, r = 0.0166, and r = -0.0128 between percent MCT and adipic, suberic, and sebacic acids, respectively. No value was statistically significant. DCA excretion amounts did not vary between breastfed and formula-fed infants. Our data suggest that clinicians should not expect elevated dicarboxylic aciduria in infants who are fed a standard formula without added MCT oil.

Urinary Dicarboxylic Acid Excretion in Formula-Fed Infants

Purpose. The common practice of medium-chain triglyceride (MCT) feeding has been associated with high urinary dicarboxylic acid excretion levels in infants. The purpose of this study was to investigate the effect of MCT supplementation on urine metabolite excretion by infants on different formulas. Methods. Urine sample data from a Metabolic Screening Laboratory were provided, medical records were accessed to record infant formula, and ingredient lists of formulas were reviewed. The urinary acid profiles were compared based on the percentage of fat content coming from MCT. Results. A MANOVA was conducted and there was a statistically significant effect of acid profiles. Pairwise comparisons indicate a significant difference between high and low %MCT ( P = .0002), low and medium %MCT ( P = .0156), and high and low/medium %MCT ( P = .0030) for adipic acid. For both suberic acid and sebacic acid, there was a significant difference between high and low %MCT ( P = .0001), high and medium %MCT ( P = .0001, P = .0015), and high and low/medium %MCT ( P = .0001). This study suggests that relative amounts of dicarboxylic acids cannot be used alone as a diagnostic criteria. The exact amount of MCT in each formula needs to be considered.