Academic Pediatrics

OBJECTIVE: To determine the effectiveness of text/telephone outreach messages and personal contact attempts on well child care (WCC) scheduling and completion and measles, mumps, and rubella (MMR) vaccine receipt. METHODS: We conducted an intent-to-treat, 2x2 factorial randomized clinical trial with 3 replications at three academic pediatric primary care practices from 9/27/20 to 8/6/21. We randomized participants to 1 of 4 groups: 1 automated message (Group 1), 2 automated messages (Group 2), 1 automated message plus personal contact attempts (Group 3), or 2 automated messages plus personal contact attempts (Group 4)...

BACKGROUND: Parents of children with special health care needs (CSHCN) are at risk of poorer health outcomes. Material hardships also pose significant health risks to parents. Little is known about how protective factors may mitigate these risks, and if effects are similar between mothers and fathers. METHODS: This was a cross-sectional survey study conducted using the US 2018/2019 National Survey of Children's Health, including parents of children 0-17 with income <200% of the Federal Poverty Level...

OBJECTIVE: To evaluate the effect of the COVID-19 pandemic on childhood lead testing and blood lead levels METHODS: A retrospective analysis of lead tests and results was performed across three urban medical centers during the pre-COVID-19 (March 10, 2019-March 9, 2020) and COVID-19 (March 10, 2020-March 10, 2022) periods. Interrupted time series analysis with quasi-Poisson regression was used to evaluate changes in lead testing between study periods. The relationship between sociodemographic features with detectable (≧2 µg/dL) and elevated (≧3...

Primary care professionals (PCPs) can play a valuable role in the initial assessment of possible child sexual abuse (CSA), an all too prevalent problem. PCPs, however, are often reluctant to conduct these assessments. The goal of this paper is to help PCPs be more competent and comfortable playing a limited but key role. This is much needed as there may be no need for further assessment and also because of a relative paucity of medical experts in this area. While some children present with physical problems, the child's history is generally the critical information...

OBJECTIVE: To determine feasibility, acceptability and explore outcomes of behavioral economic (BE) strategies to increase parent-child shared reading within a Reach Out and Read Program. METHODS: We conducted rapid cycle interviews with 10 parents to assess text messages followed by an 8-week randomized controlled trial of 3 BE strategies at 2 urban primary care practices: daily text-messages (texting); daily text-messages and regret messaging (regret); or daily text-messages, regret messaging, and lottery participation (lottery)...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND: Within healthcare settings, morbidity and mortality for autistic individuals is high, with unmet health needs despite greater healthcare utilization. OBJECTIVE: We conducted a scoping review of interventions designed to improve the healthcare experiences of autistic individuals and assessed the methodology and outcomes used to evaluate them. DATA SOURCES: Literature from January 2005 to August 2023 was searched using PubMed, EMBASE, CINAHL, PsycINFO as well as hand searching...

OBJECTIVE: Heightened resident supervision due to patient safety concerns is increasingly common in pediatrics and may leave residents with fewer opportunities for independent decision-making, a diminished sense of autonomy, and decreased engagement. This may ultimately threaten their development into competent clinicians. Understanding how pediatric residents experience supervision's influence on their involvement in decision-making, engagement in patient care, and learning is crucial to safeguard their transition to independent practice...

OBJECTIVE: To explore barriers, facilitators, and benefits of collaboration between academic pediatricians and institutional offices of government relations (OGR) to enhance policy advocacy efforts. METHODS: The Academic Pediatric Associations' Health Policy Scholars met with the government relations team in their affiliated institutions as part of their experiential learning curriculum. Afterwards, they submitted written reflections which were coded and analyzed using inductive qualitative content analysis to identify key themes...

