1. Copyright © 2015 Lippincott Williams & Wilkins. Unauthorized commercial reproduction of this slide is prohibited Supplemental PowerPoint Slides School Scoliosis Screenings: Family Experiences and Potential Anxiety after Orthopaedic Referral Tabatha Hines, Ph.D.1,2, Sandy Roland, Ph.D.1,2, Dylan Nguyen, M.A.1, Beth Kennard, Psy.D.2, Heather Richard, Psy.D.1,2, Carroll W. Hughes, Ph.D.2, Shawn M. McClintock, Ph.D., M.S.C.S.2,3, Brandon Ramo, M.D.1,4, Tony Herring, M.D.1,4 1Texas Scottish Rite Hospital for Children, Dallas, Texas 2Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas 3Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina 4Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas

2. Study Design The psychological consequences associated with School Scoliosis Screening (SSS), though frequently alluded to, has never been empirically examined This study utilized a cross-sequential design to compare changes in reported anxiety between true-positive, false-positive and healthy control participant and parent/guardian Patients and parents/guardians completed the State-Trait Anxiety Inventory (STAI), demographic and socioeconomic questionnaire, and satisfaction questionnaire before and after clinic visit

3. Findings Baseline comparisons revealed that: – Patients reported significantly elevated levels of state-anxiety, compared to healthy controls (p=.04) – Parents of SSS patients also reported elevated levels of state-anxiety, compared to parents of healthy controls (p=.02) Pre/post comparison revealed that: – SSS patients with false-positive results reported a significant decline in state-anxiety (p<.001) – SSS patients with true-positive results did not report a significant decline in state-anxiety – Healthy controls also did not report a significant decline in state-anxiety Pre/post comparison further revealed that: – Parents of SSS patients with false-positive results reported a significant decline in state-anxiety (p=.03) – Parents of SSS patients with true –positive results did not report a significant decline in state- anxiety – Parents of healthy controls also did not report a significant decline in state-anxiety Less than half of SSS families received information concerning scoliosis from school – A third of SSS parents who received scoliosis screening information from school indicated that the information received did not adequately address their concerns

4. Conclusion Understanding the emotional toll SSS has on patients and families is important, yet under-researched This study showed an elevation in state-anxiety for patients and families referred for SSS Families also reported lack of information provided by school regarding scoliosis and SSS process Knowledge of SSS-induced anxiety will hopefully further drive research to better inform involved parties of referral process and overall benefits/costs to patients and families