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Health Needs of Vulnerable Children: Challenges and Solutions: Second Edition
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Health Needs of Vulnerable Children: Challenges and Solutions: Second Edition

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (1 June 2023) | Viewed by 16352

Special Issue Editors

Dr. Eunice Rodriguez

E-Mail Website
Guest Editor
Department of Pediatrics, Stanford University, Stanford, CA 94305, USA
Interests: health disparities; health impact of social programs and policies; school health; health education; disease prevention
Special Issues, Collections and Topics in MDPI journals
Dr. Ryan Christopher Padrez

E-Mail Website
Guest Editor
Department of Pediatrics, Stanford University, Stanford, CA 94305, USA
Interests: health policy and health systems; school-based health; early childhood development; children with special care needs; health disparities and social determinants of health; medical home and primary care redesign
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

Due to the success of the first edition of the Special Issue "Health Needs of Vulnerable Children: Challenges and Solutions" published in the International Journal of Environmental Research and Public Health (IJERPH) (https://www.mdpi.com/journal/ijerph/special_issues/Children_Needs), we would like to continue exploration of this topic. IJERPH is a peer-reviewed scientific journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information on the journal, we refer you to https://www.mdpi.com/journal/ijerph. 

Improving public health is an important objective for policy makers, and the health of children could have long-lasting consequences over the life course. We use the term "vulnerable children" in a broad sense to include various types of vulnerabilities. Children who are in extreme crisis situations, such as displacement due to climate disaster, civic unrest and violence or economic crisis, as well as those who suffer abuse, are victims of trafficking, or have complex health needs would be among the most vulnerable. However, many other children are also at risk of experiencing health problems due to a variety of persisting challenges, such as poverty and lack of social protection policies. In the more affluent communities, children might be especially vulnerable to stressors that precipitate mental health conditions including self-inflicted harm and suicide. The COVID pandemic has exacerbated existing vulnerabilities and has also accelerated the need for successful interventions.

There is extensive research documenting childhood vulnerabilities and health challenges during those critical developmental years. Yet, this Special Issue aims to go one step further and focus on programs and policies that have proved to have a positive impact among diverse groups of vulnerable children. With a diverse collection of papers, concentrating on different aspects of children’s health and vulnerabilities, we intend to offer a critical guide for policy efforts and planning for public health.

This second edition of the Special Issue is open to any subject area related to the health needs of vulnerable children and, most importantly, to interventions and policies that have proved to have a positive impact on improving children’s health. The listed keywords suggest just a few of the many possibilities. 

Dr. Eunice Rodriguez
Dr. Ryan Christopher Padrez
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Children’s health
  • Social programs and health
  • Health policy
  • Social policies and children
  • Community and health interventions
  • Quality of life and children
  • Underserved populations
  • At risk children
  • Mental and physical vulnerability
  • Public Health

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Related Special Issue

Published Papers (7 papers)

