Spill-proof beverage container usage among young WIC-enrolled children.

PURPOSE: Currently, research is lacking regarding the use of spill-proof beverage containers (SPBCs). The purpose of this study was to assess the relationship between daytime SPBCs use for sugared beverages, caries, socioeconomic status, and other covariates in high-caries risk 12- to 49-month-old children attending a Women, Infants and Children (WIC) program. METHODS: Data were analyzed using baseline information from 415 Iowa WIC-enrolled children who participated in a psychoeducational study. Mothers completed a series of detailed questionnaires regarding their SES and their child's beverage consumption. Dental examinations using d1d2.3 (noncavitated and cavitated carious lesions) criteria were completed for the children. Bivariate relationships for consumption of any sugared beverage using SPBCs were assessed and followed by multivariable modeling using logistic regression (alpha=0.05). RESULTS: Only 18 children (four percent) reported using SPBCs for any sugared beverage during the night versus 290 (70 percent) during the day. Daytime consumption of sugared beverages from SPBCs was less likely to be reported in older children (P<.001) and in African American children when compared to both Hispanics (P>.001) and Caucasians (P=.001). CONCLUSIONS: Iowa WIC children primarily consume sugared beverages using spill-proof beverage containers during the day; children who were younger and Hispanic or Caucasian were more likely to use SPBCs to consume sugared beverages.

Spill-proof Beverage Container Usage among Young WIC-enrolled Children.

PURPOSE: Currently, research is lacking regarding the use of spill-proof beverage containers (SPBCs). The purpose of this study was to assess the relationship between daytime SPBCs use for sugared beverages, caries, socioeconomic status, and other covariates in high-caries risk 12- to 49-month-old children attending a Women, Infants and Children (WIC) program. METHODS: Data were analyzed using baseline information from 415 Iowa WIC-enrolled children who participated in a psychoeducational study. Mothers completed a series of detailed questionnaires regarding their SES and their child's beverage consumption. Dental examinations using d1d2.3 (noncavitated and cavitated carious lesions) criteria were completed for the children. Bivariate relationships for consumption of any sugared beverage using SPBCs were assessed and followed by multivariable modeling using logistic regression (alpha=0.05). RESULTS: Only 18 children (four percent) reported using SPBCs for any sugared beverage during the night versus 290 (70 percent) during the day. Daytime consumption of sugared beverages from SPBCs was less likely to be reported in older children (P<.001) and in African American children when compared to both Hispanics (P>.001) and Caucasians (P=.001). CONCLUSIONS: Iowa WIC children primarily consume sugared beverages using spill-proof beverage containers during the day; children who were younger and Hispanic or Caucasian were more likely to use SPBCs to consume sugared beverages.

An effective psychoeducational intervention for early childhood caries prevention: part I.

PURPOSE: The purpose was to compare whether mothers exposed to an autonomy-supportive psychoeducational videotaped message, informed by the self-determination theory (SDT), demonstrated greater changes in oral health knowledge and behavioral intentions as a preventive means for early childhood caries (ECC) than mothers exposed to a neutral message delivered by brochure. METHODS: Data were collected at baseline, one-, and six-month follow-ups from 415 12- to 49-month-old WIC-enrolled children and their mothers: 283 in the video intervention group and 132 in the brochure control group. Mothers completed questionnaires on maternal knowledge and behavioral intentions for oral health care. Chi-square, Wilcoxon rank-sum, and Mann-Whitney tests were used to analyze data (P<.05). RESULTS: Relative to their baseline scores, the intervention group showed a greater increase in knowledge than the control group, both at one-month (P=.002) and six-month follow-ups (P<.001). The video group also demonstrated a greater increase in behavioral intentions than controls, both at one-month (P<.05) and six-month follow-ups (P<.001). Knowledge and behavioral intention levels at six-month follow-up did not differ significantly from those at one-month follow-up, indicating that intervention-based increases in these measures were maintained over time. CONCLUSIONS: Data provided evidence of the effectiveness of the autonomy-supportive psychoeducational intervention for ECC prevention relative to a neutral brochure.

An effective psychoeducational intervention for early childhood caries prevention: part II.

