ABSTRACT
Purpose of Study Research has shown that low levels of physical activity in U.S. adolescents contributes to childhood obesity. Some studies have shown benefits from Doctor's office and school-based interventions for underserved adolescents with less access to affordable healthcare. Few studies have examined the Emergency Department (ED) as a setting to reach this population. The purpose of this study is to determine the receptivity of underserved adolescents with receiving an ED intervention to increase their physical activity. Methods Used This pilot study consists of a cross-sectional survey. The study population included were underserved adolescents between the ages of 12 to 18 who qualified for public insurance and presented to the ED. Children with private insurance or those presenting with COVID-19 or COVID-19 symptoms were excluded. Data points collected included age, race/ethnicity, comfort levels for discussing physical activity in the ED on a 1:10 scale, likelihood to change their opinions about physical activity in ED on a 1-10 scale, preferred setting to receive an intervention on physical activity, and setting most likely to change their opinions about physical activity. Summary of Results Out of the 47 patients that were enrolled to date, 51% were male, the mean age was 15 years (SD 2 yrs.). Patients identified as Hispanic/Latino (34.0%), White/ Caucasian (29.8%), African American (27.7%), Biracial (6.4%), and Asian (2.1%). For comfort level discussing physical activity in the ED, the mean was 6.5 (SD 2.4), 53.2% picked high comfort (7-10), 36.2% picked medium comfort (4-6), and 10.6% picked low comfort (0-3). For likelihood to change their opinions about physical activity in the ED, the mean was 6.6 (SD 2.5), 57.4% picked high likelihood (7-10), 29.8% picked medium likelihood (4-6), and 12.8% picked low likelihood (0-3). Most preferred physical activity intervention settings were: School (56.8%), Doctor's office (31.8%), and ED (6.8%). Settings most likely to change an adolescent's physical activity opinions were: Doctor's office (44.2%), ED (30.2%), and School (20.9%). Comfort level and likelihood levels were similar across gender and race/ethnicity groups when tested with a Kruskal-Wallis test. Conclusions Underserved adolescents report being comfortable and likely to change their physical activity opinions if approached in the ED setting. This reported receptivity suggests the ED may be a good venue to institute an intervention. The most preferred intervention setting for underserved adolescents was school, and the venue most likely to impact change was the Doctor's office followed by the ED. (Table Presented).
ABSTRACT
Purpose of Study Firearm violence comprises a large percentage of pediatric injuries within the United States. Among all highincome countries, 91% of childhood firearm deaths occur in US children younger than 14 years. Coronavirus-19 Pandemic is associated with increased firearm violence, but little is known about the impact on children. Our objective is to evaluate the pediatric rates of firearm-related injuries within the state of Connecticut (CT) before- and during-COVID. Methods Used Data was ed from the Connecticut Health Information Management Exchange (CHIME) datasets from 2016-2020. All cases of firearm related injuries were identified by ICD -10 codes. Two study groups were created using events occurring in 2018 and 2019 (before-COVID) and events occurring in 2020 (during COVID). Before and during COVID groups were compared to assess differences in rates of injuries and any associations by age, sex, race, cause of injury, bodily location of injury, and geographic location of event. Summary of Results A total of 188 encounters were identified. The mean age was 14 years (SD+/- 3.5), 20% girls, 80% boys, 43% White, 37% Black, and 12% Hispanic. The overall rate of firearm injuries before COVID was 1.6 per 100,000 and during COIVD was 2.1/100,000 (p<0.01). Adjusting for population changes, the incidence of firearm injuries in CT increased by 33%. White and Black children accounted for similar proportion of injuries in all time periods. In all years, about 80% were unintentional while half were injured in suburban areas compared to urban and rural (p=0.97). Almost half of all injuries involved an extremity. Conclusions The proportion of children with firearm related injuries significantly increased during COVID compared to the preceding two years. The age, sex and race/ethnicity of injured children was similar before and during the COVID-19 pandemic. Unintentional injury accounted for the majority of injuries. Overall the proportion of White and Black children injured by firearms was similar, and children living in suburban areas were injured more than other areas. (Table Presented).