Michelle Barratt | The University of Texas Health Science Center at Houston (original) (raw)

Papers by Michelle Barratt

American Journal of Obstetrics and Gynecology, 2022

Journal of Investigative Medicine, 1999

Pediatric dentistry, 2018

Purpose: The purpose of this study was to determine how ethnicity influences parental acceptabili... more Purpose: The purpose of this study was to determine how ethnicity influences parental acceptability of behavior management techniques (BMTs) used during dental treatment of children. This is the first known study to compare ethnic differences in acceptance levels of the BMTs. Methods: Parental acceptance of 10 BMTs (tell-show-do, voice control, non-verbal communication, positive reinforcement, distraction, parental presence/absence, nitrous oxide, protective stabilization, sedation, and general anesthesia) was rated using a visual analogue scale (VAS) after watching vignettes of each technique. Parental preferences were stratified by ethnicity and analyzed. Results: Among the 104 parents (21 Caucasians, 29 Hispanics, 30 Asians, and 24 African Americans) who qualified and completed the study, we observed that, overall, non-invasive techniques (positive reinforcement and tell-show-do) were most accepted by parents, while invasive techniques (voice control and protective stabilization)...

Journal of Educational Evaluation for Health Professions, 2020

Purpose: According to the entrustable professional activities (EPA) for entering residency by the... more Purpose: According to the entrustable professional activities (EPA) for entering residency by the Association of American Medical Colleges, incoming residents are expected to independently obtain informed consent for procedures they are likely to perform. This requires residents to not only inform their patients but to ensure comprehension of that information. We assessed the communication skills demonstrated by 372 incoming pediatric interns between 2007 and 2018 at the University of Texas Health Science Center at Houston, obtaining informed consent for a lumbar puncture.Methods: During a simulated case in which interns were tasked with obtaining informed consent for a lumbar puncture, a standardized patient evaluated interns by rating 7 communication-based survey items using 5-point Likert scale from “poor” to “excellent.” We then converted the scale to a numerical system and calculated intern proficiency scores (sum of ratings for each resident) and average item performance (aver...

Journal of Adolescent Health, 2019

Blood pressure, Oct 26, 2018

Determining familial aggregation is an important first step in narrowing the search for disease-c... more Determining familial aggregation is an important first step in narrowing the search for disease-causing genes and hence we determined the familial aggregation of EH among first degree relatives of children with EH. We prospectively enrolled children with EH along with their first degree relatives from a tertiary pediatric hypertension clinic in a large ambulatory care center. We utilized rigorous methodology for blood pressure (BP) measurements and diagnoses of EH to reduce the heterogeneity in the phenotype. For those enrolled, parental BP status was confirmed by in-clinic direct BP measurements. We also enrolled control children without EH along with their first degree relatives from the same pediatric ambulatory center. In our case-control study of 153 families, the odds of having familial EH was more than 3 times higher among the cases than in controls (OR: 3.63, 95% CI: 1.85-7.12) with 71% of the cases and 41% of the controls reporting familial EH. One parent with EH was seen i...

Journal of Educational Evaluation for Health Professions, 2016

The individualized learning plan (ILP) is a tool that promotes self-directed learning. The aim of... more The individualized learning plan (ILP) is a tool that promotes self-directed learning. The aim of this pilot study was to look at the perception of the ILPs in United States senior medical school students as a way to improve their learning experience during their advanced practice clerkship. We conducted a survey of graduating medical students that contained both quantitative and open-ended questions regarding the students’ experiences with the ILP during their advanced practice clerkship from July 2014 to March 2016. We systematically identified and compiled themes among the qualitative responses. Responses from 294 out of 460 subjects were included for analysis (63.9%). Ninety students (30.6%) reported that the ILP was definitely reviewed at the midpoint and 88 (29.9%) at the final evaluation. One hundred sixty one students (54.8%) felt the ILP provided a framework for learning. One hundred sixty one students (61.6%) felt it was a useful tool in helping open a discussion between t...