PURPOSE: The purpose was to compare whether mothers exposed to an autonomy-supportive psychoeducational videotaped message, informed by self-determination theory (SDT), demonstrated greater changes in behavior concerning their children's oral health than mothers exposed to a neutral message delivered by brochure. METHODS: Data were collected at baseline, one- and six-month follow-ups from 415 12- to 49-month-old WIC-enrolled children and their mothers: 283 in the video intervention group and 132 in the brochure control group. Mothers completed questionnaires regarding their child's dietary/oral hygiene habits. Chi-square, Wilcoxon Signed Rank, Mann-Whitney, and McNemar tests were used to analyze data (P<0.05). RESULTS: Significantly more positive changes were observed for dietary/oral hygiene behaviors among the intervention group mothers at one- and six-month follow-ups than for the controls. Significantly fewer mothers in the intervention group shared dining ware with their child at both one- (P=0.0046) and six-month follow-ups (P<0.0001); this practice was decreased only at six-months for the control group mothers (P=0.05). Restricting consideration only to mothers who were not checking for white spot lesions at baseline, a significantly greater proportion of mothers in the intervention group performed this behavior at six-months (P=0.0044). CONCLUSIONS: Data provided evidence of the effectiveness of the SDT videotaped oral health message relative to a neutral brochure.

Core functions of nursing home social services departments in the United States.

OBJECTIVE: To report social services departmental involvement in 52 functions. DESIGN: Cross-sectional data collected from a nationally representative sample of 1071 nursing home social services directors who were asked to report the extent to which their department was involved in 52 functions (activities). The functions were organized under the framework of the NASW Clinical Indicators for Social Work and Psychosocial Services in Nursing Homes. SETTING: Nursing home. PARTICIPANTS: Social services directors. INTERVENTION: Not applicable. MEASUREMENT: Self-administered survey. RESULTS: Eighty percent of respondents indicated their department is "usually or always" involved in a core set of 24 functions (out of 52). For each of the 52 functions, at least 40% of departments are at least sometimes involved. CONCLUSION: Findings reveal both a core set of functions in which departments are "usually or always" involved, as well as many in which some, but not all, departments are involved. This variability of departmental involvement suggests that staff should clearly communicate the functions of their department so that residents, families, fellow staff, and the community know what can be expected. Future research should investigate how to maximize social services to achieve and maintain the highest possible quality of life for residents, address family concerns, and contribute to team effectiveness.

Dental caries in a cohort of very young American Indian children.

OBJECTIVES: This paper reports the prevalence and severity of caries in a group of 16-month-old American Indian children. METHODS: The study is an ongoing longitudinal study of risk factors for caries in children from a Northern Plains Tribal community. Children were examined for caries and risk factor data collected at approximately 1, 4, 8, 12, and 16 months of age. Surface-specific caries data were collected and the presence of precavitated "white spot" lesions was recorded at the subject level. RESULTS: The mean age was 15.4 months for the sample of 232 children. Caries prevalence was 31.9 percent, while an additional 29.3 percent had white spot lesions only. Mean dmfs was 1.57, and ranged from 0 to 44 surfaces. Nearly 3 percent of all erupted tooth surfaces were affected and maxillary central incisors had the highest prevalence of caries (22 percent). CONCLUSIONS: Among the very youngest children, dental caries prevalence was very high among these American Indian children.

Factors associated with mutans streptococci among young WIC-enrolled children.

OBJECTIVES: The objective of this study is to assess relationships between the presence or absence of mutans streptococci (MS) and other covariates in children aged 12-49 months. METHODS: Data were analyzed using baseline information from 411 children enrolled in the Special Supplemental Food Program for Women, Infants and Children (WIC) who participated in a psychoeducational study in Iowa. Children were assessed for MS using a semiquantitative method (RODAC plates). Dental examinations using d(1) d(2) .(3) criteria and presence of visible plaque on incisors and molars were completed. Mothers completed a series of detailed questionnaires regarding their child's oral health, their socioeconomic status, their child's dietary/oral hygiene habits, and beverage consumption, among other behaviors. Bivariate relationships with the presence of MS were assessed and followed by multivariable modeling using logistic regression (alpha = 0.05). RESULTS: MS was present in 144 children (35 percent). Bivariate relationships with MS presence were identified for multiple covariates that included demographic characteristics, type of beverage consumption, dental caries, and plaque measures. Multivariate logistic regression modeling suggested that MS presence in children was positively associated with nonwhite race of the child, number of teeth present, presence of cavitated lesions, proportion of teeth with plaque, and lower levels of maternal education. CONCLUSIONS: The presence of MS was associated with greater caries and plaque scores and with low maternal education and nonwhite racial background.

