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This Month in Archives of Pediatrics and Adolescent Medicine
March 2008

This Month in Archives of Pediatrics & Adolescent Medicine

Arch Pediatr Adolesc Med. 2008;162(3):198. doi:10.1001/archpedi.162.3.198
Team Sports for Overweight Children: The Stanford Sports Study

As the number of children who are overweight or obese grows, a variety of approaches, including ways to increase physical activity, are necessary to address the problem. In this randomized trial, low-income children in grades 4 or 5 who were overweight or obese were randomized to a coed soccer team or a 25-session nutrition and health education intervention. All of the children playing soccer decreased their body mass indexes at 3- and 6-month follow-ups compared with 42% of the controls. Parents reported that being on the soccer team improved their children's confidence, self-esteem, and eating habits and increased their physical activity. Children not previously exposed to team sports will participate in a program specifically designed for overweight children.

See page 232

Screening for Drug Abuse in College Students

This study reports on a survey of medical and nonmedical prescription drug use by 3639 students at a large public university. Medical use of sleeping medication, narcotics, stimulants, or sedative/anxiety medications were reported by most respondents, and 1 in 5 reported nonmedical use of at least 1 class of these drugs. The nonmedical use of prescription drugs was associated with a 5- to 6-fold greater risk of having a positive screen for drug abuse compared with nonusers. In contrast, medical use of these drugs was not associated with an increased risk of drug abuse. The appropriate diagnosis, treatment, and therapeutic monitoring of students who are receiving abusable prescription medications is crucial to help prevent the abuse of these medications.

See page 225

A Randomized Trial of the Effects of Reducing Television Viewing

Television viewing is associated with increased energy intake and decreased energy expenditure; longer screen time may be an important risk factor for obesity. In this trial, 4- to 7-year-old children with body mass indexes (BMIs) higher than the 75th percentile were randomized to an intervention that reduced their screen time by 50% or to a control group that only monitored screen time. The intervention group had a 4-fold greater reduction in sedentary behaviors, decreased BMIs, and an 82% greater reduction in energy intake compared with controls. There were no differences between groups in changes in physical activity. The intervention worked best in families with low socioeconomic statuses. This study shows that changes in the home may be important for reducing BMIs and preventing obesity in children.

Figure.
Reduction in age- and sex-standardized body mass index (zBMI) values relative to baseline for the intervention and control groups over time. A statistically significant difference in the rate of change in zBMI by group was observed (P < .05). Data are given as mean (SEM).

Reduction in age- and sex-standardized body mass index (zBMI) values relative to baseline for the intervention and control groups over time. A statistically significant difference in the rate of change in zBMI by group was observed (P < .05). Data are given as mean (SEM).

See page 239

Incarceration and Psychotropic Drug Use in Youth

This study of youth aged 11 to 17 years who were enrolled in Medicaid and involved with the juvenile justice system in Florida sought to examine the effect of incarceration on the use of community mental health services and psychotropic medication. Only 5% or less of these youth had 2 or more claims for psychotropic drug use before incarceration; less than 2% of youth were newly prescribed such medication after release; and many youth taking medication before incarceration did not have it prescribed after release. Youth in longer-term facilities were less likely to resume medication after release than youth in shorter-term facilities. This study demonstrates that youth involved with the juvenile justice system have inadequate treatment of their mental health disorders, both before and after incarceration. The results provide evidence for disruption of medication use and little initiation of treatment during incarceration.

Figure.
Psychotropic medication use by Medicaid enrollees before and after juvenile incarceration. The study includes youth enrolled in Medicaid 90 days before incarceration and 90 days after release. Medication prior is defined as 2 or more psychotropic prescription claims in the 90 days prior to incarceration; medication after is defined as any psychotropic prescription claims within 30 days after incarceration.

Psychotropic medication use by Medicaid enrollees before and after juvenile incarceration. The study includes youth enrolled in Medicaid 90 days before incarceration and 90 days after release. Medication prior is defined as 2 or more psychotropic prescription claims in the 90 days prior to incarceration; medication after is defined as any psychotropic prescription claims within 30 days after incarceration.

See page 219

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