Nursing Research, 2016

Background: Exposure to high levels of maternal stress and ineffective maternal-child engagement ... more Background: Exposure to high levels of maternal stress and ineffective maternal-child engagement (MC-E) may adversely affect child health-related outcomes. Objective: The aim of this study was to examine the impact of maternal stress and MC-E on maternal and child biological responses (salivary cortisol and testosterone) and child health outcome in mother-child dyads of preschool children (3-5.9 years) in a low socioeconomic setting. Methods: Observational and biobehavioral data were collected from 50 mother-child dyads in a preschool setting. Assessments included maternal stress with the Perceived Stress Scale, child health outcomes with the Pediatric Quality of Life Inventory, and MC-E with videotaped mother-child interactions and scored with the Keys to Interactive Parenting Scale. Morning and evening saliva samples were collected from mother and child for biological assays. Results: Maternal stress was negatively correlated with MC-E (r = −.32, p < .05) and child health outcome (r = −.33, p < .05). Lower levels of MC-E predicted higher morning cortisol (p = .02) and higher morning and bedtime testosterone levels in children (p = .03 and p = .04, respectively). Child biological responses did not predict child health outcome. Discussion: Maternal stress and MC-E during mother-child interactions play a significant role in the regulation of child stress physiology and child health outcome. Elevated cortisol and testosterone related to high maternal stress and low MC-E may increase the child's vulnerability to negative health outcomes-if sustained. More biobehavioral research is needed to understand how parent-child interactions affect child development and health outcomes in early childhood.

Seminars in Pediatric Infectious Diseases, 2005

ABSTRACT This article addresses the epidemiology of several common sexually transmitted infection... more ABSTRACT This article addresses the epidemiology of several common sexually transmitted infections (STIs) in adolescents. Chlamydia is a common occurrence in adolescents, more so than is gonorrhea, but both are of particular concern because they may cause pelvic inflammatory disease. Many experts recommend screening for chlamydia in sexually active adolescents, particularly females. Trichomonas vaginalis is significant as a marker for risk of contracting other STIs and because of its association with pregnancy complications and with increased risk of transmission of HIV. Genital herpes simplex virus (HSV) infection, which usually has been caused by HSV-2, is a common finding in adolescents, and it now is caused also by HSV-1 in some populations. Human papillomavirus (HPV), though widespread in adolescents, usually is a self-limited infection, and malignancy resulting from HPV is a rare occurrence in this age group. The least common of the diseases discussed below is syphilis, but a recent sharp increase in incidence has occurred in men who have sex with men.

Pediatrics, 2001

Sexual assault is a broad-based term that encompasses a wide range of sexual victimizations, incl... more Sexual assault is a broad-based term that encompasses a wide range of sexual victimizations, including rape. Since the American Academy of Pediatrics published its last policy statement on this topic in 1994, additional information and data have emerged about sexual assault and rape in adolescents, the adolescent's perception of sexual assault, and the treatment and management of the adolescent who has been a victim of sexual assault. This new information mandates an updated knowledge base for pediatricians who care for adolescent patients. This statement provides that update, focusing on sexual assault and rape in the adolescent population.

Archives of Pediatrics & Adolescent Medicine, 1992

Continuity clinic is a mandated part of all accredited pediatric residency programs, yet there ar... more Continuity clinic is a mandated part of all accredited pediatric residency programs, yet there are minimal guidelines regarding structure and function. In 1988, we surveyed 101 residency programs, asking them to describe their continuity clinic experience. Eighty-seven residency programs (86%) responded to the 40-item questionnaire. The results showed clinics to be similar in many aspects, with consistent emphasis on developmental issues and anticipatory guidance. Areas of concern included lack of monitoring of the patient panel (31% did not monitor), excess care for chronic diseases or handicapping conditions (mean, 22% of patients), and lack of training in telephone advice (43% provided no such training).

American Journal of Epidemiology, 2004

In epidemiologic studies of the relation between circumcision and sexually transmitted infections... more In epidemiologic studies of the relation between circumcision and sexually transmitted infections, it is necessary to rely on self-report of circumcision status. The purpose of this 2002 study in Houston, Texas, was to determine whether adolescent males could make correct self-reports. During physical examinations, adolescents were asked whether they were circumcised. The authors then examined the adolescents' genitalia. Circumcision status was recorded as complete (glans penis fully exposed), partial (glans partly covered), or uncircumcised (glans completely covered). The mean age of the 1,508 subjects was 15.0 (standard deviation, 1.63) years; 64% were Black, 29% Hispanic, and 7% White. Forty-nine percent had full, 1% partial, and 50% no circumcision. Of the 738 fully circumcised subjects, 512 (69%) considered themselves circumcised, 54 (7%) considered themselves uncircumcised, and 172 (23%) did not know. Of the 751 uncircumcised youth, 491 (65%) described themselves as uncircumcised, 27 (4%) reported being circumcised, and 233 (31%) did not know. The sensitivity of self-report among those who thought they knew their status was 90.5%, and the specificity was 94.8%; 27% did not know their status. In this population, self-report of circumcision status did not result in accurate information mainly because many adolescents were unsure of their status.