Most nursing home social service directors lack training in working with lesbian, gay, and bisexual residents.

The purpose of this descriptive study is to report findings from a nationally representative mail-in survey of nursing home social service directors (n = 1,071) who were asked if they had received at least one hour of training in six different areas of cultural competency in the past five years. Of the six areas, the lowest percentage of directors reported having training in homophobia. Three-fourths of the sample had not received even one hour of homophobia training over the past five years. Directors who were more recently educated were more likely to report having received homophobia training, as were directors with a college degree, and those who worked in nursing homes located in the West and South regions of the United States. Directors with the most experience were less likely to report having received training. Findings call for immediate development and dissemination of heterosexism and homophobia training of social service staff, policy changes within the nursing home, and policy advocacy priorities for social workers.

Nursing home social services directors' opinions about the number of residents they can serve.

An appropriate number of qualified staff is a key factor contributing to quality of care and quality of life for nursing home residents. While much of the literature focuses on the importance of adequate nursing ratios, this descriptive study is the first to focus on the social services staff ratio. Nationally representative survey results from over 1,000 nursing home social services directors reveal that the mean number of residents per full-time equivalent social worker in the United States is 89.3 and the median is 79 residents (note that this figure includes both long-term and subacute residents). Furthermore, although the federal government requires nursing homes with more than 120 beds to employ 1 full-time qualified social worker to meet resident psychosocial needs, when asked their opinion, the majority of respondents indicated that 1 full-time social worker could handle 60 or fewer long-term care residents or 20 or fewer subacute care residents. Nursing home characteristics helped to explain the variation in social services directors' opinions. These findings suggest that the federal policy related to social services staffing should be revisited. Policy makers would benefit from reliable and current data regarding social service staffing. Research is needed to understand the relationship between social services staffing and resident outcomes.

Depression screening in nursing homes: involvement of social services departments.

OBJECTIVE: To determine the percentage of nursing home (NH) social services (SSs) departments that screen at-risk residents for depression. To report characteristics of SS departments that "usually or always" are involved in depression screening. DESIGN: Cross-sectional, nationally representative survey. SETTING: NHs. PARTICIPANTS: 1,071 Nursing Home Social Service Directors. MEASUREMENT: Survey. RESULTS: Over two-thirds (68.5%) of the SS directors reported that their department was "usually" or "always" involved in screening at-risk residents for depression. Preliminary findings from this exploratory study indicate the odds of screening for depression increased if the SS director had a degree in social work; if the NH was part of a chain; and by U.S. region. NHs in the Northeast were less likely, and those in the Midwest and West were more likely, than their southern counterparts to head up SSs departments that screen for depression. CONCLUSIONS: Future research and clinical practice related to NH depression screening and treatment should include social workers. SS staff, especially those educated in social work, can be an important resource to NH staff, residents, and family members. The federal government holds NHs responsible for psychosocial care, including psychosocial depression care.

Characteristics of nursing home social services directors: how common is a degree in social work?

PURPOSE: To report the percentage of nursing homes whose social services director has a degree in social work, to report the characteristics of social service directors, and to describe the characteristics of nursing homes most likely to employ a degreed social worker. These questions are important because social workers are core members of the interdisciplinary team in nursing homes and have responsibilities for the psychosocial well-being of residents. DESIGN AND METHODS: Cross-sectional nationally representative survey of 1071 social service directors employed in US nursing homes certified to receive Medicare and/or Medicaid. RESULTS: Most nursing homes do employ at least one (and typically only one) social service staff person. Most are employed full-time and half have a degree in social work. About 20% do not have a college degree. The vast majority of social service directors are white and are women. Close to 40% are licensed social workers. Full-time salaries varies enormously from less than $15,000 to over $60,000 per year. Most do not belong to an organization that helps them keep apprised of developments in nursing home social services. Using logistic regression and controlling for the effects of other independent variables, for-profit nursing homes with fewer than 121 beds, in sparsely populated counties in the West are the least likely to hire a degreed social worker as social service director. IMPLICATIONS: The wide range in educational preparedness and salary indicates 2 roles: a social work role and a social services role. The different roles have implications for initial role preparation and continuing education. Clear communication about the role expectations associated with social services and social work would benefit residents, family, staff, and physicians, who would then be better prepared to draw on their skills in helping to meet the psychosocial needs of residents.