Trends in health behavior at an afterschool program: the impact of COVID-19 on students' behavior.

BACKGROUND: A minority of American youth meet CDC physical activity (PA) recommendations; children in the Bronx face additional structural barriers to engaging in PA. The B'N Fit Power expansion draws on pilot programming to increase the proportion of middle school students who engage in one hour of daily PA. The COVID-19 pandemic presented additional obstacles, including increased food insecurity and suspension of organized PA programming. This research aimed to evaluate differences in baseline target behavior attainment before and after the start of the COVID-19 pandemic to inform future programming to help children reduce their risk of obesity. METHODS: Afterschool program leaders at three Bronx public schools collected demographic and target behavior data at baseline and attendance data throughout the school year. RESULTS: During the 2016-2017 and 2017-2018 school years, 76 students enrolled and completed one year of programming, which was administered at a single site (61% Hispanic, 46% female). Of these, 76 (100%) completed a baseline target behaviors questionnaire. During the 2021-2022 school year, 417 students enrolled and completed one year of programming at one of the three sites (70% Hispanic, 48% female). 89 (21%) completed a baseline target behaviors questionnaire. Participants surveyed after the start of the COVID-19 pandemic reported drinking more sugar-sweetened beverages (Median=3 daily, IQR 2-5), sleeping less (Median=8 hours daily, IQR 6-9 hours), and consuming fast food more frequently (Median=1 time weekly, IQR 0 times weekly-2 to 3 times weekly) than those surveyed prior to the start of the pandemic. The number of PA hours completed each week trended toward significant decline (Median=3, IQR 2-5, p=0.09) in students tracked after the start of the pandemic . CONCLUSIONS: The attainment of several target behaviors among school children linked to the reduction of childhood obesity declined during the COVID-19 pandemic. These findings can be applied to enhancing existing real-world afterschool PA programming.

Routine Ophthalmological Examination Rates in Adults with Sickle Cell Disease Are Low and Must Be Improved.

The American Academy of Ophthalmology and the National Heart, Lung and Blood Institute recommend patients with sickle cell disease (SCD) undergo dilated funduscopic exams (DFE) every 1-2 years to screen for sickle retinopathy. There is a paucity of data on the adherence rate to these guidelines; a retrospective study was performed to evaluate our institution's adherence. A chart review of 842 adults with SCD, seen 3/2017-3/2021 in the Montefiore healthcare system (All Patients), was done. Only about half of All Patients (n = 842) had >1 DFE during the study period (Total Examined Patients, n = 415). The Total Examined Patients were categorized as screening, those without retinopathy (Retinopathy-, n = 199), or follow-up, including individuals previously diagnosed with retinopathy (Retinopathy+, n = 216). Only 40.3% of screening patients (n = 87) had DFE at least biennially. As expected, there was a significant decrease in the average DFE rate of the Total Examined Patients after the COVID-19 pandemic started (13.6%) compared to pre-COVID (29.8%, p < 0.001). Similarly, there was a significant decrease in the screening rate of Retinopathy- patients from 18.6% on average pre-COVID to 6.7% during COVID (p < 0.001). This data shows the sickle retinopathy screening rate is low and innovative approaches may need to be employed to remedy this issue.

Impact of the COVID-19 Pandemic on Quantity and Characteristics of Ophthalmology Consults.

Purpose: To assess the COVID-19 exposure risk to consulting ophthalmologists and the pandemic effect on consultations at one of the most impacted hospital systems in New York. Methods: In a retrospective, cross-sectional study, ophthalmology consult notes and COVID-19 test results were collected from the electronic medical record from February to May in 2019 and 2020. Results: Of 2,215 total notes analyzed, consults decreased from 1,374 to 841 between years (p = 0.0002). In 2020, 22.5% of all consults were COVID tested and 2.4% were positive within 2 weeks of in-person evaluation. In 2020, 1.8% of consults were electronic. Ventilated patients increased between years (7.5% to 10.8%; p = 0.04). Conclusions: Although consultations decreased during the Spring 2020 peak, the majority (98.2%) remained as in-person evaluations. While few patients tested COVID positive, this likely reflects the limited availability of testing early in the pandemic. Consulting ophthalmologists remained at high risk of COVID-19 exposure during the pandemic peak.