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Article: Bacteria Isolated From Equine Uteri in The United Arab Emirates: A Retrospective Study.

Omar, Hussein / Hambidge, Margaret / Firmanes, Bernadette / Shabandri, Abdul M / Wilsher, Sandra

2022 Volume 115, Page(s) 104029

Abstract: The United Arab Emirates (UAE) presents a unique environment in which to breed horses with a non-physiological breeding season coupled with high temperatures and humidity for much of the year. This study aimed to describe bacterial isolates from the ... ...

Abstract	The United Arab Emirates (UAE) presents a unique environment in which to breed horses with a non-physiological breeding season coupled with high temperatures and humidity for much of the year. This study aimed to describe bacterial isolates from the uteri of mares in the UAE and compare them to those reported elsewhere in the world. Bacterial antibiotic resistance was also analyzed to give a starting point for future monitoring. A total of 2,022 swabs taken over five breeding seasons from the endometrium (n = 1,350) or from uterine lavages (n = 672) were submitted for microbiological culture and antibiotic sensitivity testing. At 48 hours post-inoculation 616 of 2,022 (30.5%) of cultures showed microbial growth from which 690 isolates were identified. Most positive plates (548 of 616; 89%) grew one isolate; 68 cultures had two (62 of 616; 10.1%) or three (6 of 616; 1%) isolates. The most frequently isolated bacteria were β-hemolytic Streptococcus (36.5%; 252 of 690), E. coli (10.6%; 73 of 690), P. aeruginosa (10.1%; 70 of 690), K. pneumoniae (8.8%; 61 of 690) and Aeromonas hydrophila (4.1%; 28 of 690). The lowest level of antibiotic susceptibility for all isolates was shown by trimethoprim-sulphonamide (36.4%; 198 of 544), with amikacin showing the highest (76.1%; 271 of 356). A significant decrease in susceptibility to doxycycline, enrofloxacin, and erythromycin, but a significant increase for amoxicillin with clavulanic acid, was seen for β-hemolytic Streptococcus. Decreasing susceptibility of trimethoprim-sulphonamide between two time periods was seen for E. coli. Compared to other studies UAE-based mares had a high incidence of P. aeruginosa and K. pneumoniae isolates, whereas E. coli was represented far less frequently as an isolate.
MeSH term(s)	Animals ; Anti-Bacterial Agents/pharmacology ; Bacteria ; Escherichia coli ; Female ; Horses ; Klebsiella pneumoniae ; Pseudomonas aeruginosa ; Retrospective Studies ; Sulfonamides ; Trimethoprim ; United Arab Emirates/epidemiology ; Uterus/microbiology
Chemical Substances	Anti-Bacterial Agents ; Sulfonamides ; Trimethoprim (AN164J8Y0X)
Language	English
Publishing date	2022-06-02
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2102631-2
ISSN	1542-7412 ; 0737-0806
ISSN (online)	1542-7412
ISSN	0737-0806
DOI	10.1016/j.jevs.2022.104029
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Article ; Online: Evaluating the Implementation of the Connect for Health Pediatric Weight Management Program.

Simione, Meg / Frost, Holly M / Farrar-Muir, Haley / Luo, Man / Granadeño, Jazmin / Torres, Carlos / Boudreau, Alexy Arauz / Moreland, Jennifer / Wallace, Jessica / Young, Jackie / Orav, John / Sease, Kerry / Hambidge, Simon J / Taveras, Elsie M

JAMA network open

2024 Volume 7, Issue 1, Page(s) e2352648

Abstract: Importance: Adoption of primary care interventions to reduce childhood obesity is limited. Progress in reducing obesity prevalence and eliminating disparities can be achieved by implementing effective childhood obesity management interventions in ... ...

