Early intervention programs for toddlers with Autism Spectrum Disorder: a systematic review

This review identified 8 randomized controlled trials (RCTs) that evaluated early intervention (EI) programs for infants in the age-group 18-48 months who either had been diagnosed with, or were considered at risk for, autism spectrum disorder (ASD). The studies were summarized in terms of participant characteristics, intervention characteristics, rigor of study/research and outcomes. Intervention characteristics included the provision of training to parents. All the studies used RCT design, with control subjects who were either toddlers of typical development (TD) or toddlers with ASD following “treatment as usual” (TAU) or another treatment, and all were rated as strong in terms of quality/rigor. Positive results were recorded for parental acceptability and satisfaction, and reduction of parenting stress. In most of the studies, the social communication and developmental skills of the toddlers were enhanced. We conclude that EI programs for ASD show promise, and may be beneficial for both the toddlers and the parents, but the limited number of RCTs and the wide variety in intervention programs and assessment instruments used indicates the need for additional research to evaluate the specific benefits.

Implementation of the norwegian ‘Starting right’ child health service innovation: implementation adjustments, adoption, and acceptability

Background An increased and/or stable proportion of the child and adolescent population reports symptoms of impaired health, and the symptoms can be identified early. Therefore, structured child- and parent-reported outcome measures need to be implemented in child and school health services for decision support and identification of children at risk. We aimed to (a) qualitatively examine adjustments of active implementation from the pilot implementation of the Norwegian ‘Starting Right’ health service innovation including an online child health assessment tool and practical routines, and (b) measure practitioners´ adoption and parental acceptability. Methods We used a mixed-methods design to qualitatively examine adjustments from working notes and meeting memoranda, and quantitatively assess adoption and acceptability from user rates provided by the systems log. Twenty-one child and school health nurses (CSHNs) from two child health centers participated in the implementation pilot of online health assessments in children aged 2-, 4- and 6-year. We used a deductive and narrative analysis approach using Fixsen et al.´s core implementation components to code and sort adjustments. Results Core implementation components were adjusted throughout the pilot implementation. Researchers´ increased their availability in reciprocity with staff evaluation to integrate active implementation adjustments. We launched a project for improved data systems integration. The overall CSHNs adoption rate was satisfactory and higher in center A, where a medical secretary supported the nurses through the entire pilot phase, than in center B (96 vs. 55 %). Parental acceptability rate was overall high (77 %) with increased rates among parents of 6-year-old children (98 %) compared with younger ones (78–85 %), and in cases where both parents received the questionnaires. Conclusions The ‘Starting Right’ health service innovation implementation was actively adjusted by integration of core implementation components mainly based on staff evaluation. The CSHNs adopted the innovation which was also acceptable to parents.

Parental Acceptability of COVID-19 Vaccination for Children Under the Age of 18 Years: Cross-Sectional Online Survey

Background It is expected that COVID-19 vaccines will become available in China by the end of 2020. Vaccinating children against COVID-19 would contribute to the control of the pandemic and the recovery of the global economy. For children under the age of 18 years, parents are usually the decision makers regarding their children’s vaccination. Objective The goal of this study was to investigate parental acceptability of free COVID-19 vaccination for children under the age of 18 years in China. Methods This is a secondary analysis of a cross-sectional, closed online survey among 2053 factory workers in Shenzhen, China, implemented from September 1 to 7, 2020. Participants of the online survey were full-time employees aged 18 years or over who had resumed work in factories in Shenzhen. Factory workers in Shenzhen are required to receive physical examinations once a year. Eligible workers attending six designated physical examination sites were invited to complete an online survey. This study was based on a subsample of those who had at least one child under the age of 18 years (N=1052). After being briefed that COVID-19 vaccines developed by China are likely to be available by the end of 2020, participants were asked about their likelihood of having their children under the age of 18 years take up free COVID-19 vaccination provided by the government, if it existed. Multivariate logistic regression models were fitted to examine the associations of perceptions related to COVID-19 vaccination based on the theory of planned behavior (TPB) and exposure to information related to COVID-19 through social media with parental acceptability, after controlling for significant background characteristics. Results The prevalence of parents’ acceptability of COVID-19 vaccination for their children was 72.6% (764/1052). After adjusting for significant background characteristics, positive attitudes toward COVID-19 vaccination (adjusted odds ratio [AOR] 1.70, 95% CI 1.50-1.91), the perception that a family member would support them in having their children take up COVID-19 vaccination (ie, perceived subjective norm) (AOR 4.18, 95% CI 3.21-5.43), and perceived behavioral control to have the children take up COVID-19 vaccination (AOR 1.84, 95% CI 1.49-2.26) were associated with higher parental acceptability of COVID-19 vaccination. Regarding social media influence, higher exposure to positive information related to COVID-19 vaccination was associated with higher parental acceptability of COVID-19 vaccination (AOR 1.35, 95% CI 1.17-1.56). Higher exposure to negative information related to COVID-19 vaccination was negatively associated with the dependent variable (AOR 0.85, 95% CI 0.74-0.99). Conclusions Parents’ acceptability of COVID-19 vaccination for their children under 18 years of age was high in China. The TPB is a useful framework to guide the development of future campaigns promoting COVID-19 vaccination targeting parents. Transparency in communicating about the vaccine development process and vaccine safety testing is important. Public health authorities should also address misinformation in a timely manner.

