Alba Osorio was afraid to take her 4-year-old daughter Alice out in public because Alice might have a temper tantrum.

“The tantrums, she starts screaming and crying,” Osorio said, adding that her efforts to calm the child down were often unsuccessful. “We had to do something because this situation is hard for her and for us as the parents.”

Through word-of-mouth from a neighbor, she heard of a pair of programs offered through the USF Health Morsani College of Medicine that aims to help parents and guardians deal with outbursts, poor life skills and other challenging child behavior.

The Helping our Toddlers, Developing our Children’s Skills (HOT DOCS) and DOCS K-5 each are six-week courses sponsored by the Children’s Board of Hillsborough County that tap into the expertise of USF Health child and adolescent psychologists.

HOT DOCS is for children up to age 5 and covers basics, like eating, bathing, dressing and following directions, as well as managing tantrums. DOCS K–5 works with children up to fifth grade. It focuses on doing homework, staying safe, socializing and changing challenging behaviors.

Heather Agazzi, PhD, is a board-certified child and adolescent psychologist, a professor of pediatrics in the USF Health Morsani College of Medicine, and director of the DOCS Parenting Programs. She said she recognized in her practice that dealing with child behavior was a problem for many parents in Hillsborough County.

“Early life-challenging behavior often leads to school failure and other problems,” Dr. Agazzi said. “We want to try and meet those children’s needs as early in life as possible.”

Heather Agazzi, PhD

Weekly sessions, offered in English and Spanish, include skills review, parenting tips, special play activities, plan development, coaching and feedback.

“We typically have three HOT DOCS classes running and one DOCS K-5 (class),” Dr. Agazzi said.

Cristina Ortiz took the class in 2006 and said she was amazed at the impact it had on her son. She was initially hired as a translator and, over the years, was promoted until she became program coordinator.

Cristina Ortiz

“Knowing all the struggle, I do understand what families go through, and I love that this program is available for them to bring them a lot of help—and not only what we provide through HOT DOCS but I also give them a lot of resources,” Ortiz said.

She also teaches the Spanish version of the class, which is necessary. According to a March 2020 Tampa Bay Times article, almost 40 percent of people identified as Spanish speakers in Hillsborough County have trouble speaking English.

For Osorio, the program has been a welcome help in curbing her daughter’s tantrums.

“It means a lot to us to have access to this program,” Osorio said. “To us, the program really works. . . . We saw a change in our daughter’s behavior at home, outside, at school, and every day is different now, and it’s better for her and for us.”

Registration fee for each course is $20 per participant for parents and caregivers.

To get information and sign-up, Call or email hotdocs@usf.edu
(813) 974-1048

Children under 12 years old are currently not eligible for the Moderna COVID-19 vaccine. The USF Health Morsani College of Medicine has been selected as one of several sites conducting trials on Moderna’s coronavirus vaccine for this age group.

The first part of the trial, which focused on children 6-12 years old, is complete. USF Health researchers want to enroll 100 children ages 6 months to 5 years for a second trial by early December.

“A vaccine for children is necessary because they can transmit COVID-19, get sick enough to be hospitalized, experience long COVID—and sadly some children have died from COVID,” said Carina Rodriguez, MD, principal investigator for the Moderna trial at USF.

Carina Rodriguez, MD, principal investigator for the Moderna trial at USF Health.

Dr. Rodriguez, who is also a professor and chief of the Division of Pediatric Infectious Diseases in USF Health’s Department of Pediatrics, said, “the goal is to look for an efficacious and safe COVID vaccine for children.” She continued, “It’s needed to accomplish the end of this pandemic.”

For more information about the trials or enrollment, please send an email to usfchildrenscovidvaccine@gmail.com or call/text at 813-853-1149.

USF College of Public Health researcher leads newly published Florida study

The study published in the January 2018 issue of Health Affairs found an association between the rate of opioid prescriptions in Florida and the number of children removed from their homes due to neglect.

TAMPA, Fla. (Jan.  8, 2018) — The opioid epidemic has become so severe it’s considered a national public health emergency. Addiction to prescription painkillers, such as oxycodone and morphine, has contributed to a dramatic rise in overdose deaths and health care costs. What many don’t realize, it’s also associated with an alarming number of children placed into foster care.

In a study published in this month’s issue of “Health Affairs,” researchers analyzed the association between the rate of opioid prescriptions in Florida and the number of children removed from their homes due to parental neglect.

“Through my experience as a foster parent, I’ve seen first-hand how the foster system has been overwhelmed by children removed from homes where the parents are opioid-dependent,” said lead author Troy Quast, PhD, of the University of South Florida College of Public Health. “My goal in this study was to gain insight into the factors behind this surge.”

Troy Quast, PhD

Quast and his colleagues reviewed 2012-2015 data on Florida’s 67 counties submitted to the federal government’s Adoption and Foster Care Analysis and Reporting System. They found that in 2015, roughly two out of every 1,000 kids and teens were removed from their homes due to parental neglect, reflecting a staggering 129 percent increase since 2012.

According to the Florida Drug-Related Outcomes Surveillance and Tracking System, the number of opioids prescribed during this same time period rose 9 percent. In 2012, doctors prescribed 72.33 prescriptions for every 100 residents. The rate grew to 81.34 by 2015, averaging 74.1 prescriptions during the 2012-2015 time frame. It’s important to note the rate dropped 2.5 percent in 2013, following the implementation of several new state policies regarding pain clinics and a prescription drug monitoring program.

The range of Florida’s opioid prescription rate was dramatic. Some counties averaged about one prescription a year for every three people, while other counties had as many as 1 ½ opioid prescriptions per person each year. The highest rates were found in predominantly white counties.