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13 pages, 907 KiB  
Article
Addressing Health-Related Social Needs and Mental Health Needs in the Neonatal Intensive Care Unit: Exploring Challenges and the Potential of Technology
by Eline van de Kamp, Jasmin Ma, Nagendra Monangi, Fuchiang Rich Tsui, Shilpa G. Jani, Jae H. Kim, Robert S. Kahn and C. Jason Wang
Int. J. Environ. Res. Public Health 2023, 20(24), 7161; https://doi.org/10.3390/ijerph20247161 - 9 Dec 2023
Cited by 1 | Viewed by 2310
Abstract
Unaddressed health-related social needs (HRSNs) and parental mental health needs in an infant’s environment can negatively affect their health outcomes. This study examines the challenges and potential technological solutions for addressing these needs in the neonatal intensive care unit (NICU) setting and beyond. [...] Read more.
Unaddressed health-related social needs (HRSNs) and parental mental health needs in an infant’s environment can negatively affect their health outcomes. This study examines the challenges and potential technological solutions for addressing these needs in the neonatal intensive care unit (NICU) setting and beyond. In all, 22 semistructured interviews were conducted with members of the NICU care team and other relevant stakeholders, based on an interpretive description approach. The participants were selected from three safety net hospitals in the U.S. with level IV NICUs. The challenges identified include navigating the multitude of burdens families in the NICU experience, resource constraints within and beyond the health system, a lack of streamlined or consistent processes, no closed-loop referrals to track status and outcomes, and gaps in support postdischarge. Opportunities for leveraging technology to facilitate screening and referral include automating screening, initiating risk-based referrals, using remote check-ins, facilitating resource navigation, tracking referrals, and providing language support. However, technological implementations should avoid perpetuating disparities and consider potential privacy or data-sharing concerns. Although advances in technological health tools alone cannot address all the challenges, they have the potential to offer dynamic tools to support the healthcare setting in identifying and addressing the unique needs and circumstances of each family in the NICU. Full article
(This article belongs to the Special Issue Health Needs of Vulnerable Children: Challenges and Solutions: Second Edition)
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13 pages, 348 KiB  
Article
Understanding ART Adherence among Adolescent Girls and Young Women in Western Kenya: A Cross-Sectional Study of Barriers and Facilitators
by Jonathan Altamirano, Isdorah A. Odero, Mevis Omollo, Eucabeth Awuonda, Ken Ondeng’e, Jennifer L. Kang, Rasika Behl, Richard Ndivo, Michael Baiocchi, Hellen C. Barsosio and Clea C. Sarnquist
Int. J. Environ. Res. Public Health 2023, 20(20), 6922; https://doi.org/10.3390/ijerph20206922 - 14 Oct 2023
Viewed by 2482
Abstract
Background: HIV remains a leading cause of death for adolescent girls and young women (AGYW) in sub-Saharan Africa. This population has a high incidence of HIV and other comorbidities, such as experiencing violence, and low antiretroviral therapy (ART) adherence. To reach global HIV [...] Read more.
Background: HIV remains a leading cause of death for adolescent girls and young women (AGYW) in sub-Saharan Africa. This population has a high incidence of HIV and other comorbidities, such as experiencing violence, and low antiretroviral therapy (ART) adherence. To reach global HIV goals, data are needed on the specific adherence barriers for AGYW living with HIV, so interventions can be targeted effectively. Methods: Cross-sectional data were collected at urban and rural health facilities in and around Kisumu County, western Kenya, from January to June 2022, from AGYW 15–24 years of age who were living with HIV. Surveys included questions on intimate partner violence, mental health issues, food security, and orphanhood. Adherence was categorized using viral load testing where available and the Center for Adherence Support Evaluation (CASE) adherence index otherwise. Logistic regression was used to assess associations between potential explanatory variables and adherence. Findings: In total, 309 AGYW participated. AGYW with experiences of emotional violence (Odds Ratio [OR] = 1.94, 95% Confidence Interval [CI] = 1.03–3.66), moderate or severe depression (OR = 3.19, 95% CI = 1.47–6.94), and/or substance use (OR = 2.71, 95% CI = 1.24–5.92) had significantly higher odds of poor adherence when compared to AGYW without these respective experiences. Physical and sexual violence, food insecurity, and orphanhood were not associated with poor adherence in this cohort. Interpretation: Elucidating the risk factors associated with poor adherence among AGYW living with HIV allows us to identify potential targets for future interventions to improve ART adherence and HIV care outcomes. Mental health and violence prevention interventions, including combination interventions, may prove to be promising approaches. Full article
(This article belongs to the Special Issue Health Needs of Vulnerable Children: Challenges and Solutions: Second Edition)
9 pages, 298 KiB  
Article
Can a Clinic-Based Community Health Worker Intervention Buffer the Negative Impact of the COVID-19 Pandemic on Health and Well-Being of Low-Income Families during Early Childhood