Abstract	Importance: Adoption of primary care interventions to reduce childhood obesity is limited. Progress in reducing obesity prevalence and eliminating disparities can be achieved by implementing effective childhood obesity management interventions in primary care settings. Objective: To examine the extent to which implementation strategies supported the uptake of research evidence and implementation of the Connect for Health pediatric weight management program. Design, setting, and participants: This quality improvement study took place at 3 geographically and demographically diverse health care organizations with substantially high numbers of children living in low-income communities in Denver, Colorado; Boston, Massachusetts; and Greenville, South Carolina, from November 2019 to April 2022. Participants included pediatric primary care clinicians and staff and families with children aged 2 to 12 years with a body mass index (BMI) in the 85th percentile or higher. Exposures: Pediatric weight management program with clinician-facing tools (ie, clinical decision support tools) and family-facing tools (ie, educational handouts, text messaging program, community resource guide) along with implementation strategies (ie, training and feedback, technical assistance, virtual learning community, aligning with hospital performance metrics) to support the uptake. Main outcomes and measures: Primary outcomes were constructs from the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) Framework examined through parent, clinician, and leadership surveys and electronic health record data to understand the number of children screened and identified, use of the clinical decision support tools, program acceptability, fidelity to the intervention and implementation strategies, and program sustainability. Results: The program screened and identified 18 333 children across 3 organizations (Denver Health, 8480 children [46.3%]; mean [SD] age, 7.97 [3.31] years; 3863 [45.5%] female; Massachusetts General Hospital (MGH), 6190 children [33.8%]; mean [SD] age, 7.49 [3.19] years; 2920 [47.2%] female; Prisma Health, 3663 children [20.0%]; mean [SD] age, 7.33 [3.15] years; 1692 [46.2%] female) as having an elevated BMI. The actionable flagging system was used for 8718 children (48%). The reach was equitable, with 7843 children (92.4%) from Denver Health, 4071 children (65.8%) from MGH, and 1720 children (47%) from Prisma Health being from racially and ethnically minoritized groups. The sites had high fidelity to the program and 6 implementation strategies, with 4 strategies (67%) used consistently at Denver Health, 6 (100%) at MGH, and 5 (83%) at Prisma Health. A high program acceptability was found across the 3 health care organizations; for example, the mean (SD) Acceptability of Intervention Measure score was 3.72 (0.84) at Denver Health, 3.82 (0.86) at MGH, and 4.28 (0.68) at Prisma Health. The implementation strategies were associated with 7091 (39%) uses of the clinical decision support tool. The mean (SD) program sustainability scores were 4.46 (1.61) at Denver Health, 5.63 (1.28) at MGH, and 5.54 (0.92) at Prisma Health. Conclusions and relevance: These findings suggest that by understanding what strategies enable the adoption of scalable and implementation-ready programs by other health care organizations, it is feasible to improve the screening, identification, and management of children with overweight or obesity and mitigate existing disparities.
MeSH term(s)	Humans ; Child ; Female ; Male ; Pediatric Obesity/prevention & control ; Weight Reduction Programs ; Benchmarking ; Body Mass Index ; Hospitals, General
Language	English
Publishing date	2024-01-02
Publishing country	United States
Document type	Journal Article
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2023.52648
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Article ; Online: The trend in mean height of Guatemalan women born between 1945 and 1995: a century behind.

Arriaza, Astrid / Hambidge, K Michael / Krebs, Nancy F / Garcés, Ana / Channon, Andrew Amos

Journal of health, population, and nutrition

2022 Volume 41, Issue 1, Page(s) 43

Abstract: ... than those in the metropolis. Mean height is reduced 0.980 cm for each 1000 m increase in elevation.: Conclusions ...

