198: Physical Activity Prescribing By Community Paediatricians for Children with Chronic Pain: A Vignette Based Study
Bibliographic record
Abstract
Regular physical activity (PA) promotes optimum health and development. Youth with chronic pain are less physically active than healthy peers. Recommendation by a health care provider is a key factor influencing the decision to initiate a regular program. The Canadian Paediatric Society provides general fitness guidelines and some disease-specific recommendations. Little is known about PA prescribing behaviors of paediatricians working with children and youth with chronic pain. Describe PA prescribing behaviors of paediatricians for children and youth with chronic pain. Examine patient/provider characteristics that influence PA prescribing. Ethics approval was obtained. The survey was developed on FluidSurveys. A survey link was distributed to 360 paediatricians on the Canadian Paediatric Society Community Paediatrics listserv. Ten vignettes varied on eight factors (age, sex, income level, pain intensity, pain frequency, pain duration, location and current physical activity participation). No vignette patient achieved recommended PA levels and all were safe to increase PA. Analysis included descriptive analysis and Generalized Estimating Equations with confidence as the dependent. Eighteen paediatricians participated, providing 122 completed vignette responses; 67% of participants were female, 50% of participants indicated they were regularly active, 78% worked in a unidisciplinary setting. The mean duration of practice was 17 years. Paediatricians recommended the following activity for vignette patients with chronic pain: restrict or reduce PA (2.5%), continue current level (13.1%), general activity increase recommendations (26.2%), specific advice to increase (27%), refer to other provider for advice on increasing level (31.1%). Paediatricians (n=121) had the following level of confidence in their recommendations: 2.5% were not at all confident, 38.8% were not so confident, 47.1% were confident and 11.6% were highly confident. Paediatricians (n=119) had the following level of confidence that their recommendations would be followed: 9.8% were not at all confident, 41% were not so confident, 34.4% were confident and 12.3% were highly confident. Factors significantly associated with confidence in PA prescribing included regular physician PA practices (P=0.035), multi-disciplinary setting (P=0.014) and fewer years of practice (P=0.024). Most participants' recommended increased PA. Higher physician activity level, multidisciplinary practice and fewer years in practice were associated with increased confidence in recommendations. Development of supports such as educational material or clinical decision tools for PA prescribing for children and youth with chronic pain may benefit community paediatricians and their patients.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.015 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".