Browsing by Author "Robinson, Christina"
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Item Chronic Disease Presentations found in Elementary School Children(2020) Khan, Urooj; Robinson, Christina; Madina, RevanthPurpose: For the past few decades, chronic illnesses in children have been increasing. Chronic conditions generally lasts more than three months, affects everyday activities, and can require extensive medical care. In the United States, approximately 18% of children live with a chronic health condition. Common chronic childhood diseases include asthma, obesity, food allergies, and ADHD. Catch-1 is a health program which offers free health screenings to elementary students. It features a team of health providers including physicians, nurses, dental hygienists, audiologists, and speech pathologists, as well as their respective students. Through this program, health screenings are provided to the children of Morningside Elementary school in Fort Worth, Texas, while fostering an interprofessional learning environment. In this study, the investigators discovered the prevalence of common chronic diseases in the school's pediatric population. Methods: The investigators conducted a retrospective chart analysis to illustrate a statistical overview of the chronic diseases of Catch-1 participants during the years 2015 - Spring of 2019. The participants were aged three to twelve, from Pre-K to 5th grade. Results: The primary diagnoses were obesity (32%), dental carries (21%), and BMI > 85%ile (18%). Most of the participants had one diagnosis (68%), while 22% had two, 2% had three, and 32% had none. Conclusion: The results of the Catch-1 program highlight the need for regular medical screenings for children. Ideally, these results will encourage policy makers to expand school nursing and medical partnerships so that chronic conditions may be screened, and interventions may occur earlier.Item Control Case Study: E-Health Text Messaging Based Intervention on Developing Lifestyle Changes Related to the Improvement of Childhood Obesity(2023) Patel, Kavita; Robinson, ChristinaBackground: The prevalence of chronic diseases in the United States including heart disease and cancer is majorly attributable to adverse lifestyle factors such as smoking, physical inactivity, poor diet, stress, negative emotion, etc. (CDC, 2012). Recent studies have shown that mothers with unhealthy lifestyles serve as an impetus for childhood obesity (Dhana et al, 2018). Community health promotion efforts and lifestyle interventions are successful in introducing healthy behaviors and promoting its adherence (Dickinson et al., 2006; Kent et al., 2015; Pekmezi, Marquez, & Marcus-Blank, 2010; Tucker et al., 2014; Tucker et al., 2016). Our study evaluates the utilization of an E-health text message system as an effective intervention for caregivers of obese pediatric patients to improve lifestyle behaviors that influence childhood obesity. Case Presentation: A 30 year old African American female presented to the Pediatric Mobile Clinic with her 3 year old child who had a BMI in the 82nd percentile. The caregiver and child met the inclusion and exclusion criteria including adequate biometric markers before they were randomized to one of 2 intervention arms: control health group or e-health group. This subject was randomized into the control intervention arm. Participants of the control arm received weekly text messages for 6 months inquiring subjects on any SMART goal and duration of their choosing as well as assessing their motivation and confidence related to that goal (scored on a scale of 10). They also received follow-up messages asking introspective questions regarding habit formation and messages with self-scripted inspirational statements. The intervention arm differed in that the SMART goal chosen by subjects had to focus on one of six lifestyle medicine factors emphasized for that week's duration. The SMART goals input by this subject centered on improving the outlook, organization, and control of her finances and career. The subject's motivation scores were similar to her confidence scores for each specific goal even though they varied overall. More importantly, both scores trended upwards within self chosen goal periods lasting ≥ 3 weeks. Additionally, a common theme emphasized in the subject’s responses to introspective questions regarding her goals focused on maintaining "positivity”. The patient indicated a 7/10 on her 6-month exit survey, highlighting that the program "somewhat” supported the patient on a road to wellness by helping her "break things down into achievable goals each week”. Conclusions: This case illustrates the role an E-health intervention program had in helping the patient construct and keep track of achievable goals. The program was still beneficial to the control-intervention arm subject as indicated by her exit survey. Observed increases in confidence and motivation scores within prolonged goal periods highlights the impact this program had in establishing the self-accountability necessary for conceiving new goals and maintaining consistency. In