Abstract	Background: Adult height is a cumulative indicator of living standards with mean height increasing with a greater socio-economic level. Guatemalan adult women have the lowest mean height worldwide. The country's population is ethnically divided between indigenous and non-indigenous groups. This study aims to identify trends in the mean height for indigenous and non-indigenous adult women born between 1945 and 1995 in Guatemala and the association with individual, household and environmental factors. Methods: We used pooled data of adult women from five Demographic and Health Surveys. Mixed-effects multilevel linear regression models estimate the mean height associated with the explanatory variables. Mean height was modelled as a function of birth year cohort, wealth, education, geo-administrative regions and elevation. Results: The mean height increased 0.021 cm per year on average. The annual increase for indigenous women was 0.027 cm, while 0.017 cm for non-indigenous women. Height is associated with household wealth and women's education level. We found an interaction effect between ethnicity and household wealth, with indigenous women at the lowest quintile 0.867 cm shorter than the corresponding non-indigenous group. Height is associated with the geo-administrative region, those women in western regions being shorter than those in the metropolis. Mean height is reduced 0.980 cm for each 1000 m increase in elevation. Conclusions: Guatemalan women have grown only 1 cm over half century, a slow improvement between 1945 and 1995, a period characterised by political instability and civil war. There are persistent inequalities in women's height associated with socio-economic status, education and attributes of the geographical context. These aspects need to be considered when implementing strategies to encourage growth. Further research is required to understand the evolution of adult height and the standard of living in post-war Guatemala.
MeSH term(s)	Adult ; Body Height ; Educational Status ; Ethnicity ; Female ; Humans ; Social Class ; Socioeconomic Factors
Language	English
Publishing date	2022-09-15
Publishing country	Bangladesh
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2025045-9
ISSN	2072-1315 ; 1606-0997
ISSN (online)	2072-1315
ISSN	1606-0997
DOI	10.1186/s41043-022-00324-8
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Article ; Online: Zinc Supplementation Initiated Prior to or During Pregnancy Modestly Impacted Maternal Status and High Prevalence of Hypozincemia in Pregnancy and Lactation: The Women First Preconception Maternal Nutrition Trial.

Kemp, Jennifer F / Hambidge, K Michael / Westcott, Jamie L / Ali, Sumera Aziz / Saleem, Sarah / Garcés, Ana / Figueroa, Lester / Somannavar, Manjunath S / Goudar, Shivaprasad S / Long, Julie M / Hendricks, Audrey E / Krebs, Nancy F

The Journal of nutrition

2024

Abstract: Background: Data regarding effects of small-quantity-lipid-based nutrient supplements (SQ-LNS) on maternal serum zinc concentrations (SZC) in pregnancy and lactation are limited.: Objectives: The objectives of this study were to evaluate the effect ... ...

Abstract	Background: Data regarding effects of small-quantity-lipid-based nutrient supplements (SQ-LNS) on maternal serum zinc concentrations (SZC) in pregnancy and lactation are limited. Objectives: The objectives of this study were to evaluate the effect of preconception compared with prenatal zinc supplementation (compared with control) on maternal SZC and hypozincemia during pregnancy and early lactation in women in low-resource settings, and assess associations with birth anthropometry. Methods: From ∼100 women/arm at each of 3 sites (Guatemala, India, and Pakistan) of the Women First Preconception Maternal Nutrition trial, we compared SZC at 12- and 34-wk gestation (n = 651 and 838, respectively) and 3-mo postpartum (n = 742) in women randomly assigned to daily SQ-LNS containing 15 mg zinc from ≥3 mo before conception (preconception, arm 1), from ∼12 wk gestation through delivery (early pregnancy, arm 2) or not at all (control, arm 3). Birth anthropometry was examined for newborns with ultrasound-determined gestational age. Statistical analyses were performed separately for each time point. Results: At 12-wk gestation and 3-mo postpartum, no statistical differences in mean SZC were observed among arms. At 34-wk, mean SZC for arms 1 and 2 were significantly higher than for arm 3 (50.3, 50.8, 47.8 μg/dL, respectively; P = 0.005). Results were not impacted by correction for inflammation or albumin concentrations. Prevalence of hypozincemia at 12-wk (<56 μg/dL) was 23% in Guatemala, 26% in India, and 65% in Pakistan; at 34 wk (<50 μg/dL), 36% in Guatemala, 48% in India, and 74% in Pakistan; and at 3-mo postpartum (<66 μg/dL) 79% in Guatemala, 91% in India, and 92% in Pakistan. Maternal hypozincemia at 34-wk was associated with lower birth length-for-age Z-scores (all sites P = 0.013, Pakistan P = 0.008) and weight-for-age Z-scores (all sites P = 0.017, Pakistan P = 0.022). Conclusions: Despite daily zinc supplementation for ≥7 mo, high rates of maternal hypozincemia were observed. The association of hypozincemia with impaired fetal growth suggests widespread zinc deficiency in these settings. This trial is registered at clinicaltrials.gov as #NCT01883193.
Language	English
Publishing date	2024-04-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	218373-0
ISSN	1541-6100 ; 0022-3166
ISSN (online)	1541-6100
ISSN	0022-3166
DOI	10.1016/j.tjnut.2024.04.018
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Article ; Online: Influenza vaccination accuracy among adults: Self-report compared with electronic health record data.