Journal of Clinical Pediatric Dentistry, 2019

Objective: This study aimed to assess fluoride intake in infants from formula reconstituted with ... more Objective: This study aimed to assess fluoride intake in infants from formula reconstituted with water, with fluorosis risk in mind. Study Design: Data on water source, formula brand/type, volume of formula consumption and infant weight were collected for infants at two-, four-, six-, nine- and twelve-month pediatrician well child visits. Identified formula brands and water types were reconstituted and analyzed for fluoride concentration. Patient body mass and volume consumed/day were used to estimate fluoride intake from reconstituted formula. Descriptive statistics, one-way analysis of variance and chi-square tests were utilized. Results: All infants consumed formula reconstituted with minimally fluoridated water (0.0– 0.3 ppm). 4.4% of infants exceeded the recommended upper limit (UL) of 0.1mg/kg/day. Although mean daily fluoride consumption significantly differed among all groups, the proportion of infants at each visit milestone that exceeded daily fluoride intake of 0.1mg/kg/d...

Academic pediatrics, 2018

Telephone interpretation and recent technology advances assist patients with more timely access t... more Telephone interpretation and recent technology advances assist patients with more timely access to rare languages, but no one has examined the role of this technology in the medical setting and how medical students can be prepared for their use. We sought to determine if structured curriculum on interpretation would promote learners self-reported competency in these encounters and if proficiency would be demonstrated in actual patient encounters. Training on the principles of interpreter use with a focus on communication technology was added to medical student education. The students later voluntarily completed a retrospective pre/post training competency self-assessment. A cohort of students rotating at a clinical site had a blinded review of their telephone interpretation encounters scored on a modified validated scale and compared to scored encounters with preintervention learners. Nested ANOVA models were used for audio file analysis. A total of 176 students who completed the tr...

Pediatrics in Review, 2013

Teaching and Learning in Medicine, 1997

... Michelle Sasynuik Barratt, Christine E. Koerner, Sunita A. Hajare, and Robin Jacquet-Williams... more ... Michelle Sasynuik Barratt, Christine E. Koerner, Sunita A. Hajare, and Robin Jacquet-Williams Department of Pediatrics University of Texas-Houston ... a formalized curriculum in medico-legal issues for our postgraduate level 2 (PL2) pediatric residents and dual internal medicine ...

PEDIATRICS, 2006

The goal was to compare visit data from Continuity Research Network practices with data for a nat... more The goal was to compare visit data from Continuity Research Network practices with data for a nationally representative sample of pediatric visits in practice settings from the National Ambulatory Medical Care Survey. A cross-sectional study comparing data for Continuity Research Network practice visits during a 1-week period in 2002 with data from the 2000 National Ambulatory Medical Care Survey was performed. Continuity Research Network and National Ambulatory Medical Care Survey data were derived from 30 patient visits per practice site for patients &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 22 years of age, with the primary care providers being residents and practicing pediatricians, respectively. Eighteen Continuity Research Network practices reported on 540 visits, compared with 32 National Ambulatory Medical Care Survey physicians reporting on 792 visits. Continuity Research Network patients were more likely to be black non-Hispanic or Hispanic/Latino and to have public insurance. The top 5 reasons for visits were the same for Continuity Research Network and National Ambulatory Medical Care Survey visits, although the orders varied slightly. These 5 reasons accounted for 58% of Continuity Research Network visits and 49% of National Ambulatory Medical Care Survey visits. Continuity Research Network visits were more likely to result in patient instructions to return at a specific time (78% vs 52%). Residents in Continuity Research Network practices provide care to more underserved patients but evaluate problems that are similar to those observed in office practices; the Continuity Research Network practices thus provide important training experiences for residents who will serve both minority and nonminority children.

Clinical Pediatrics, 2014

To document the prevalence of junk foods seen at clinic visits. A cross-sectional 23-item survey ... more To document the prevalence of junk foods seen at clinic visits. A cross-sectional 23-item survey of observed food items were completed by medical staff using a convenience sample of families from June 2, 2011 to March 2, 2012. The study was conducted in pediatric clinics affiliated with the University of Texas Medical School at Houston. A convenience sample consisting of 738 families with children from 4 months to 16 years old presenting for visits were included in the study. Children exclusively breast and formula fed was excluded. Junk food was observed 20.9% at the clinic visits. Junk food was often seen at clinic visits. There was a trend toward higher body mass index in patients whose families had junk food at the visit.