Abstract：
OBJECTIVE:To describe influences on shared decision making between primary care pediatricians and parents of young children with autism spectrum disorder (ASD). METHODS:We conducted a qualitative study using key informant interviews with 20 pediatricians of varying experience from 10 primary care practices and 20 English-speaking parents of young children (aged 2-5 years) with a parent-reported diagnosis of ASD. Subjects were recruited through purposive sampling. Interviews were audiotaped, transcribed verbatim, and analyzed using an integrated approach to data analysis. Differences in coding were resolved by consensus. We achieved thematic saturation and ceased recruitment after 20 interviews were completed within each group. RESULTS:Three primary themes emerged: 1) pediatricians and parents reported knowledge gaps by pediatricians about ASD treatments and community resources as well as ambiguity regarding the pediatrician's role in ASD care; 2) there was little communication between parents and pediatricians about treatment choices; 3) use of complementary and alternative medical treatments created conflict between pediatricians and parents, and as a result, parents may independently pursue treatments, without the benefit of discussing safety and efficacy with pediatricians. Despite these barriers, parents desired increased support and guidance from their pediatricians, including for complementary and alternative medicine. CONCLUSIONS:Much work is needed to effectively foster shared decision making in the context of ASD treatment decisions in primary care, including pediatrician training in ASD to enhance knowledge about evidence-based and novel treatments, clinical practice guidelines, and community resources.
journal_name
Acad Pediatrjournal_title
Academic pediatricsauthors
Levy SE,Frasso R,Colantonio S,Reed H,Stein G,Barg FK,Mandell DS,Fiks AGdoi
10.1016/j.acap.2016.04.007subject
Has Abstractpub_date
2016-08-01 00:00:00pages
571-8issue
6eissn
1876-2859issn
1876-2867pii
S1876-2859(16)30142-5journal_volume
16pub_type
杂志文章abstract：BACKGROUND:Provider elicitation of parent developmental and behavioral (DB) concerns is the foundation of DB surveillance. Language differences may affect whether providers assess parental DB concerns. OBJECTIVE:The aim of this study was to compare children in English versus Spanish primary language households by risk...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2008.12.006
更新日期：2009-03-01 00:00:00
abstract：:The goal of designing innovative curricula and programs in medical education is to create interventions that will change the attitudes, knowledge, skills, and behaviors of learners in order to prepare them to contribute to the health of patients and communities they serve. Systematic evaluation allows curriculum/progr...
journal_title：Academic pediatrics
pub_type： 杂志文章,评审
doi：10.1016/j.acap.2020.07.005
更新日期：2020-01-01 00:00:00
abstract：BACKGROUND:Given the high prevalence of asthma and obesity in minority children, there is a need to identify targets for intervention to decrease the impact of these conditions on children's functioning in this high-risk group. OBJECTIVE:To examine in urban children with persistent asthma, 1) differences in asthma ind...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2019.07.001
更新日期：2020-01-01 00:00:00
abstract：OBJECTIVE:The aim of this study was to determine the percentage of hospitals with adequate sample size to meaningfully compare performance by using the Agency for Healthcare Research and Quality (AHRQ) pediatric quality indicators (PDIs), which measure pediatric inpatient adverse events such as decubitus ulcer rate and...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2010.04.025
更新日期：2010-07-01 00:00:00
abstract：OBJECTIVE:The number of pediatric Global Health (GH) tracks has more than doubled in less than 10 years. The goal of this study was to describe the characteristics of the pediatric GH tracks to identify commonalities and differences in track structure, funding, and education. In addition, we also identified demographic...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2018.03.009
更新日期：2018-08-01 00:00:00
abstract：:Though the use of mobile devices (e.g., tablets, smartphones) by young children is pervasive and increasing, research relating children's use of mobile devices to their development is only beginning to emerge. Learning, language development, and self-regulation skills among children aged zero to five are of particular...