Daley, Matthew F / Reifler, Liza M / Shoup, Jo Ann / Glanz, Jason M / Lewin, Bruno J / Klein, Nicola P / Kharbanda, Elyse O / McLean, Huong Q / Hambidge, Simon J / Nelson, Jennifer C / Naleway, Allison L / Weintraub, Eric S / McNeil, Michael M / Razzaghi, Hilda / Singleton, James A

Vaccine

2024 Volume 42, Issue 11, Page(s) 2740–2746

Abstract: Objective: To assess the validity of electronic health record (EHR)-based influenza vaccination data among adults in a multistate network.: Methods: Following the 2018-2019 and 2019-2020 influenza seasons, surveys were conducted among a random sample ...

Abstract	Objective: To assess the validity of electronic health record (EHR)-based influenza vaccination data among adults in a multistate network. Methods: Following the 2018-2019 and 2019-2020 influenza seasons, surveys were conducted among a random sample of adults who did or did not appear influenza-vaccinated (per EHR data) during the influenza season. Participants were asked to report their influenza vaccination status; self-report was treated as the criterion standard. Results were combined across survey years. Results: Survey response rate was 44.7% (777 of 1740) for the 2018-2019 influenza season and 40.5% (505 of 1246) for the 2019-2020 influenza season. The sensitivity of EHR-based influenza vaccination data was 75.0% (95% confidence interval [CI] 68.1, 81.1), specificity 98.4% (95% CI 92.9, 99.9), and negative predictive value 73.9% (95% CI 68.0, 79.3). Conclusions: In a multistate research network across two recent influenza seasons, there was moderate concordance between EHR-based vaccination data and self-report.
MeSH term(s)	Adult ; Humans ; Electronic Health Records ; Self Report ; Influenza, Human/prevention & control ; Vaccination ; Surveys and Questionnaires ; Influenza Vaccines ; Seasons
Chemical Substances	Influenza Vaccines
Language	English
Publishing date	2024-03-25
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2024.03.052
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Article ; Online: The association of timing of repeat cesarean with outcomes among a cohort of Guatemalan women with a history of prior cesarean birth.

Harrison, Margo S / Garces, Ana / Figueroa, Lester / Westcott, Jamie / Hambidge, Michael / Krebs, Nancy F

BMC pregnancy and childbirth

2021 Volume 21, Issue 1, Page(s) 516

Abstract: Background: The objective of this analysis was to observe whether maternal and perinatal/neonatal outcomes of birth vary by timing of repeat cesarean among women with a history of one prior cesarean birth in a Guatemalan cohort.: Methods: This ... ...

