Piloting CenteringParenting in Two Alberta Public Health Well-Child Clinics.

OBJECTIVES: To pilot a group health service delivery model, CenteringParenting, for new parents, to assess its feasibility and impact on maternal and infant outcomes. DESIGN AND SAMPLE: Families attended six, 2-hr group sessions in their child's first year of life with three to seven other families. Health assessments, parent-led discussions, and vaccinations occurred within the group. MEASURES: Demographic, breastfeeding, vaccination, maternal psychosocial health, parenting, and satisfaction data were collected and compared to a representative cohort. RESULTS: Four groups ran in two clinics. Four to eight parent/infant dyads participated in each group, 24 total dyads. Most participating parents were mothers. Dyads in the group model received 12 hr of contact with Public Health over the year compared to 3 hr in the typical one-on-one model. Participants were younger, more likely to have lower levels of education, and lower household income than the comparison group. Parents reported improvements in parenting experiences following the program. At 4 months, all CenteringParenting babies were vaccinated compared to 95% of babies in the comparison group. CONCLUSIONS: The pilot was successfully completed. Additional research is required to examine the effectiveness of CenteringParenting. Data collected provide insight into potential primary outcomes of interest and informs larger, rigorously designed longitudinal studies.

A growth status measurement pilot in four Calgary area schools: perceptions of grade 5 students and their parents.

Reliable measures of growth in children are necessary for planning and evaluating obesity prevention programs. Currently, measured growth data are unavailable in Calgary for school-age children. This single sample, cross-sectional study included Grade 5 students and their parents. Height and weight measurements of 305 students (68% of those eligible) were taken in private in June 2007 and converted to Body Mass Index (BMI) categories. All but one student (99.7%) completed a questionnaire assessing perceptions of the measurement process. Parents received their child's growth data, an information package on healthy eating and active living, additional resources, and a questionnaire. A third of parents completed the questionnaire. Most students (94.1%) reported feeling "OK" or "Happy" about being measured. In addition, 93.2% of parents reported having "Low" or "Neutral" concerns about the measurement. Furthermore, 28.1% of responding parents reported seeking additional resources or considered making a lifestyle change for their family following the pilot. Measurement of students completed in private by nurses was acceptable to participants.

Conditioning and hyperalgesia in newborns exposed to repeated heel lances.

CONTEXT: Hospitalized infants undergo repeated invasive procedures. It is unknown whether cumulative experiences with pain lead to anticipatory pain behaviors and hyperalgesia. OBJECTIVES: To determine whether newborns who are born to mothers with diabetes and undergo repeated pain learn to anticipate pain and exhibit more pain during a painful procedure than normal infants. DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort study of 21 full-term newborns born to mothers with diabetes and 21 born to mothers with uneventful pregnancies, at a university teaching hospital between August 1999 and October 2000. Infants of diabetic mothers underwent repeated heel lances in the first 24 to 36 hours of life for monitoring of blood glucose concentrations. Pain responses of all infants undergoing a venipuncture on the dorsum of the hand to obtain blood for the newborn screening test after the first day of life were compared. In addition, from September through November 2001, 12 infants of diabetic mothers and 12 normal infants were compared for pain reactions to intramuscular vitamin K injection after birth. MAIN OUTCOME MEASURES: Percentages of time observed grimacing and crying and visual analog scale (VAS) scores. RESULTS: Raters were blinded to exposure group. Median baseline scores for grimacing, crying time, and VAS did not differ significantly between groups (P =.27, P =.32, and P =.32, respectively). Median scores (interquartile range) for grimacing during skin cleansing were higher in infants of diabetic mothers (22.2% [77.5%] vs 0% [15%]; P =.03). The VAS scores for both groups were zero, but the distribution of the scores was significantly different (86% of normal infants vs 52% of infants of diabetic mothers had scores of zero) (P =.04). During venipuncture, infants of diabetic mothers had higher median scores for grimacing (81.7% [32.5%] vs 40% [73.4%]; P =.01), VAS (69% [27.5%] vs 5% [60.5%]; P =.002), and crying (40.2% [77%] vs 0% [54.8%]; P =.03) compared with normal infants. There were no differences between groups on any pain measure in response to intramuscular injection. CONCLUSIONS: Newborns who had diabetic mothers and were exposed to repeated heel lances in the first 24 to 36 hours of life learned to anticipate pain and exhibited more intense pain responses during venipuncture than normal infants.