Academic Pediatrics最新文献

{"title":"Erratum to “An Exploration of the Impact of Racism and Discrimination on the Mental Health of Latinx Youth” [Acad Pediatr. 2024;24(suppl 7):S139–S146]","authors":"Ashley Cureton PhD, MSW , Fernanda Lima Cross PhD, MSW , Sarah Polk MD, ScM, MHS","doi":"10.1016/j.acap.2025.102813","DOIUrl":"10.1016/j.acap.2025.102813","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102813"},"PeriodicalIF":3.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacts of the Smart Beginnings Parenting Program on Early Childhood Special Education Evaluation and Service Referral.","authors":"Leah J Hunter, Ashleigh I Aviles, Elizabeth B Miller, Caitlin F Canfield, Katherine Guyon-Harris, Pamela A Morris-Perez, Alan L Mendelsohn, Daniel S Shaw","doi":"10.1016/j.acap.2025.102826","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102826","url":null,"abstract":"<p><strong>Objective: </strong>Little is known about how parenting interventions might influence families' access to related healthcare services during early childhood. This study describes the effects of a parenting intervention, Smart Beginnings (SB), on referrals to early intervention (EI) or early childhood special education (ECSE) after evaluation within a predominantly Black/Latine sample with low incomes. SB is a tiered intervention integrating a universal parenting program delivered in primary care clinics (PlayReadVIP) with a targeted home visiting program (Family Check-Up).</p><p><strong>Methods: </strong>Data were drawn from a randomized controlled trial of SB, with sites in NYC and Pittsburgh, PA. The 280 families (132 treatment; 148 control) were 43% Black, 47% Latine, 37% Spanish-speaking, and 100% Medicaid-eligible. Hierarchical logistic regressions examined associations between expressive vocabulary and problem behaviors (internalizing and externalizing symptoms) at 2 years, and the impact of the SB intervention on the likelihood of EI/ECSE evaluation and service referrals based on evaluation results by 4 years.</p><p><strong>Results: </strong>Across sites, children's lower expressive vocabulary and higher problem behaviors at 2 years predicted receiving EI/ECSE evaluation and service referrals by age 4. Assignment to the SB intervention reduced the likelihood of evaluations leading to referrals for EI/ECSE service.</p><p><strong>Conclusions: </strong>Results from this RCT showed that children with early behavior and language challenges were more likely to receive EI/ECSE evaluation and services by preschool-age. Children assigned to SB were less likely to be referred for services. Studying factors that predict EI/ECSE involvement for children from historically marginalized populations can help promote equity in early care systems.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102826"},"PeriodicalIF":3.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Policy Approaches to Achieve Health Equity for Immigrant Children.","authors":"Ben D'Avanzo, Gabrielle Lessard, Jenny Rejeske, Wendy Cervantes, Isha Weerasinghe","doi":"10.1016/j.acap.2025.102824","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102824","url":null,"abstract":"<p><strong>Objective: </strong>In this paper we aim to make comprehensive policy recommendations to support children in immigrant families, including access to permanent immigration status, culturally responsive mental health care services, creating safe spaces in settings that serve children and families, centering the needs of children in the immigration system, expanding immigrant access to public programs, and ensuring robust research on the importance of such policies. Immigrant children face unique challenges in achieving adequate health care across many conditions and circumstances, driven by policy decisions that can be addressed. Opportunities exist for those working to improve the health of children to educate policymakers and present additional research demonstrating the value of these policy changes.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102824"},"PeriodicalIF":3.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Illustrating the role of infant well child visits in the association between transportation insecurity and acute healthcare use.","authors":"Jewel Park, Michelle Gorecki, Aaron Flicker, Allison Reyner, Adrienne Henize, Melissa Klein, Andrew F Beck","doi":"10.1016/j.acap.2025.102827","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102827","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the role of well-child visits (WCVs) in mediating associations between transportation insecurity and acute healthcare usage among infants.