Abstract	Background: The objective of this analysis was to observe whether maternal and perinatal/neonatal outcomes of birth vary by timing of repeat cesarean among women with a history of one prior cesarean birth in a Guatemalan cohort. Methods: This secondary analysis was conducted using data from a prospective study conducted in communities in Chimaltenango, Guatemala through the Global Network for Women's and Children's Health Research. Results: Between January 2017 and April 2020, 26,465 women delivered; 3,143 (11.9%) of those women had a singleton gestation and a history of prior cesarean delivery. 2,210 (79.9%) women with a history of prior cesarean birth had data available on mode of delivery and gave birth by repeat cesarean; 1312 (59.4%) were pre-labor cesareans while 896 (40.5%) were intrapartum cesarean births. Risk factors associated with an increased risk of intrapartum cesarean birth included hospital delivery as compared to "other" location (ARR 1.6 [1.2,2.1]) and dysfunctional labor (ARR 1.6 [1.4,1.9]). Variables associated with a reduced risk of intrapartum cesarean birth were hypertensive disease (ARR 0.7 [0.6,0.9]), schooling (ARR 0.9 [0.8,0.9]), and increasing age, which was associated with a very slight reduction in the outcome (ARR 0.99 [0.98,0.99]). Maternal and neonatal outcomes did not vary by type of cesarean birth. Conclusion: Outcomes of cesarean birth do not seem to vary by timing of repeat cesarean birth, with hypertensive disease increasing the likelihood of pre-labor cesarean. This information might be useful in counseling women that outcomes after failed trial of labor do not appear worse than those after pre-labor cesarean birth.
MeSH term(s)	Adult ; Cesarean Section, Repeat/methods ; Cesarean Section, Repeat/statistics & numerical data ; Cohort Studies ; Female ; Guatemala ; Humans ; Pregnancy ; Risk Factors ; Socioeconomic Factors
Language	English
Publishing date	2021-07-20
Publishing country	England
Document type	Journal Article
ISSN	1471-2393
ISSN (online)	1471-2393
DOI	10.1186/s12884-021-04000-3
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Article ; Online: How birth outcomes among a cohort of Guatemalan women with a history of prior cesarean vary by mode or birth across different interpregnancy intervals.

Harrison, Margo S / Garces, Ana / Figueroa, Lester / Westcott, Jamie / Hambidge, Michael / Krebs, Nancy F

Reproductive health

2021 Volume 18, Issue 1, Page(s) 99

Abstract: Objectives: Our objectives were to analyze how pregnancy outcomes varied by cesarean birth as compared to vaginal birth across varying interpregnancy intervals (IPI) and determine if IPI modified mode of birth.: Methods: This secondary analysis used ... ...

Abstract	Objectives: Our objectives were to analyze how pregnancy outcomes varied by cesarean birth as compared to vaginal birth across varying interpregnancy intervals (IPI) and determine if IPI modified mode of birth. Methods: This secondary analysis used data from a prospective registry of home and hospital births in Chimaltenango, Guatemala from January 2017 through April 2020, through the Global Network for Women's and Children's Health Research. Bivariate comparisons and multivariable logistic regression were used to answer our study question, and the data was analyzed with STATA software v.15.1. Results: Of 26,465 Guatemalan women enrolled in the registry, 2794 (10.6%) had a history of prior cesarean. 560 (20.1%) women delivered by vaginal birth after cesarean with the remaining 2,233 (79.9%) delivered by repeat cesarean. Repeat cesarean reduced the risk of needing a dilation and curettage compared to vaginal birth after cesarean, but this association did not vary by IPI, all p-values > p = 0.05. Repeat cesarean delivery, as compared to vaginal birth after cesarean, significantly reduced the likelihood a woman breastfeeding within one hour of birth (AOR ranged from 0.009 to 0.10), but IPI was not associated with the outcome. Regarding stillbirth, repeat cesarean birth reduced the likelihood of stillbirth as compared to vaginal birth (AOR 0.2), but again IPI was not associated with the outcome. Conclusion: Outcomes by mode of delivery among a Guatemalan cohort of women with a history of prior cesarean birth do not vary by IPI.
MeSH term(s)	Adult ; Birth Intervals/statistics & numerical data ; Cesarean Section/adverse effects ; Cesarean Section/statistics & numerical data ; Child ; Child Health ; Cohort Studies ; Female ; Guatemala/epidemiology ; Humans ; Infant, Newborn ; Labor, Obstetric ; Pregnancy ; Pregnancy Outcome/epidemiology ; Retrospective Studies ; Time Factors ; Vaginal Birth after Cesarean/statistics & numerical data ; Women's Health
Language	English
Publishing date	2021-05-21
Publishing country	England
Document type	Journal Article
ZDB-ID	2149029-6
ISSN	1742-4755 ; 1742-4755
ISSN (online)	1742-4755
ISSN	1742-4755
DOI	10.1186/s12978-021-01153-4
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Book ; Conference proceedings: Zinc in human medicine