effect, this case emphasizes how the intervention aids in promoting a subject’s intrinsic motivation in relation to the development of their goals and eventual habits. Overall, this case suggests that having any intervention in place, even to the degree involved within case controls, is significant compared to no intervention.Item Craving for Change: Culturally Tailored E-Health Intervention to Support SMART Goal Setting of Lifestyle Modifications Among Underserved Racial/Ethnic Families to Combat Obesity(2023) Abed, Fatima; Robinson, Christina; Yockey, AndrewPurpose: Examine the impact of the mixed-method intervention program Family Central E-Health, utilizing interactive, culturally tailored, e-health text messaging to promote healthy lifestyle behaviors in six domains (diet, physical activity, sleep, social connection, tobacco cessation, and stress management), and combat chronic disease such as obesity among a diverse racial/ethnic and low socioeconomic sample of caregivers of overweight/obese children. Methods: A sample of 14 adult caregivers of overweight/obese children receiving care from the University of North Texas Health Science Center Pediatric Mobile Clinic participated in the e-health intervention group (n = 8) or a control group of usual care (n = 6). The transtheoretical behavior change framework was applied to health briefs shared through a bi-directional text messaging software to customize SMART (Specific, Measurable, Attainable, Relevant, and Time) goal setting, monitor attitude (motivation and confidence), and assess behavioral change on the six domains of lifestyle modifications. The study aims were accomplished through weekly surveys throughout the study (6-month duration), at study close, 3 months post-intervention, and 6 months post-intervention. Results: Longitudinal analysis and differences in overall means of motivation and confidence between the two groups were minimal and not statistically significant. Descriptive thematic analysis of the participants’ attitudes and experiences revealed lifestyle modification domains of physical activity, social connection, and stress management with the most utilization in SMART goal setting and initiating health-promoting behaviors. Conclusion: The Family Central E-Health intervention may be an effective and culturally sensitive model for managing and preventing obesity, and alike chronic diseases among diverse racial/ethnic and/or low socioeconomic caregivers and their families. Reduction of harmful health behaviors and initiation of health-promoting behaviors through SMART goal setting within the six lifestyle domains can help address existing health disparities. Health education and lifestyle modification interventions are important and future directions include investigating participant empowerment, resiliency, and wellbeing, especially within underserved and diverse communities.Item E-Health Text Messaging based Intervention on Healthy Lifestyle Changes and Obesity in the Socioeconomically Disadvantaged Population(2023) Hussain, Rumaila; Robinson, ChristinaThe obesity epidemic, known to be a multifactorial medical condition, in the United States has been declared a public health crisis. Parental obesity more than doubles the risk of adult obesity among both obese and nonobese children under 10 years of age. (Whitaker, Wright et al. 1997) Naturally, parents are often the strongest role models of their young children, who tend to imitate their eating behaviors as well as other lifestyle behaviors. (Lubna, Paloma et al. 2021) Therefore, it is of paramount importance to have upstream intervention programs to make positive changes in the obesity-promoting lifestyle behaviors of parents that often contribute to. The e-health text messaging platform integrated six major contributing factors of obesity, which included caloric content and quality of diet, physical activity, sleep, social connection, tobacco, and stress management. We hypothesized that if we could change the attitudes, knowledge, and beliefs of the caregivers, then this would cause a ripple effect leading to their children adopting the same healthy lifestyles, thereby decreasing the prevalence of the obesity epidemic. Subject 4 is a Black or African American female who was part of the intervention arm which received text messages every week for 6 months which included health education on 6 different topics. The participant was surveyed biweekly about her knowledge, attitudes, and behaviors regarding health education topics via text messages. Throughout the study, subject 4 showed high motivation to make positive changes in her life. Her goals consisted of sleeping 8 hours a night, staying hydrated, exercising 30 minutes daily, meditating, praying, and decreasing her sugar intake. Subject 4 mentioned that "consistency” and "accountability” are what motivated her. The platform was able to give her a sense of accountability by ensuring that she was staying consistent by monitoring her progress toward her goals. She mentioned that having goals for her habits impacted her health and wellness by keeping her "consistent.” She