</p><p><strong>Methods: </strong>This was a retrospective cohort study of 4,114 infants seen for newborn visits at three primary care centers between February 1, 2019 and March 31, 2021. Each infant was followed through 15 months of age. The outcome of interest was acute healthcare usage, defined by high-acuity emergency department (ED) visit or hospitalization. The exposure was transportation insecurity as reported by parents through standardized questionnaires administered during WCVs. We stratified analyses by WCV attendance (≥6 WCVs vs. <6 WCVs in first 15 months of life) to assess whether WCVs mediated associations between acute healthcare usage and transportation insecurity.</p><p><strong>Results: </strong>Of 4,114 eligible infants, 8.7% endorsed transportation insecurity. Patients reporting transportation insecurity, compared to those who did not, had higher rates of incomplete WCV attendance (60.3% vs. 44.2%, p<0.001), ED visitation (38.0% vs. 28.7%; p<0.001), and hospitalization (19.8% vs. 14.1%; p=0.004). Transportation insecurity, compared to no transportation security, was significantly associated with having <6 WCVs (adjusted odds ratio [aOR] 1.64, 95% confidence interval [CI] 1.29, 2.09), ED visitation (aOR 1.45, 95%CI 1.14, 1.85), and hospitalization (aOR 1.52, 95%CI 1.13, 2.04). However, WCV attendance did not mediate associations between transportation insecurity and ED visits or hospitalizations.</p><p><strong>Conclusion: </strong>Transportation insecurity was associated with fewer WCVs; however, WCV attendance did not mediate associations between acute healthcare usage and transportation insecurity. Future research could focus on mechanisms linking transportation insecurity to suboptimal health outcomes.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102827"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New York State's Paid Family Leave Program and Children's Health Care Use.","authors":"Taryn W Morrissey, Neko Michelle Castleberry, Daniel P Miller","doi":"10.1016/j.acap.2025.102822","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102822","url":null,"abstract":"<p><strong>Objectives: </strong>Prior research has linked paid family leave programs with improvements in maternal and infant health. This study assessed changes in children's healthcare use following implementation of New York State's Paid Family Leave Program (NYSPFL) and whether these changes vary by socioeconomic status.</p><p><strong>Methods: </strong>We used difference-in-differences (DD) and synthetic control method (SCM) approaches with data from the 2016-2019 waves of the National Survey of Children's Health (NSCH; n ~24,000) to estimate the plausibly causal effects of NYSPFL on the healthcare use of children under age 18. We compared NYS residents to residents in states that implemented paid family leave after 2019.</p><p><strong>Results: </strong>SCM analyses indicate a 3.3 percentage point (-16%) reduction in emergency department visits among children aged 0-17 following NYSPFL implementation; findings were similar in the DD models but not significant (-2.3pp; 95% CI, -0.092, 0.061). DD models found large reductions in delays of necessary healthcare among parents whose children had chronic conditions, but not among the full sample.</p><p><strong>Conclusions: </strong>Findings suggest that state paid family leave programs support families' obtaining necessary healthcare for children with chronic conditions, and reduce emergency department visits among families with children across the age spectrum.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102822"},"PeriodicalIF":3.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life is Calling.","authors":"Cara Texler","doi":"10.1016/j.acap.2025.102823","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102823","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102823"},"PeriodicalIF":3.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Connecting Families: Poverty Screening and Financial Support Navigation for Families of Young Children in Primary Care: A Pilot Randomized Controlled Trial","authors":"Imaan Bayoumi MD ,&nbsp;Patricia C. Parkin MD ,&nbsp;Mary Martin MSc ,&nbsp;Charles D.G. Keown-Stoneman PhD ,&nbsp;Catherine S. Birken MD, MSc ,&nbsp;Jonathon L. Maguire MD, MSc ,&nbsp;Cornelia M. Borkhoff PhD","doi":"10.1016/j.acap.2025.102820","DOIUrl":"10.1016/j.acap.2025.102820","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the feasibility of a randomized controlled trial (RCT) evaluating the impact of community support worker (CSW) supported, structured review of financial supports and social system navigation.