Abstract:
OBJECTIVE:Reach Out and Read (ROR) is a primary care-based intervention supported by considerable evidence regarding its efficacy. Implementation of ROR, however, varies across participating sites. The objective of this study was to identify practice attributes associated with variability in ROR implementation. METHODS:Twenty primary care providers and 70 support staff from 7 clinics in Baltimore, Maryland, participated in semistructured interviews. Sites were purposefully selected on the basis of the perceived success of their ROR program implementation. All interviews were transcribed and inductively analyzed to identify themes. Themes were compared to predictors postulated by a conceptual model for team effectiveness across a variety of workplace settings. RESULTS:Only one theme (integration of ROR procedures) addressed the design of ROR implementation within clinics. Nearly all other themes identified group processes and group psychosocial traits broadly reflective of clinic culture. At struggling sites, staff found their jobs burdensome and communication lacking. They demonstrated disrespect for patients and families. In this context, they experienced difficulty integrating ROR into their daily routines. Staff at successful sites worked as a team and expressed strong commitments to their communities. Integration of ROR at these sites tended to occur smoothly. Providers from all sites reported strong pressures to increase productivity, and thought that these pressures impaired their ability to deliver high-quality primary care. CONCLUSIONS:Clinic culture influences the implementation of an efficacious primary care intervention. Characteristics of clinic culture therefore need to be identified and taken into account in future efforts to improve its implementation.
journal_name
Acad Pediatrjournal_title
Academic pediatricsauthors
King TM,Muzaffar S,George Mdoi
10.1016/j.acap.2008.10.004subject
Has Abstractpub_date
2009-01-01 00:00:00pages
40-6issue
1eissn
1876-2859issn
1876-2867pii
S1876-2859(08)00212-Xjournal_volume
9pub_type
杂志文章,多中心研究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 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: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: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::Education, like clinical medicine, should be based on the most current evidence in the field. Unfortunately, medical educators can be overwhelmed by the sheer volume and range of resources for this literature. This article provides an overview of 15 articles from 2016 that the authors consider the top articles in the ...
journal_title:Academic pediatrics
pub_type: 杂志文章,评审
doi:10.1016/j.acap.2018.01.015
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVES:The cognitive expertise of Pediatric Hospitalists (PH) lies not in standard knowledge but in making decisions under conditions of uncertainty. To maintain expertise, PH should engage in deliberate practice via self-assessments that promote higher-level cognitive processes necessary to address problems with m...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2020.10.003
更新日期:2020-10-14 00:00:00
abstract:BACKGROUND:Limited English proficiency (LEP) is a known barrier to preventive care. Children from families with LEP face socioeconomic circumstances associated with increased odds of developmental delays and decreased participation in early care and education programs. Little is known about developmental surveillance a...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2015.12.007
更新日期:2016-09-01 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:OBJECTIVE:To determine pediatric resident training and preparation for 14 Accreditation Council for Graduate Medical Education (ACGME)-required procedures. METHODS:We included a national, random sample of 1000 graduating pediatric residents in 2015. For each of the ACGME-required procedures, residents were asked if th...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2017.08.001
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:(1) To describe coparenting among adolescent mothers and the biological fathers of their children. (2) To examine the effects of coparenting on young children's social-emotional development and whether these effects vary by father's residence status, parental education, and child characteristics. METHODS:Sec...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2012.07.007
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVES:To develop, validate, and test the feasibility of implementation of 4 new quality measures assessing emergency department (ED) and inpatient care for suicidal youth. METHODS:Four quality measures were developed to assess hospital-based care for suicidal youth. These measures, focused on counseling caregiver...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2017.09.017
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:Guidelines recommend closer outpatient follow-up for exclusively breastfed newborns, especially those with pronounced weight loss, because of increased risk of hyperbilirubinemia and dehydration that might require readmission. Our objective was to determine how feeding method and weight loss are associated wi...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2017.11.005
更新日期:2018-08-01 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:Child health is strongly influenced by social determinants. Little is known about the opinions of primary caregivers regarding the physicians' role in addressing social needs. Our objective was to examine caregivers' opinions about that role and any associations between those opinions, previous exposure to sc...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2015.06.002
更新日期:2016-03-01 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::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 examine the association between chronic school absenteeism and adverse childhood experiences (ACEs) among school-age children. METHODS:We conducted a secondary analysis of data from the 2011-2012 National Survey of Children's Health including children 6 to 17 years old. The primary outcome variable was ch...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2017.09.013
更新日期:2017-01-01 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: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::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:The Advisory Committee on Immunization Practices (ACIP) has recommended routine human papillomavirus (HPV) vaccination at age 11 or 12 years for girls since 2006 and for boys since 2011. We sought to describe adolescent HPV vaccination coverage, doses administered from 2009 to 2012, and age at first vaccinati...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2014.03.005
更新日期:2014-09-01 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: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::The effect of child poverty and related early life experiences on adult health outcomes and patterns of aging has become a central focus of child health research and advocacy. In this article a critical review of this proliferating literature and its relevance to child health programs and policy are presented. This li...
journal_title:Academic pediatrics
pub_type: 杂志文章,评审
doi:10.1016/j.acap.2016.01.014
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:To determine which of the 21 general pediatrics milestone subcompetencies are most difficult to assess using traditional methodologies and which are best suited to simulation-based assessment. METHODS:We surveyed 2 samples: pediatric simulation experts and pediatric program directors. Respondents were asked ...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2015.09.007
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:We examined changes in insurance coverage and health care utilization associated with the Affordable Care Act (ACA) among subgroups of Asian youth relative to non-Latino white youth. METHODS:Data were from the 2010 to 2017 American Community Survey and National Health Interview Survey. Difference-in-differen...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2019.11.004
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Children with special health care needs (CSHCN) are at increased risk for functional disabilities. Care coordination has been shown to decrease unmet health service use but has yet been shown to improve functional status. We hypothesize that care coordination services lower the odds of functional disability ...
journal_title:Academic pediatrics
pub_type: 杂志文章
doi:10.1016/j.acap.2014.08.006
更新日期:2015-03-01 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: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: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