The analysis by Dr. Quast and his colleagues showed that on average, for every additional 6.7 opioid prescriptions per 100 people, the removal rate for parental neglect increased by 32 percent. This estimated increase corresponds to roughly 2,000 additional children removed, resulting in an annual state fiscal cost of $40 million. Previous studies have shown children removed from their homes due to parental neglect have a greater likelihood of juvenile delinquency, teen motherhood, mental and physical health problems and adult criminality.

“While the reported drop in opioid prescription rates over the last two years is encouraging, unfortunately it appears illicit opioid use has more than offset the decrease,” said Dr. Quast. “We need to keep affected children in the forefront of our minds when tackling this crisis.”

By Kathleen Armstrong, PhD, NCSP

Most of us are in a state of disbelief because of the recent horrific events at Sandy Hook Elementary School in Connecticut. We not only morn the senseless loss of innocent lives, but as parents and providers we also wonder what we can do to help our children. Below are some ideas that you can use to help children cope: 

– Try to keep routines as normal as possible. Children gain security from the predictability of daily routines, including attending school and other activities.

– Limit children’s exposure to media including television and radio, so that they do not re-experience the tragedy over and over.

– Listen to children’s fears and concerns, encourage them to share their feelings, and provide as much information as they are developmentally able to handle.

• Preschool children need brief, simple information, and reassurance
• School-age children may have more questions about their own safety and what is being done to protect children.
• Older children and adolescents may want to talk about their own ideas for making things safer.

– Tell your children that you love them, give them plenty of hugs and reassure them that they will be okay.

– Consider praying or thinking hopeful thoughts for the victims and their families, and help children express their feelings by drawing a picture, writing a poem or saying a prayer.

– Be observant for changes in your child’s behavior, appetite, or sleep patterns, which can be an indicator their grief response. Some children may need the extra support from a mental health professional or clergy.

You can find more information about helping children cope with crisis at the National Association of School Psychologist website www.nasponline.org/resources 

Dr. Armstrong is professor and director of Pediatric Psychology in the USF Health Department of Pediatrics.

USF graduate students and community professionals will gain stronger research skills for addressing drug abuse and other behavioral health problems in children and adolescents with the help of a $1.72 million grant from the National Institute on Drug Abuse.

The 5-year grant supports a project called the Institute for Translational Research Education in Adolescent Drug Abuse and focuses on translational research methods, policies and perspectives, and the practical skills of participatory research, said Julie Baldwin, PhD, principal investigator, and professor in the Department of Community and Family Health in the USF College of Public Health. Co-investigators are Bruce Lubotsky Levin, DrPH, associate professor and curriculum director, Tom Massey, PhD, associate professor and evaluation director, and Donna Burton, Ed.M., research assistant professor and project director, all of whom are faculty in the USF College of Behavioral and Community Sciences. Drs. Levin and Massey are also joint faculty in the Department of Community and Family Health, and Ms. Burton is a doctoral candidate in the department.

From left, Dr. Tom Massey, Dr. Julie Baldwin, Dr. Bruce Lubotsky Levin, and Donna Burton.

This grant will use a unique cross-disciplinary approach between public health and behavioral health and relies on a model of graduate education that includes graduate web-based and face-to-face training, service learning in the community, and a community based capstone project.  Trainees will earn graduate college credit (15 hours) fully paid by the grant, culminating with the awarding of a graduate certificate.  Further, this NIDA grant and the graduate certificate program serves as an additional research component of the Graduate Studies in Behavioral Health Program, a collaborative teaching and research initiative between the USF College of Public Health and the USF College of Behavioral and Community Sciences.

Central to the project is its community-based team mentoring approach, which includes community, service-based mentors, academic mentors, and national mentors, Dr. Baldwin said.

“This group of mentors will guide trainees in the latest science of alcohol, tobacco, other drug (ATOD) prevention, intervention and sustainability with an added emphasis on translational issues of evidence based practices (EBPs),” Dr. Massey said. 

Training sites will include agencies in the community for whom child and adolescent behavioral health is of interest.  Training will include an annual conference bringing together experts in the etiology and epidemiology of adolescent behavioral health (including ATOD and other emotional and behavioral disorders of childhood), and experts in translational science and implementation of EBPs. 

“For all program participants, the core curricula will include a Capstone Project, conceptualized during the first semester of the graduate certificate program, based upon course presentations of problems, issues, and trends in epidemiology of child and adolescent drug use and mental disorders, and guided by each mentoring team,” Dr. Levin said.

“Program participants will have four full semesters to conceptualize, plan, and complete their Capstone Projects, resulting in graduate level research initiatives that represent meaningful and cutting-edge applied research and academic development in the content areas selected,” Ms. Burton said. “When complete, students will present their Capstone Projects at the annual conference.”

Examples of applicable projects might include: evaluation of existing implementation projects within community programs; development of a grant proposal that addresses implementation of an evidence-based practice in a clinical setting; or the design of a research project that would enhance community-based clinical programming.

The ultimate goal of this grant is to develop, cultivate, and disseminate an innovative model of research education that addresses best practices for translational research in the field of child and adolescent drug use and co-occurring disorders.

“By fostering collaboration, team-building, and cross-disciplinary approaches, researchers’ knowledge of EBPs and skills in delivering EBPs in community settings are enhanced, which ensures that interventions are more effective and accessible,” Dr. Baldwin said. “Furthermore, we will strive to create greater awareness among researchers and educators regarding the impact of practice on the evidence base.”

Story by Sarah A. Worth, photos by Eric Younghans, USF Health Office of Communications