BACKGROUND: Pediatricians publish opinion/editorials in newspapers as a form of advocacy. No research has characterized these publications to determine the scope of this communication. OBJECTIVE: We examined the characteristics of pediatrician-authored op-eds, comparing articles published in a seasonally matched six-month period before and after the onset of the COVID-19 pandemic. METHODS: We reviewed 249 pediatrician-authored op-eds (109 before COVID-19; 140 during COVID-19 pandemic) over two six-month periods accessed through America's Newspapers database in June 2021...

OBJECTIVE: This project sought to describe provider- and parent-identified needs and barriers to obtaining home- and community-based services (HCBS) for children with disability (CWD) and to determine ways pediatric healthcare institutions can improve access to HCBS services. METHODS: In this exploratory sequential mixed methods evaluation, semi-structed interviews and focus groups were conducted with multidisciplinary providers and staff from an independent children's hospital, followed by a survey of English and Spanish-speaking parents of CWD...

OBJECTIVE: Learning more about resident characteristics, career choices, job search experiences, and satisfaction for different racial and ethnic backgrounds can inform needs and approaches to diversifying the physician workforce. METHODS: We analyzed survey data collected from national random samples of pediatric residents graduating from 2011 to 2022. We used χ2 linear association to examine trends in reported race and ethnicity and multivariable logistic regression to estimate associations of race and ethnicity with graduates' characteristics including debt, career choice, job search experience, and satisfaction with specialty choice and report predicted percentage values (PV)...

No abstract text is available yet for this article.

OBJECTIVE: This paper examines the distribution, parameters, and determinants of safety net program use among a nationally representative sample of low-income children with autism spectrum disorder (ASD). METHODS: We used data from the 2021 National Survey of Children's Health to produce population estimates of material hardship and safety net program use among 554 low-income households of children with ASD, ages 3-17 years, relative to 2,831 children with other special healthcare needs (SHCN) and 8,758 children with no SHCN of the same age...

OBJECTIVE: Understanding the types of functional challenges faced by adolescents and young adults with disabilities (AYA-WD) can help payers, clinicians, community-based service providers, and policymakers recognize and meet needs. This paper describes state-level prevalence rates for (1) AYA-WD overall and for (2) impairment types singly and in combinations; and (3) examines how rates may differ between those insured by Medicaid versus commercial insurance. METHODS: This descriptive study uses Colorado's All Payer Claims Dataset 2014-2018 to identify insured 10- to 26-year-olds (Medicaid only: 333,931; commercially only: 392,444)...

OBJECTIVE: We assessed the impact of an online intervention using clinician prompts for human papillomavirus (HPV) vaccination with a cluster randomized controlled trial. METHODS: The randomized trial occurred July 2021-January 2022 in 48 primary care pediatric practices (24 intervention, 24 control) across the US. We trained clinicians via two online learning modules, plus weekly 'quick tips' delivered via text or email. The training taught practices to implement a staff prompt to the clinician (e...

OBJECTIVE: To evaluate the screening test accuracy and reliability of the parent-report preschool Strengths and Difficulties Questionnaire (P-SDQ) in primary care settings. METHODS: Children 24-48 months were recruited at scheduled primary care visits in Toronto, Canada. Parents completed the P-SDQ at baseline, 2 and 12 weeks. At 12 weeks, parents were invited to a semi-structured diagnostic phone interview, the Preschool Age Psychiatric Assessment (PAPA). Criterion validity between baseline P-SDQ scores (Total Difficulties Score [TDS], internalizing and externalizing subscale) and DSM-5 diagnoses on PAPA was evaluated using area under the curve (AUC) and calculating screening test properties (sensitivity and specificity)...

OBJECTIVE: Fewer than 40% of U.S. children complete the human papilloma virus (HPV) vaccine series before their 13th birthday. In our large pediatric primary care network, HPV vaccine completion rate by age 13 was 30%. We hypothesized that a phased quality improvement (QI) initiative would increase rates of HPV vaccine completion by age 13 across our network. METHODS: This QI initiative was conducted in a network of 30 practices located across 2 states, in urban and suburban settings, consisting of teaching and non-teaching clinics, and ranging in size from 3 to 50 providers per office...