by Taylor Salaguinto, Yasmin Guzman, Sarah J. Lowry, Kendra Liljenquist, Rachel LaFontaine, Janette E. Ortiz, Peter G. Szilagyi, Kevin Fiscella, Marcia R. Weaver and Tumaini R. Coker
Int. J. Environ. Res. Public Health 2023, 20(14), 6407; https://doi.org/10.3390/ijerph20146407 - 20 Jul 2023
Cited by 1 | Viewed by 1408
Abstract
We examined changes in self-reported mental health, physical health, and emotional support among low-income parents with children ages 0–2 years old from pre-pandemic to pandemic periods and compared changes in parental health among parents who did versus did not have access to a [...] Read more.
We examined changes in self-reported mental health, physical health, and emotional support among low-income parents with children ages 0–2 years old from pre-pandemic to pandemic periods and compared changes in parental health among parents who did versus did not have access to a clinic-based community health worker intervention supporting parents at early childhood preventive care visits. We utilized longitudinal parent survey data from pre-COVID-19 and COVID-19 time periods from both the intervention and control arms of an existing cohort of parents enrolled in a 10-clinic cluster randomized controlled trial (RCT). At enrollment (pre-pandemic) and 12-month follow-up (pandemic), participants reported on mental health, physical health, and emotional support using PROMIS measures (n = 401). During the pre-pandemic portion, control and intervention group parents had similar mean T-scores for mental health, physical health, and emotional support. At follow-up, mean T-scores for mental health, physical health, and emotional support decreased across both control and intervention groups, but intervention group parents had smaller declines in mental health T-scores (p = 0.005). Our findings indicate that low-income parents with young children suffered significant declines in mental and physical health and emotional support during the pandemic and that the decline in mental health may have been buffered by the community health worker intervention. Full article
(This article belongs to the Special Issue Health Needs of Vulnerable Children: Challenges and Solutions: Second Edition)
10 pages, 443 KiB  
Article
New Caregiver Diagnoses of Severe Depression and Child Asthma Controller Medication Adherence
by Janet M. Currie, Michele Mercer, Russ Michael and Daniel Pichardo
Int. J. Environ. Res. Public Health 2023, 20(11), 5986; https://doi.org/10.3390/ijerph20115986 - 29 May 2023
Cited by 1 | Viewed by 1816
Abstract
Background and Objectives: Children with asthma who have depressed caregivers are known to be less adherent to medication regimes. However, it is less clear how adherence responds to a caregiver’s new diagnosis of severe depression or whether there is a similar relationship with [...] Read more.
Background and Objectives: Children with asthma who have depressed caregivers are known to be less adherent to medication regimes. However, it is less clear how adherence responds to a caregiver’s new diagnosis of severe depression or whether there is a similar relationship with other serious caregiver diagnoses. The hypothesis is that adherence worsens both with new diagnoses of depression and possibly with new diagnoses of other serious conditions. Methods: This study follows a cohort of 341,444 continuously insured children with asthma before and after a caregiver’s new diagnosis of severe depression or another serious health condition. The effect of a new depression diagnosis on a child’s medication adherence is compared to the effect of new diagnoses of other common caregiver chronic conditions including diabetes, cancer, congestive heart failure, coronary artery disease, and chronic obstructive pulmonary disease. Results: Results show that children’s medication adherence declines following a caregiver’s new diagnosis of severe depression, but that it also declines following a caregiver’s new diagnosis of diabetes. There is no association with new diagnoses of the other caregiver chronic conditions examined. Conclusions: Children whose caregivers have a new diagnosis of depression or diabetes may be at increased risk of deterioration in their medication adherence. These caregivers may benefit from additional support and follow-up. The relationship between caregivers’ health and children’s medication adherence is complex and deserves further study. Full article
(This article belongs to the Special Issue Health Needs of Vulnerable Children: Challenges and Solutions: Second Edition)
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18 pages, 384 KiB  
Article
Leveraging the Expertise of the Community: A Case for Expansion of a Peer Workforce in Child, Adolescent, and Family Mental Health
by Hillary A. Robertson, Matthew G. Biel, Katherine R. Hayes, Sara Snowden, Latisha Curtis, Dominique Charlot-Swilley, Elyssa S. Clauson, Arrealia Gavins, Caslin M. Sisk, Noel Bravo, Erica E. Coates and Celene E. Domitrovich
Int. J. Environ. Res. Public Health 2023, 20(11), 5921; https://doi.org/10.3390/ijerph20115921 - 23 May 2023
Cited by 3 | Viewed by 2390
Abstract
The rise in child and adolescent mental health concerns has led to the need for an expanded workforce to meet the needs of our nation’s families. Peer paraprofessionals (PPs) have proven to be impactful in the areas of adult mental health (MH) and [...] Read more.
