TEOAEs screening performed by school nurses is a fast, efficient, and feasible model. Children who pass TEOAEs screening have a very high likelihood of being free from hearing impairment. Application may be particularly relevant in underserved communities.
Early detection and treatment of vision disorders in children are important to avoid lifelong visual impairment; however, preschool vision-screening rates are low. Traditional methods of screening lack the precision of objective tests and are difficult to administer in preschoolers. This study adopted a method using school nurses to conduct vision screening in preschoolers with a portable autorefractor. In addition, the effectiveness of the school nurse in conducting follow-up was evaluated. In a sample of 600 children, more than 98% completed the screening, and 7% were referred for follow-up evaluation. Seventeen percent of parents had plans to follow-up after receiving a brochure indicating that their child would benefit from a comprehensive eye exam. However, after a conversation with the school nurse, 86% had plans to schedule an evaluation with an eye care professional. Of the 15 students with known follow-up, 10 received glasses. The described method is effective in identifying young children with potential vision problems and facilitating their correction after contact made by the school nurse.
The objective of this study is to determine the prevalence of cardiovascular risk in a primarily Latino/ Hispanic preschool population of low socioeconomic status. Preschool health screenings were conducted as part of a publicly funded demonstration project designed to provide consultation, education, services, and support to children living in underserved communities. Cross-sectional analysis was restricted to 2- to 5-year-olds with recorded values for age, gender, ethnicity, height, weight, triceps skinfold, resting heart rate, and blood pressure, resulting in 608 subjects. Most of the study population was of Latino/Hispanic descent. The prevalence of overweight and obesity rivaled adult data, with almost 50% of preschoolers aged 2 to 5 years being overweight or obese. Prevalence of overweight/obesity did not vary by age or gender. The Latino/Hispanic population had a significantly greater prevalence of overweight and obesity (P = .003, P = .02), but severe obesity (body mass index ≥ 99th percentile) did not vary by ethnicity. Obesity and severe obesity were independent risk factors for systolic blood pressure in the hypertensive range (relative risk [RR] = 2.45, 95% confidence interval [CI] = 1.73-3.45, P < .0001; RR = 2.53, 95% CI = 1.46-4.38; P = .001, respectively). The risk of cardiovascular disease is high in the preschool population studied, especially in the severely obese. Adverse risk was identified in obese children as early as 2 years old. Economically disadvantaged children, particularly of Latino/ Hispanic descent, may be at higher risk. This is an important consideration given population projections by 2050. These findings support the need for earlier intervention as the preschool years may be a more feasible and effective period for intervention.
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