No abstract

Background Public health programs are tasked with educating the community on health topics, but it is unclear whether these programs are acceptable to learners. Currently, these programs are delivered via a variety of platforms including in-person, virtually, and over the telephone. Sickle cell trait (SCT) education for parents of children with this trait is one of many education programs provided by the Ohio Department of Health. The novel SCTaware videoconference education program was developed by a research team after central Ohio’s standard program transitioned from in-person to telephone-only education during the COVID-19 pandemic. Objective Our objectives were to investigate the acceptability of the format and engagement with the SCTaware education and assess parental worry about having a child with SCT before and after receiving SCTaware. Methods This was a single-center, prospective study of English-speaking parents of children <3 years of age identified to have hemoglobin S trait by newborn screening. Parents who previously received SCT education by telephone, were able to be contacted, and had access to an electronic device capable of videoconferencing were eligible to complete surveys after receiving the virtual SCTaware education program. The SCTaware educator also completed a survey to assess participant engagement. Data were summarized descriptively and a McNemar test was used to compare parental worry before and after receiving SCTaware. Results In total, 55 participants completed follow-up surveys after receiving standard SCT telephone education and then completing SCTaware. Most (n=51) participants reported that the SCTaware content and visuals were very easy to understand (n=47) and facilitated conversation with the educator (n=42). All of them said the visuals were respectful and trustworthy, helped them understand content better, and that their questions were addressed. Nearly two-thirds (62%, n=34) reported that the pictures appeared very personal and applied to them. The educator noted most participants (n=45) were engaged and asked questions despite having to manage distractions during their education sessions. Many participants (n=33) reported some level of worry following telephone-only education; this was significantly reduced after receiving SCTaware (P<.001). Conclusions Our results suggest that SCTaware is acceptable and engaging to parents. While telephone education may make SCT education more accessible, these findings suggest that many parents experience significant worry about their child with SCT after these sessions. A study to evaluate SCTaware’s effectiveness at closing parents’ SCT knowledge gaps is ongoing.

Acute transverse myelitis (ATM) is an inflammatory disease of the spinal cord, characterized by rapid onset of bilateral neurological symptoms. The term myelitis refers to inflammation of the spinal cord, which often leads to demyelination. The clinical finding of a pattern of altered sensation is often a horizontal band-like sensation at the dermatomal level of the lesion, with sensory changes below. The symptoms usually develop over hours to days; they typically present as muscle weakness, ascending paralysis, and autonomic dysfunction. Recovery is variable, but often prolonged over many months, and can lead to a wide range of deficits. 1 Our report reviews a unique case of transverse myelitis in a patient with Lyme disease. A 27 year old male presented to the emergency department with past medical history of diabetes mellitus and hyperlipidemia with a week long history of fever to 102℉, non-productive cough, nausea, and decreased motor function and sensation in the bilateral lower extremities. Strength was intact in bilateral biceps, triceps, and wrists, but diminished in bilateral hips, knees, and ankles. Sensation to light touch was diminished from the level of T8 and below, fine touch sensation diminished from the level of T10 and below, and there was diminished proprioception in bilateral toes. There was intact pain sensation in all extremities and hyperreflexia in bilateral upper extremities. An MRI was obtrained which demonstrated cervical syrinx with expansion of the spinal cord and resultant cervical stenosis with cord compression indicating need for surgical intervention. A posterior cervical decompressive laminectomy at levels C4-C7 and posterior thoracic decompressive laminectomy at level T1 were scheduled, with a subsequent lumbar puncture. Serum findings were significant for elevated Lyme disease antibody titer (7.89) and antibody reaction to 8 borrelial proteins. After detection of Lyme disease, the patient was started on antibiotics. Over the course of the hospital stay, motor function continually improved with the aid of physical therapy. Sensation also significantly improved. Lyme disease may not always be identifiable with CSF collection from lumbar puncture, and as a result the etiology of ATM may go unknown. Guillain-Barre syndrome is a common differential which has a similar presentation. However, the treatment consists of plasmapheresis and immunoglobulin. This is an important distinction in order to to provide the appropriate treatment modalities to the patient.

BACKGROUND Public health programs are tasked with educating the community on pertinent public health topics, but it is unclear how effective these programs are and if they are acceptable for learners. Currently, these programs are delivered via a variety of platforms including in-person, virtually, and over the telephone. Sickle cell trait (SCT) education for parents of children with this trait is one of many education programs provided by the Ohio Department of Health. The novel SCTaware videoconference education program was developed by a research team after central Ohio’s standard program transitioned from in-person to telephone-only during the COVID-19 pandemic. OBJECTIVE Our objective was to investigate acceptability of format and engagement with the SCTaware education, and to assess parental worry about having a child with SCT before and after receiving SCTaware. METHODS This was a single center, prospective study of English-speaking parents of children <3 years of age identified to have Hemoglobin S-trait by newborn screening. Parents who previously received SCT education by telephone, who were able to be contacted, and had access to an electronic device capable of videoconferencing were eligible to complete surveys after receiving the virtual SCTaware education program. The SCTaware Educator also completed a survey to assess participant engagement. Data were summarized descriptively and a McNemar’s test was used to compare parental worry before and after receiving SCTaware. RESULTS Fifty-five participants completed follow-up surveys after receiving standard SCT telephone education and then completing SCTaware. Most (n=51) participants reported that the SCTaware content and visuals were very easy to understand (n=47) and facilitated conversation with the Educator (n=42). All said the visuals were respectful and trustworthy, helped them understand content better, and that their questions were addressed. Nearly two-thirds (62%) reported that the pictures appeared very personal and applied to them. The Educator noted most participants (n=45) were engaged and asked questions (n=45), despite having to manage distractions during their education sessions. Many participants (n=33) reported some level of worry following telephone-only education; this was significantly reduced after receiving SCTaware (p < 0.0001). CONCLUSIONS Our results suggest that SCTaware is acceptable and engaging to parents. While telephone education may make SCT education more accessible, these findings suggest that many parents experience significant worry about their child with SCT after these sessions. A study to evaluate SCTaware’s effectiveness at closing parents’ SCT knowledge gaps is ongoing.