Health Promotion, Shared Decision Making, & Motivational Interviewing Flashcards
How many well-child visits are recommended by the AAP from birth to adolescence?
14
How many helath supervision visits are recommended by the AAP between birth and 3 years of age?
12
What is CRAFFT?
screening tool to assess adolescents’ use of alcohol & drugs
Dr. John’s preferred depression screening for ages 11 to 21?
PHQ-9
what is PHQ-9? (ages?)
depression screening tool for ages 11-21
when is cholesterol screening recommended?
9-11 years
when is screening recommended for hematocrit & hemoglobin?
15 & 30 mos
when is screening recommended for HIV?
16-18 years
when should routine cervical cancer screening begin?
21 yrs old; routine pelvics not needed
how are newborns screened for critical congenital heart disease?
w/use of pulse oximetry: after 24 hrs but before hospital discharge
prevention should account for what percentage of pediatric visits?
1/3
what do the changes in the 2014 aap guidelines place an emphasis on?
doing screening for mental health disorders
when are autism screenings performed?
18 & 24 mos
how can we support optimal nutrition in preventative care?
monitor breastfeeding & weight/height/HC
example of broad band screening for mental health?
Pediatric Symptom Checklist
a neurodevelopmental screening should be performed when?
9, 18, & 30 mos
at age 9 mos, child should developmentally:
- -can separate from parents, move around
- -develop pincer grasp
what does pincer grasp indicate?
acts as surrogate for cortical & overall brain development
pincer grasp should be developed by age:
9 mos
when is autism screening performed?
- -at 18 mos
- -can do repeat at 24 mos if something is wrong
when can you screen for language?
–at 24 mos –> 20% will be delayed
at 24 mos, how many children will show language delay?
20%
Name 4 screening tools for development:
1) Ages & Stages
2) Denver II
3) Peds
4) Language: CAT/CLAMS
what is CAT/CLAMS?
language screening tool
–Cognitive Adaptive Test/Clinical Linguistic & Auditory Milestone Scale
what is M-CHAT?
Modified checklist for autism in Toddler
Reach Out & Read is used when?
start at 6 mos, through 5 years
–for lower-income families
criticism of health belief model?
Habits are not included
–relationship b/t variables is not clear
Transtheoretical Model
–hypothesizes a number of qualitatively different discrete stages & process of change
Transtheoretical Model: 6 Stages
1) Pre-Contemplation
2) Contemplation
3) Determination/Preparation
4) Action
5) Maintenance
6) Relapse/Recycle
which children face the most difficulty in adjusting to adolescence?
early maturing & late maturing adolescents
developmentally, how do changes in the pre-frontal cortex affect teens?
1) increase in white matter (insulated & myelinated) –> increase in # of connections between prefrontal cortex & other areas in the brain = crucial component of complex behaviors & decision-making
2) increased sensitivity to dopamine in the brain
- -sensation-seeking behaviors ETC
strength-based approach to adolescents is different bc:
traditionally, risk-based approach focused on problems & weaknesses
–strength-based sees adolescent as resilient, reframes the adolescent
in 1904, G. stanley Hall coined term “storm & stress,” said that 3 key elements of adolecent development are:
1) conflict w/parents
2) mood disruption
3) risky behavior
in 1959, Erikson’s idea of adolescent development:
confusion or diffusion of identity vs. achieving a stable identity
“7 C’s” Model of Resilience:
1) Confidence
2) Competence
3) Connection
4) Character
5) Contribution (Lerner & colleagues)
6) Coping
7) Control
three principles used to engage youth as “their own expert” :
1) self-determination theory (“I know what’s best for me.”)
2) Nurturant-authoritative approach (not authoritarian, but authoritative!–nurturance supporting the youth’s emotional experience)
3) Mindfulness
3 impt topics w/behavior change:
1) Importance
2) Confidence
3) Readiness
2 tools to look at when assessing pt’s motivation t o change:
1) Readiness ruler: how ready is the pt for change?
2) Confidence ruler: how confident is the pt that he/she will be successful in making the change?
DARN-CAT
related to motivational interviewing
Desires Abilities Reasons Needs Commitment Action to Take change
talking to pt about change: OARS
Open-ended questions
Affirmations
Reflections
Summarization
who is at highest risk for death by drowning?
Afr Amer teens ages 15-19
and youngest children
when can child be left along in bathtub?
around 6 years
for whom are pedestrian injuries most common?
boys 5-9 years old