journal_title：Academic pediatrics
pub_type： 杂志文章,评审
doi：10.1016/j.acap.2021.01.007
更新日期：2021-01-21 00:00:00
abstract：BACKGROUND:Professional guidelines and state Medicaid policies encourage pediatricians to provide oral health screening, anticipatory guidance, and fluoride varnish application to young patients. Because oral health activities are becoming more common in medical offices, the objective of this study was to assess pediat...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2014.07.001
更新日期：2014-11-01 00:00:00
abstract：OBJECTIVE:Fewer than 50% of children with developmental delay are identified before they start school, and only 10% of those identified receive services. Between May 2014 and August 2016, the Home Visiting Collaborative Improvement and Innovation Network (HV-CoIIN) aimed to improve early detection and linkage to servic...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2020.08.020
更新日期：2020-09-03 00:00:00
abstract：:In response to the COVID-19 pandemic, the medical education community was forced to transition to the virtual space seemingly overnight, with little time to prepare. As such, many medical educators are actively seeking ways to improve delivery of online content and utilize features of different technologies. This View...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2020.11.009
更新日期：2021-01-01 00:00:00
abstract：OBJECTIVE:To examine insurance-based disparities in provider-related barriers to care among children in California in the wake of changes to the insurance market resulting from the Affordable Care Act. METHODS:Our sample included 6514 children (ages 0 to 11 years) from the 2014-2016 California Health Interview Survey....
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2018.09.003
更新日期：2019-04-01 00:00:00
abstract：OBJECTIVE:Pregnancy is common during residency, yet the duration of allowed paid leave is inadequate and utilizing unpaid family medical leave act (FMLA) time has financial and professional consequences. We evaluated the effectiveness of a novel parenting elective, consistent with educational goals for pediatric reside...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2020.02.008
更新日期：2020-07-01 00:00:00
abstract：OBJECTIVE:In October 2016, the American Board of Medical Specialties approved the petition for pediatric hospital medicine (PHM) to become the newest pediatric subspecialty. Knowledge about residents entering the PHM workforce is needed to inform certification and fellowship accreditation. This study describes the char...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2017.05.001
更新日期：2018-03-01 00:00:00
abstract：OBJECTIVE:To evaluate a pediatric otoscopy curriculum with the use of outcome measures that included assessment of skills with real patients. METHODS:Thirty-three residents in an intervention group from 2 institutions received the curriculum. In the previous year, 21 residents in a nonintervention group did not receiv...
journal_title：Academic pediatrics
pub_type： 杂志文章,多中心研究
doi：10.1016/j.acap.2018.02.009
更新日期：2018-08-01 00:00:00
abstract：OBJECTIVE:Hispanic parents in the United States are disproportionately affected by low health literacy and limited English proficiency (LEP). We examined associations between health literacy, LEP, and liquid medication dosing errors in Hispanic parents. METHODS:Cross-sectional analysis of data from a multisite randomi...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2016.10.001
更新日期：2017-01-01 00:00:00
abstract：OBJECTIVE:Almost one-half of all pediatric gastrostomy tube insertions are accompanied by a fundoplication, yet little is understood about the surgical decision-making for these procedures. The objective of this study was to examine the decision-making process of surgeons about whether to perform a fundoplication in ch...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2012.07.006
更新日期：2012-11-01 00:00:00
abstract：OBJECTIVE:The objective of this study is to provide a comprehensive epidemiological profile detailing food allergy (FA) prevalence and related correlates among Medicaid-enrolled children. METHODS:The 2012 Medicaid Analytic eXtract person-level 100% files for 50 states and the District of Columbia were analyzed. The an...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2020.03.005
更新日期：2021-01-01 00:00:00
abstract：OBJECTIVE:Previous research suggests that cognitive functioning is associated with the risk of several adult psychiatric disorders. In this study we investigated whether adolescents who perform worse than expected at secondary school are at a higher risk for general mental health problems. METHODS:In a cross-sectional...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2017.04.016
更新日期：2017-08-01 00:00:00
abstract：BACKGROUND AND PURPOSE:The coming years could be a watershed period for children and health care as the nation implements the most significant federal health care legislation in 50 years: the Accountable Care Act (ACA). A year earlier, the American Recovery and Reinvestment Act (ARRA) set up a framework and road map fo...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2010.10.003
更新日期：2011-05-01 00:00:00
abstract：OBJECTIVE:Since the introduction of resident work-hour standards, pediatric residency programs have struggled to preserve robust continuity clinic experiences. Many programs have resorted to more flexible approaches to resident scheduling. We know little regarding the impact of such changes. We compared 2 continuity cl...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2009.11.002
更新日期：2010-03-01 00:00:00
abstract：OBJECTIVE:To prevent iron deficiency, 2014 Canadian recommendations for healthy term infants from 6 to 24 months recommend iron-rich complementary foods such as meat and meat alternatives 2 or more times a day. The purpose of our study was to evaluate the association between meat and meat-alternative consumption and ir...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2016.01.003
更新日期：2016-01-01 00:00:00
abstract：OBJECTIVE:Although it is known that children with mental health problems utilize primary care services more than most other children, it is unknown how addressing mental health problems in primary care affects children's subsequent services utilization. This study measures primary care utilization in the context of a r...
journal_title：Academic pediatrics
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.acap.2010.06.012
更新日期：2010-09-01 00:00:00
abstract：OBJECTIVE:To estimate the prevalence of use of fetal-harm drugs among women who received postpartum care in hospitals in Haiti and to identify groups of women at higher risk for potentially harmful medication exposures. METHODS:Women who received postpartum care in 2 large hospitals in Port-au-Prince, Haiti, from Augu...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2010.09.003
更新日期：2010-11-01 00:00:00
abstract：OBJECTIVE:To develop and validate a computable phenotype algorithm for identifying patient populations with sickle cell disease. METHODS:In this retrospective study we used electronic health record data from the Children's Hospital of Wisconsin to develop a computable phenotype algorithm for sickle cell disease. The a...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2016.12.005
更新日期：2017-04-01 00:00:00
abstract：OBJECTIVE:To examine the prevalence of positive screening scores, construct validity, and opportunities for follow-up in a large sample of adolescents who chose to fill out the Pediatric Symptom Checklist-Youth Form (PSC-Y) through the Mental Health America (MHA) Web site. METHODS:MHA sent researchers a deidentified d...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2017.08.013
更新日期：2018-01-01 00:00:00
abstract：OBJECTIVE:A cluster randomized trial was performed to evaluate an educational intervention to improve parental attitudes and vaccine uptake in vaccine-hesitant parents. METHODS:Two primary care sites were randomized to provide families with either usual care or an intervention (video and written information) for vacci...
journal_title：Academic pediatrics
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.acap.2013.03.011
更新日期：2013-09-01 00:00:00
abstract：OBJECTIVE:The stress associated with adverse childhood experiences (ACEs) has immediate and long-lasting effects. The objectives of this study were to examine 1) how often pediatricians ask patients' families about ACEs, 2) how familiar pediatricians are with the original ACE study, and 3) physician/practice characteri...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2015.08.002
更新日期：2016-03-01 00:00:00
abstract：OBJECTIVE:An innovative low-cost parenting intervention, implemented through health services in Jamaica showed benefits to children's cognitive development at 18 months and parent's attitudes concerning childcare. We assessed the impact of the intervention on child and parent outcomes at 6 years of age. METHODS:A clus...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2021.01.003
更新日期：2021-01-09 00:00:00
abstract：BACKGROUND:Neonatal tracheal intubation (NTI) is an important clinical skill. Suboptimal performance is associated with patient harm. Simulation training can improve NTI performance. Improving performance requires an objective assessment of competency. Competency assessment tools need strong evidence of validity. We hy...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2018.07.008
更新日期：2019-03-01 00:00:00
abstract：OBJECTIVE:We sought to determine the age at which US parents first turned their child's car seat to face forward and information sources used to make that decision at the time of the release of the 2011 guidelines for child passenger safety and 30 months later. METHODS:We administered 2 separate cross-sectional Web-ba...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2014.10.004
更新日期：2015-09-01 00:00:00
abstract：OBJECTIVE:To compare the prevalence of a medical home for children with public versus private insurance and identify components of the medical home that contribute to any differences. METHODS:We performed a secondary data analysis of the 2007 National Survey of Children's Health. A medical home was defined as meeting ...
journal_title：Academic pediatrics
pub_type： 杂志文章
doi：10.1016/j.acap.2011.03.006
更新日期：2011-07-01 00:00:00