</div></div><div><h3>Methods</h3><div>A pilot RCT of parent-child dyads (1 parent and child aged 2–5 years old) endorsing the question “Do you ever have difficulty making ends meet at the end of the month?” was conducted in primary care in Kingston, Ontario, Canada. Interventions included CSW-supported social system navigation or control; both groups received a written summary of available resources. The primary outcome was feasibility, including recruitment, completion, and retention rates and intervention adherence and fidelity. Secondary outcomes were child social, emotional, and behavioral health (Strengths and Difficulties Scale [SDQ]) and parenting stress (Parenting Stress Index-IV [PSI]).</div></div><div><h3>Results</h3><div>Of 74 eligible dyads, 37 (50%) were enrolled, mean (standard deviation [SD]) child age 35.4 (11.1) months and 57% were female. Outcomes were assessed on 29 participants (78%) at 6 months and 22 participants (60%) at 12 months. Participants randomized to the intervention arm met with the CSW a mean of 1.71 (SD 1.68) times, with a range of 0 to 5 meetings, including 35.7% who did not attend any meetings with the CSW. Using analysis of covariance, the mean between-group difference in the baseline adjusted SDQ Total Difficulties Score at 6 months was −1.21 (95% confidence interval [CI] −3.82, 1.40) and at 12 months was 1.10 (95% CI −3.13, 5.34), and in the baseline adjusted PSI Total Score at 6 months was −12.88 (95% CI −21.63, −4.12) and at 12 months was 7.79 (95% CI −4.42, 20.00).</div></div><div><h3>Conclusions</h3><div>Conducting a trial enrolling families of young children experiencing financial strain is feasible. A definitive trial with modifications is warranted and is underway.</div></div><div><h3><strong>Clinical Trials Registration</strong></h3><div>clinicaltrials.gov NCT05667675.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 5","pages":"Article 102820"},"PeriodicalIF":3.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental, Patient, and Provider Perspectives on the Use of Artificial Intelligence in Pediatric Care.","authors":"Jillian Gorski, James Rudloff, Sriram Ramgopal","doi":"10.1016/j.acap.2025.102819","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102819","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102819"},"PeriodicalIF":3.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Coaching For In-The-Moment Skill Development.","authors":"Zarina Norton, Matthew Hazle, Lindsay Koressel, Margaret Wolff","doi":"10.1016/j.acap.2025.102818","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102818","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102818"},"PeriodicalIF":3.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic Indicators and Low Body Mass Index Outcome Among Adolescents and Young Adults With Social Risks","authors":"Sophie H. Allende-Richter MD, MPH ,&nbsp;Aakansha Bagepally BA ,&nbsp;Jessica Addison MD, MS, MPH ,&nbsp;Patrice Melvin PhD ,&nbsp;Inyang Isong MD, ScD, MPH ,&nbsp;Christopher P. Landrigan MD, MPH ,&nbsp;Takara L. Stanley MD","doi":"10.1016/j.acap.2025.102814","DOIUrl":"10.1016/j.acap.2025.102814","url":null,"abstract":"<div><h3>Objective</h3><div>To describe clinical characteristics among adolescents and young adults with isolated low body mass index (BMI) and identify socioeconomic indicators in the lived environment associated with this outcome.</div></div><div><h3>Methods</h3><div>Using our electronic health record, we conducted a retrospective case-control study that included 135 adolescents and young adults ages 13 to 21 from an under-resourced neighborhood of Massachusetts with isolated diagnoses of failure to thrive or underweight status. We used the Centers for Disease Control and Prevention weight classification to allocate patients into low and normal BMI categories. We used chi-square and Fisher exact tests to compare differences in clinical characteristics and neighborhood socioeconomic indicators by BMI outcome and a 2-sample test of proportions or logistic regression to calculate the effect estimate and 95% confidence interval.</div></div><div><h3>Results</h3><div>Forty percent of the participants with low BMI were diagnosed with malnutrition and required nutritional supplements. Low BMI finding was positively associated with depression, anxiety, and unmet social drivers of health—primarily driven by housing insecurity.</div></div><div><h3>Conclusions</h3><div>Our findings indicate that a significant proportion of adolescents and young adults with low BMI experience housing insecurity and unmet social needs in their lived environment and suffer from malnutrition at a critical time of their growth and development. Further research is needed to understand the role of the lived environment and outcome of low BMI, the underlying mechanisms at play, and its impact on adolescents' and young adults' growth and development.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 5","pages":"Article 102814"},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}