indicated that the program greatly supported her on her road to wellness at the end of the study and "it had helped her to stay positive and to leave bad habits.” At the 9 and 12-month follow-ups, she indicated on a scale of 1 to 10 (10 being the most consistent), 10 and 8 respectively, that she was continuing her goals/habits that she had formed to support herself on her road to wellness. This case illustrates that an e-health intervention program may benefit individuals by providing a platform where they can create personal goals, have a form of accountability that encourages them to make small changes by providing health literate education briefs, and provides a connection to local community resources to support participants to reach their goals. Additionally, this intervention program showed a beneficial impact on the subject’s wellness as indicated by the post-survey responses. This highlights that having an intervention program may be a step in the right direction to making small positive lifestyle changes and eradicating the obesity epidemic one family at a time.Item Effectively recruiting for Family-central "E-health" research: Lessons from the Lifestyle Medicine Health Education and Intervention Program Study at a Pediatric Mobile Clinic(2022) Trammell, Benjamin Lewis III; Robinson, Christina; Kade, LauraAbstract: Background: Childhood obesity is a growing global epidemic with significant racial, ethnic, and socioeconomic disparities. While current efforts to stem the tide of the obesity epidemic have focused on public policy and individual level behaviors, little research has been done on community and family-based health interventions. In this study, a novel design of personalized text messages allowed flexible participation while relaying key lifestyle information on six major contributing factors to obesity. The patient population served by the Pediatric Mobile Clinic has been known to be difficult to reach in part because of their diverse range of cultures and languages, lack of access to affordable healthcare, housing instability, phone service capabilities, and access to individualized health related information. The purpose of this sub-analysis was to identify the most efficient and effective recruitment methods to reach a broader subset of underserved patient populations. Methods: Literature review and research study personnel experience informed the design and implementation of 6 recruitment styles to help increase participant engagement. These styles included a tracking sheet, in-person discussions, phone call tree, text messages, email prompts and an Electronic Medical Record review, all of which led to a pre-screen questionnaire that determined eligibility for enrollment. Results: 377 potential patients were pre-screened resulting in 19 participants being enrolled into the study, which is a 5% enrollment rate. 39 of them were screened in person whereas the remaining 338 were screened via phone call tree. Telephone calls produced more people enrolled per month; however, telephone call recruitment required a greater volume of participants screened to produce one enrolled subject in comparison to in-person screening. In person recruitment was most effective overall with 11 of the enrolled having been recruited in person vs 8 enrolled via telephone calls. Phone calling results in greater volume but may not be as efficient. The largest prescreen failure group was due to the inability of being able to contact potential participants followed by English not being a patient's primary language. Conclusions: Enrolling people in-person may be beneficial because you are able to make a human connection which could result in a greater conversion of prospective patients to consented participants. Contacting patients multiple times via different forms of communication (Text message; email; voicemail) helped increase recruitment numbers. Recruiting patients via multiple and diverse methods may be beneficial for enrollment, particularly with underserved patients who live busy lives and may not be as accessible during clinic or traditional 9-5 hours. Future studies should consider expanding their recruitment base by applying for IRB approval of materials in multiple languages. The recruitment methodology and findings from this unique and underserved patient population could potentially inform and shape future community and family-based e-health studies.Item Healthy Body: Activity Book(Gibson D. Lewis Library, 2022-05-02) Sheldon. Lorraine; Wright, Madison; Luna, Annabel; Robinson, Christina; Mozdbar, Sima; Fallahee, KateThe Healthy Body Activity Book is a printable resource for children to learn about how the body functions. It is a complimentary booklet to the parent materials, The Healthy Kids Medical Book. It has lessons and activities about immunity, eyes & vision, digestion & nutrition, dental care, muscles, heart, & bones, and the brain, nerves, & senses. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.Item Healthy Kids: Medical Book(Gibson D. Lewis Library, 2022-05-02) Sheldon. Lorraine; Wright, Madison; Luna, Annabel; Robinson, Christina; Mozdbar, Sima; Fallahee, KateThe Healthy Kids Medical Book is a printable tool for parents to track their child's medical history and log wellness checks from infant to 21 years old. It also includes helpful resources about vaccinations, sports physicals, and wellness checks. All the content is written in English and Spanish, including a glossary of terms. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.Item Impact of Lifestyle Intervention using Family Central(2021) Banh, Debini; Lopez, Aimee; Robinson, ChristinaChronic diseases due to preventative causes are becoming increasingly prevalent among Americans. The Pediatric Mobile Clinic provides free medical care and vaccines to uninsured children in underserved areas of Fort Worth. These underserved populations have health concerns that demonstrate the need for lifestyle medicine interventions that can promote healthful eating, physical activity, sleep, and other healthy behaviors in order to help prevent chronic disease while also improving the wellbeing of the family. Participants were placed into three groups that initially met once a month to discuss a Family Central topic (i.e Nutrition, Physical Activity, Tobacco Avoidance, Sleep, Stress Management, and Social Connection). Sessions were converted to a virtual platform due to the COVID-19 pandemic. Participants engaged in discussion on the topic of the week and created SMART goals. A general linear mixed-effects model was used to examine the impact of lifestyle intervention including health lifestyle education classes on participants' knowledge, attitude, and behaviors, and clinical outcomes. Due to the small sample size and the incomplete survey responses, the results were non-parametric. However, the survey responses showed that the Family Central sessions were highly effective in all participants in increasing awareness of good health behaviors and improving health status. The Family Central program is both important and necessary for improving the health behaviors of the community. With proper education and improved health behaviors, we will see reduced likelihood of chronic disease. We hope to see a positive impact as caregivers model the health behaviors for their children.Item Lifestyle Medicine Health Education and Intervention Program "Family Central"(2024-03-21) Hull, Madison; Gavagan, Maeve; Robinson, Christina; Yockey, AndrewPurpose: Since the declaration of the obesity epidemic, children have been bearing the consequences of this public health crisis. Obesity is associated with adverse health outcomes, including type 2 diabetes, hypertension, cardiovascular disease, and cancer. Minority children and those of low socioeconomic status face higher rates of obesity. Children of obese parents are more likely to become overweight or obese themselves. Given this background, our goal was to determine the most effective ways to initiate and maintain healthful lifestyle behaviors that could prevent and reverse chronic diseases among socioeconomically disadvantaged families. The overall objective of this study was to measure the efficacy of text message platforms as an e-health intervention in delivering personalized health education content to parents of overweight/obese children by observing changes in their knowledge and attitudes of healthful lifestyle choices and the overall resultant health outcomes in their children. Methods: We customized an e-health intervention using the Mosio text message platform to address the six tenets of lifestyle medicine: nutrition, physical activity, stress management, sleep, tobacco cessation, and social connection. 19 adult caregivers of overweight/obese children from the UNTHSC Pediatric Mobile Clinic were enrolled. Caregivers were randomly assorted to an intervention group, who received 2+ educational briefs via the text message platform, Mosio, and a control group, who were referred to the patient portal for education, which is standard of care. Goal-setting behavior was examined by asking participants to set a weekly lifestyle goal and rate their confidence and motivation to achieve these goals on a scale of 1 to 10. Results: Results of this study were limited by low sample size and the effects of the COVID-19 pandemic on enrollment and retention. No statistically significant results were calculated between the intervention and control groups. Qualitative analysis yielded positive responses on an individual basis. Thematic analysis revealed the most significant utilization of SMART goal setting in the domains of physical activity, social connection, and stress management. Feedback from participants demonstrated that text message interventions helped them stay consistent with routine, avoid falling into bad habits, and create healthy habits for their family. Conclusions: While there were no statistically significant findings of this study, positive qualitative data suggests that the innovative Mosio interactive platform may serve as an ideal tool for inducing attitudinal, knowledge, and behavioral stage changes and, ultimately, acquisition of healthful lifestyle behaviors that combat chronic disease.