Hambidge, K. M.

proceedings of a Symposium on the Role of Zinc in Health and Disease, London June 27th 1984

1984

Institution	Symposium on the Role of Zinc in Health and Disease Institute of Child Health
Author's details	Institute of Child Health. Chairmen: K. M. Hambidge
Keywords	Zinc / physiology / congresses ; Zinc / deficiency / congresses
Size	II, 134 S. : Ill., graph. Darst.
Publisher	TIL Publ
Publishing place	Isleworth u.a.
Publishing country	Great Britain
Document type	Book ; Conference proceedings
HBZ-ID	HT003392450
ISBN	0-9509861-0-0 ; 978-0-9509861-0-4
Database	Catalogue ZB MED Medicine, Health

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Article ; Online: Impact of the COVID-19 Pandemic on Health Care Utilization in the Vaccine Safety Datalink: Retrospective Cohort Study.

Qian, Lei / Sy, Lina S / Hong, Vennis / Glenn, Sungching C / Ryan, Denison S / Nelson, Jennifer C / Hambidge, Simon J / Crane, Bradley / Zerbo, Ousseny / DeSilva, Malini B / Glanz, Jason M / Donahue, James G / Liles, Elizabeth / Duffy, Jonathan / Xu, Stanley

JMIR public health and surveillance

2024 Volume 10, Page(s) e48159

Abstract: Background: Understanding the long-term impact of the COVID-19 pandemic on health care utilization is important to health care organizations and policy makers for strategic planning, as well as to researchers when designing studies that use ... ...

Abstract	Background: Understanding the long-term impact of the COVID-19 pandemic on health care utilization is important to health care organizations and policy makers for strategic planning, as well as to researchers when designing studies that use observational electronic health record data during the pandemic period. Objective: This study aimed to evaluate the changes in health care utilization across all care settings among a large, diverse, and insured population in the United States during the COVID-19 pandemic. Methods: We conducted a retrospective cohort study within 8 health care organizations participating in the Vaccine Safety Datalink Project using electronic health record data from members of all ages from January 1, 2017, to December 31, 2021. The visit rates per person-year were calculated monthly during the study period for 4 health care settings combined as well as by inpatient, emergency department (ED), outpatient, and telehealth settings, both among all members and members without COVID-19. Difference-in-difference analysis and interrupted time series analysis were performed to assess the changes in visit rates from the prepandemic period (January 2017 to February 2020) to the early pandemic period (April-December 2020) and the later pandemic period (July-December 2021), respectively. An exploratory analysis was also conducted to assess trends through June 2023 at one of the largest sites, Kaiser Permanente Southern California. Results: The study included more than 11 million members from 2017 to 2021. Compared with the prepandemic period, we found reductions in visit rates during the early pandemic period for all in-person care settings. During the later pandemic period, overall use reached 8.36 visits per person-year, exceeding the prepandemic level of 7.49 visits per person-year in 2019 (adjusted percent change 5.1%, 95% CI 0.6%-9.9%); inpatient and ED visits returned to prepandemic levels among all members, although they remained low at 0.095 and 0.241 visits per person-year, indicating a 7.5% and 8% decrease compared to pre-pandemic levels among members without COVID-19, respectively. Telehealth visits, which were approximately 42% of the volume of outpatient visits during the later pandemic period, were increased by 97.5% (95% CI 86.0%-109.7%) from 0.865 visits per person-year in 2019 to 2.35 visits per person-year in the later pandemic period. The trends in Kaiser Permanente Southern California were similar to those of the entire study population. Visit rates from January 2022 to June 2023 were stable and appeared to be a continuation of the use levels observed at the end of 2021. Conclusions: Telehealth services became a mainstay of the health care system during the late COVID-19 pandemic period. Inpatient and ED visits returned to prepandemic levels, although they remained low among members without evidence of COVID-19. Our findings provide valuable information for strategic resource allocation for postpandemic patient care and for designing observational studies involving the pandemic period.
MeSH term(s)	Humans ; Pandemics/prevention & control ; Retrospective Studies ; COVID-19/epidemiology ; COVID-19/prevention & control ; Patient Acceptance of Health Care ; Telemedicine ; Vaccines
Chemical Substances	Vaccines
Language	English
Publishing date	2024-01-23
Publishing country	Canada
Document type	Journal Article
ISSN	2369-2960
ISSN (online)	2369-2960
DOI	10.2196/48159
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Article ; Online: Costs to Implement a Pediatric Weight Management Program Across 3 Distinct Contexts.