The rise in child and adolescent mental health concerns has led to the need for an expanded workforce to meet the needs of our nation’s families. Peer paraprofessionals (PPs) have proven to be impactful in the areas of adult mental health (MH) and substance use disorders, and for persons with chronic medical conditions. PPs can contribute to addressing child, adolescent, and family MH needs by being deployed in community settings and providing both emotional and tangible support to families and children. Additional use of PPs can address equity gaps in MH services by improving access to support and enhancing the cultural acceptability of MH interventions. A concentrated effort to expand and develop this workforce may help to alleviate the strain on the current MH system. The Georgetown University Infant and Early Childhood Certificate program is a paraprofessional training program that prepares community members to meet the MH needs of families with young children. The authors will describe the results of a qualitative study examining the landscape of peer paraprofessional services in DC that was conducted to support the expansion of the peer workforce to include individuals with expertise in infant and early childhood mental health. Full article
(This article belongs to the Special Issue Health Needs of Vulnerable Children: Challenges and Solutions: Second Edition)
21 pages, 1117 KiB  
Article
Remote Implementation of a School-Based Health Promotion and Health Coaching Program in Low-Income Urban and Rural Sites: Program Impact during the COVID-19 Pandemic
by Liana Gefter, Nancy Morioka-Douglas, Ashini Srivastava, Can Angela Jiang, Sonal J. Patil and Eunice Rodriguez
Int. J. Environ. Res. Public Health 2023, 20(2), 1044; https://doi.org/10.3390/ijerph20021044 - 6 Jan 2023
Cited by 2 | Viewed by 3099
Abstract
Background: Adapting existing health programs for synchronous remote implementation has the potential to support vulnerable youth during the COVID 19 pandemic and beyond. Methods: The Stanford Youth Diabetes Coaches Program (SYDCP), a school-based health promotion and coaching skills program, was adapted for remote [...] Read more.
Background: Adapting existing health programs for synchronous remote implementation has the potential to support vulnerable youth during the COVID 19 pandemic and beyond. Methods: The Stanford Youth Diabetes Coaches Program (SYDCP), a school-based health promotion and coaching skills program, was adapted for remote implementation and offered to adolescents from low-income communities in the US: an urban site in San Jose, CA and rural sites in Lawrence County, MO, and Central Valley, CA. Participants completed online pre- and post- surveys. Analysis included paired T-tests, linear regression, and qualitative coding. Results: Of 156 enrolled students, 100 completed pre- and post-surveys. Of those: 84% female; 40% Hispanic; 37% White; 28% Asian; 3% African American; 30% other race. With T-tests and regression models, the following measures showed statistically significant improvements after program participation: health knowledge, patient activation, health understanding and communication, consumption of fruits and vegetables, psychosocial assets of self-esteem, self-efficacy, problem-solving, and ability to reduce stress. Technology barriers were frequently reported at Lawrence County site. 96% participants reported making a lifestyle change after program participation. Conclusions: Remote implementation of health promotion programs for vulnerable youth in diverse settings has potential to support adoption of healthy behaviors, enhance patient activation levels, and improve psychosocial assets. Full article
(This article belongs to the Special Issue Health Needs of Vulnerable Children: Challenges and Solutions: Second Edition)
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8 pages, 438 KiB  
Brief Report
The Cost of Universal Suicide Risk Screening for Adolescents in Emergency Departments
by Kyle L. Grazier, Jacqueline Grupp-Phelan, David Brent, Adam Horwitz, Taylor C. McGuire, T. Charles Casper, Michael W. Webb and Cheryl A. King
Int. J. Environ. Res. Public Health 2023, 20(19), 6843; https://doi.org/10.3390/ijerph20196843 - 27 Sep 2023
Cited by 1 | Viewed by 1675
Abstract
Suicide is the second leading cause of death among adolescents. As nearly 20% of adolescents visit emergency departments (EDs) each year, EDs have an opportunity to identify previously unrecognized suicide risk. A novel Computerized Adaptive Screen for Suicidal Youth (CASSY) was shown in [...] Read more.
Suicide is the second leading cause of death among adolescents. As nearly 20% of adolescents visit emergency departments (EDs) each year, EDs have an opportunity to identify previously unrecognized suicide risk. A novel Computerized Adaptive Screen for Suicidal Youth (CASSY) was shown in a multisite study to be predictive for suicide attempts within 3 months. This study uses site-specific data to estimate the cost of CASSY implementation with adolescents in general EDs. When used universally with all adolescents who are present and able to participate in the screening, the average cost was USD 5.77 per adolescent. For adolescents presenting with non-behavioral complaints, the average cost was USD 2.60 per adolescent. Costs were driven primarily by time and personnel required for the further evaluation of suicide risk for those screening positive. Thus, universal screening using the CASSY, at very low costs relative to the cost of an ED visit, can facilitate services needed for at-risk adolescents. Full article
(This article belongs to the Special Issue Health Needs of Vulnerable Children: Challenges and Solutions: Second Edition)
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