Parental acceptability of coloured compomer as a restorative material in primary teeth of children - A randomized split mouth clinical trial

Coloured compomer materials have been introduced in Pediatric Dentistry and gained popularity as it develops a positive behaviour in the child and makes further treatment stress-free. However, parental satisfaction regarding the appearance of coloured compomer is questionable. This study aimed to compare the parental acceptability of coloured compomer compared to conventional compomer for the restoration of primary teeth in children. A total of sixty sites, divided into two groups, with thirty subjects in each group using split-mouth design were chosen amongst patients aged between 5 to 10 years reporting to the Department of Pedodontics and Preventive Dentistry. In the control group, conventional compomer(Material A) were placed, similarly coloured compomers(Material B) were placed in the experimental group under the standard operating protocol. Parental preference was noted by asking them to tick or point to the appropriate box labelled Material A and Material B, and the results were evaluated by statistical analysis using SPSS version 21.0. A statistically significant difference was found in parents in preference of conventional tooth coloured compomer as the restorative material. (p<0.05)Thus, the preference of parents regarding the placement of coloured compomer in primary teeth is comparatively low. Though the coloured compomer material positively influences the behaviour and treatment outcome in children, the parental satisfaction is found to be comparatively low as parents feel that it lacks the aesthetic appeal when compared to the conventional tooth-coloured restorations.

Parental Acceptability of HPV Vaccination for Adolescent Daughters and Associated Factors: A Cross-Sectional Survey in Bozhou, China

PurposeThis study aimed to investigate parents' acceptability of human papillomavirus (HPV) vaccination for their daughters and associated factors.MethodsThis cross-sectional study was conducted in a city in China with a sample population of parents with a daughter in middle school. Participants' demographic characteristics, knowledge level regarding HPV and the HPV vaccine, perspectives on the health belief model (HBM) constructs, social norms, and acceptability of the HPV vaccine were determined through self-administered questionnaires.ResultsAmong the 523 parents who completed the questionnaire, 71.5% expressed willingness to have their daughters vaccinated against HPV infection and cervical cancer. Logistic regression analysis revealed higher acceptability in the participants with higher perceived severity of HPV infection (OR = 4.823, 95% CI = 2.683, 12.049), higher knowledge-assessment score (OR = 1.298, 95% CI = 1.055, 1.476), and higher perceived safety of the HPV vaccine (OR = 6.372, 95% CI = 3.856, 14.062). Parents influenced by social norms (OR = 4.959, 95% CI = 2.989, 14.386) and those who complied with physicians' recommendations (OR = 4.896, 95% CI = 1.936, 9.258) reported higher levels of acceptability.ImplicationsOur results provide preliminary evidence on the need for health education programs and HPV vaccination campaigns. Future studies should focus on whether the factors associated with vaccination can increase parental acceptability of the HPV vaccine.

Parental Acceptability of COVID-19 Vaccination for Children Under the Age of 18 Years: Cross-Sectional Online Survey (Preprint)

BACKGROUND It is expected that COVID-19 vaccines will become available in China by the end of 2020. Vaccinating children against COVID-19 would contribute to the control of the pandemic and the recovery of the global economy. For children under the age of 18 years, parents are usually the decision makers regarding their children’s vaccination. OBJECTIVE The goal of this study was to investigate parental acceptability of free COVID-19 vaccination for children under the age of 18 years in China. METHODS This is a secondary analysis of a cross-sectional, closed online survey among 2053 factory workers in Shenzhen, China, implemented from September 1 to 7, 2020. Participants of the online survey were full-time employees aged 18 years or over who had resumed work in factories in Shenzhen. Factory workers in Shenzhen are required to receive physical examinations once a year. Eligible workers attending six designated physical examination sites were invited to complete an online survey. This study was based on a subsample of those who had at least one child under the age of 18 years (N=1052). After being briefed that COVID-19 vaccines developed by China are likely to be available by the end of 2020, participants were asked about their likelihood of having their children under the age of 18 years take up free COVID-19 vaccination provided by the government, if it existed. Multivariate logistic regression models were fitted to examine the associations of perceptions related to COVID-19 vaccination based on the theory of planned behavior (TPB) and exposure to information related to COVID-19 through social media with parental acceptability, after controlling for significant background characteristics. RESULTS The prevalence of parents’ acceptability of COVID-19 vaccination for their children was 72.6% (764/1052). After adjusting for significant background characteristics, positive attitudes toward COVID-19 vaccination (adjusted odds ratio [AOR] 1.70, 95% CI 1.50-1.91), the perception that a family member would support them in having their children take up COVID-19 vaccination (ie, perceived subjective norm) (AOR 4.18, 95% CI 3.21-5.43), and perceived behavioral control to have the children take up COVID-19 vaccination (AOR 1.84, 95% CI 1.49-2.26) were associated with higher parental acceptability of COVID-19 vaccination. Regarding social media influence, higher exposure to positive information related to COVID-19 vaccination was associated with higher parental acceptability of COVID-19 vaccination (AOR 1.35, 95% CI 1.17-1.56). Higher exposure to negative information related to COVID-19 vaccination was negatively associated with the dependent variable (AOR 0.85, 95% CI 0.74-0.99). CONCLUSIONS Parents’ acceptability of COVID-19 vaccination for their children under 18 years of age was high in China. The TPB is a useful framework to guide the development of future campaigns promoting COVID-19 vaccination targeting parents. Transparency in communicating about the vaccine development process and vaccine safety testing is important. Public health authorities should also address misinformation in a timely manner.