Smith, Natalie Riva / Simione, Meg / Farrar-Muir, Haley / Granadeno, Jazmin / Moreland, Jennifer W / Wallace, Jessica / Frost, Holly M / Young, Jackie / Craddock, Cassie / Sease, Kerry / Hambidge, Simon J / Taveras, Elsie M / Levy, Douglas E

Medical care

2023 Volume 61, Issue 10, Page(s) 715–725

Abstract: Background: The Connect for Health program is an evidence-based program that aligns with national recommendations for pediatric weight management and includes clinical decision support, educational handouts, and community resources. As implementation ... ...

Abstract	Background: The Connect for Health program is an evidence-based program that aligns with national recommendations for pediatric weight management and includes clinical decision support, educational handouts, and community resources. As implementation costs are a major driver of program adoption and maintenance decisions, we assessed the costs to implement the Connect for Health program across 3 health systems that primarily serve low-income communities with a high prevalence of childhood obesity. Methods: We used time-driven activity-based costing methods. Each health system (site) developed a process map and a detailed report of all implementation actions taken, aligned with major implementation requirements (eg, electronic health record integration) or strategies (eg, providing clinician training). For each action, sites identified the personnel involved and estimated the time they spent, allowing us to estimate the total costs of implementation and breakdown costs by major implementation activities. Results: Process maps indicated that the program integrated easily into well-child visits. Overall implementation costs ranged from $77,103 (Prisma Health) to $84,954 (Denver Health) to $142,721 (Massachusetts General Hospital). Across implementation activities, setting up the technological aspects of the program was a major driver of costs. Other cost drivers included training, engaging stakeholders, and audit and feedback activities, though there was variability across systems based on organizational context and implementation choices. Conclusions: Our work highlights the major cost drivers of implementing the Connect for Health program. Accounting for context-specific considerations when assessing the costs of implementation is crucial, especially to facilitate accurate projections of implementation costs in future settings.
MeSH term(s)	Humans ; Child ; Pediatric Obesity/prevention & control ; Weight Reduction Programs ; Educational Status ; Electronic Health Records ; Health Promotion
Language	English
Publishing date	2023-09-07
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	411646-x
ISSN	1537-1948 ; 0025-7079
ISSN (online)	1537-1948
ISSN	0025-7079
DOI	10.1097/MLR.0000000000001891
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Order via subito

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In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

Order via subito

Inter-library loan at ZB MED

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito