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 randomized trial of a communication skills training program for primary care clinicians that had a positive impact on child mental health outcomes. METHODS:From 2002 to 2005, 48 pediatric primary care clinicians at 13 sites in rural upstate New York, urban Maryland, and Washington, DC, were randomized to in-office training or to a control group. Consecutive primary care patients between the ages of 5 and 16 years were screened for mental health problems, as indicated by a possible or probable score on the Strengths and Difficulties Questionnaire (SDQ). For 397 screened children, primary care visits during the next 6 months were identified using chart review and administrative databases. Using generalized estimating equation regression to account for clustering at the clinician level, primary care utilization was compared by study group and SDQ status. RESULTS:The number of primary care visits to the trained clinicians did not differ significantly from those made to control clinicians (2.5 for both groups; P = .63). Children with possible or probable SDQ scores made, on average, 0.38 or 0.65 more visits on a per child basis, respectively, during the 6-month follow-up period than SDQ unlikely children (P = .0002). CONCLUSIONS:Seeing a trained clinician did not increase subsequent primary care utilization. However, primary care utilization was greater among children with mental health problems as measured by the SDQ. Addressing children's mental health in primary care does not increase the primary care visit burden. Research on overall health services utilization is needed.
journal_name
Acad Pediatrjournal_title
Academic pediatricsauthors
Gadomski A,Wissow LS,Slade E,Jenkins Pdoi
10.1016/j.acap.2010.06.012subject
Has Abstractpub_date
2010-09-01 00:00:00pages
346-52issue
5eissn
1876-2859issn
1876-2867pii
S1876-2859(10)00179-8journal_volume
10pub_type
杂志文章,多中心研究,随机对照试验abstract:OBJECTIVE:To explore the potential benefits and challenges of involving adolescents in the education of medical students and residents from the perspectives of adolescents who are hospitalized with chronic health conditions. METHODS:We conducted qualitative interviews with adolescents at a Canadian pediatric hospital....
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2018.05.007
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:Underreporting of adverse events by physicians is a barrier to improving patient safety. In an effort to increase resident and medical student (hereafter "trainee") reporting of adverse events, trainees developed and led a monthly conference during which they reviewed adverse event reports (AERs), identified ...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2017.01.004
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:Goals of care discussions are crucial in helping parents navigate complex medical decisions and shown to improve quality of care. Little is known about whether physicians elicit or address parents' goals during a child's hospitalization. The purpose of this study was to understand the current practice of goal...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.05.016
更新日期:2020-05-31 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:Accurate parental weight perception of one's child is an important step in addressing healthy behaviors, but its associations with socioeconomic status (SES) and household food insecurity (HFI) are unclear. We aimed to assess the association of parental weight perception with HFI. METHODS:This was a secondar...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2019.04.009
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVE:To describe the delivery of well-child care and its components; to compare that delivery with recommendations in Bright Futures; and to compare delivery of well-child care for children with special health care needs with that for children without special needs. METHODS:Over a 10-week period, 2 medical studen...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2010.12.008
更新日期:2011-01-01 00:00:00
abstract::Neonatal intensive care unit networks that encompass regions, states, and even entire countries offer the perfect platform for implementing continuous quality improvement initiatives to advance the health care provided to vulnerable neonates. Through cycles of identification and implementation of best available eviden...
journal_title:Academic pediatrics
pub_type: 杂志文章,评审
doi:10.1016/j.acap.2013.04.014
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:To evaluate how parents and physicians perceive the utility of a comprehensive, electronic previsit screener, and to assess its impact on the visit. METHODS:A mixed methods design was used. English-speaking parents were recruited from 3 primary care systems (urban MD and rural NY and VT) when they presented ...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2013.04.005
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate training in developmental and behavioral pediatrics (DBP) for graduating residents, their competencies in diagnosing and treating child mental health (MH) problems, and whether the amount of DBP training and/or perceived competencies are associated with perceived respo...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2010.03.003
更新日期:2010-07-01 00:00:00
abstract::Over the past 30 years, there have been major expansions in public health insurance for low-income children in the United States through Medicaid, the Children's Health Insurance Program (CHIP), and other state-based efforts. In addition, many low-income parents have gained Medicaid coverage since 2014 under the Affor...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2015.12.011
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the effects of simple and elaborated health care provider (HCP) reminder prompts on human papillomavirus (HPV) vaccine initiation rates. METHODS:Twenty-nine pediatric HCPs serving 5 pediatric clinics were randomized to 1 of 3 arms: 1) usual practice control, 2) simple reminder prompt, and 3) elab...
journal_title:Academic pediatrics
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.acap.2017.11.002
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:Untreated vision problems are associated with poor school performance. Whether providing glasses alone improves performance, however, remains unknown. We sought to test whether receiving glasses was associated with improved school performance for low-income minority students in Los Angeles. METHODS:From 2017...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.01.001
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:Advocates must make decisions about the types of evidence they emphasize when communicating to cultivate support for adverse childhood experience (ACE) prevention policies. This study sought to characterize public perceptions of the persuasiveness of 12 ACE evidence statements and assess differences by ideolo...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.05.031
更新日期:2020-06-15 00:00:00
abstract:OBJECTIVE:To understand why families enroll in and disenroll from Children's Health Insurance Program (CHIP), their experience with the CHIP application and renewal process, and the insurance coverage of their children after disenrolling. METHODS:We conducted a large household telephone survey in 2012 of CHIP enrollee...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2015.02.013
更新日期:2015-05-01 00:00:00
abstract::Primary care pediatricians and psychology practitioners who comanage mental health problems can develop interdisciplinary communication and collaborative skills from joint standardized patient encounters and debriefings, combined with brief didactics. Learners showed increased confidence in shared management of behavi...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2017.06.014
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:To evaluate whether school nurses can assist pediatricians in providing asthma care and reduce school absenteeism through a program called Easy Breathing for Schools (EzBfS), a 5-element school nurse-led asthma management program and the effectiveness in reducing school absenteeism. METHODS:Fifteen public sc...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2019.07.007
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:To identify the proportion of patients previously diagnosed with apparent life-threatening events (ALTE) who would meet criteria for brief resolved unexplained events (BRUE) and to identify rates of adverse outcomes in subgroups: ALTE not meeting criteria for BRUE, lower-risk BRUE, and higher-risk ALTE. METH...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2019.08.001
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:To compare job search experience and postresidency position of pediatric residents on the basis of childhood location (United States or international) and medical school location (American medical graduates [AMG] or international medical graduate [IMG]). METHODS:Annual national random samples of 1000 graduat...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2015.06.005
更新日期:2015-09-01 00:00:00
abstract::When Congress reenacted the Child Health Insurance Program (CHIP) in 2009, it incorporated a range of dental provisions that had not been considered when the program was initiated in 1997. This paper posits that this change evidences the establishment of pediatric oral health as a distinct policy issue within Congress...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2009.09.002
更新日期:2009-11-01 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
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:Despite recommendations to consume iron-, calcium-, and vitamin C-rich foods for managing blood lead levels (BLLs), limited evidence exists on how specific foods affect children's BLLs. Using data from 12- to 36-month olds (n = 992) from the 2009 to 2014 National Health and Nutrition Examination Survey, we as...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.06.009
更新日期:2020-06-17 00:00:00
abstract:OBJECTIVE:To compare preventive care quality for children at risk and not at risk for developmental, behavioral, or social delays. METHODS:Using the 2007 National Survey of Children's Health (n = 22,269), we used the Parents' Evaluation of Developmental Status (PEDS) questionnaire to identify children ages 10 months t...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2012.05.003
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:To identify factors that influence faculty to promote or reduce the expression of autonomy for pediatric hospital medicine (PHM) fellows and describe behaviors faculty employ to support fellow autonomy in the clinical setting. METHODS:This was a multicenter, qualitative study using semistructured interviews ...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2019.05.003
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Children and adolescents necessitating hospitalization for physical health conditions are at high risk for mental health conditions; however, the prevalence of mental health conditions and symptoms among hospitalized children and adolescents is uncertain. The objective of this study was to determine the prop...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2016.08.009
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:Primary care providers (PCPs) and hospitalists endorse the importance of effective communication yet studies illustrate critical communication problems between these 2 provider types. Our objective was to develop deeper insight into the dimensions of and underlying reasons for communication issues and determi...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2016.03.003
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:The American Board of Pediatrics requires that pediatricians be able to initiate stabilization of a newborn. After residency, 45% of general pediatricians routinely attend deliveries. However, there is no standard approach or tool to measure resident proficiency in newborn resuscitation across training progr...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2018.09.004
更新日期:2019-01-01 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:To evaluate the effectiveness of a traditional didactic session (TDS) as compared to a self-paced, interactive, multimedia module (SPM) on the application of evidence-based medicine (EBM) skills among medical students during their inpatient pediatric rotation. METHODS:We conducted a randomized controlled tri...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.09.012
更新日期:2020-09-30 00:00:00
abstract:OBJECTIVE:Pediatricians have regular opportunities to perform screening dental examinations on young children and to educate families on preventive oral health. We sought to assess pediatricians' current attitudes and practices related to oral health of children 0-3 years old. METHODS:A Periodic Survey of Fellows, foc...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2009.09.016
更新日期:2009-11-01 00:00:00