Academic Pediatrics最新文献

{"title":"The Day I Almost Lost My Son.","authors":"Chana Richter","doi":"10.1016/j.acap.2025.102862","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102862","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102862"},"PeriodicalIF":3.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163672","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":"Equity in Health Care Access, Utilization, and Experiences for Latino Children in California by Parental Citizenship and Household Language, 2021-2022.","authors":"Clara B Barajas, Dylan H Roby, Jim P Stimpson, Ninez A Ponce, Gabriela E Lazalde, Maria-Elena De Trinidad Young, Kathryn Kietzman, Arturo Vargas Bustamante, Alexandra C Rivera-González, Brent A Langellier, Jan M Eberth, Mark Stehr, Alexander N Ortega","doi":"10.1016/j.acap.2025.102856","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102856","url":null,"abstract":"<p><strong>Objectives: </strong>This study examines health care access, utilization, and experiences among Latino children in California by parental citizenship and household language.</p><p><strong>Methods: </strong>Merged data from the 2021-2022 California Health Interview Survey and the follow-up Latino Youth Health Study of the same years were analyzed. Primary outcomes were parental reports of children's health care access, utilization, and experiences in the past year. The main predictors were variables stratified by parental citizenship status (both citizen parents versus one citizen and one noncitizen parent or both noncitizen parents) and household language (English-only versus English-and-Spanish, or Spanish-only). Multivariable analyses adjusted for parental education, family income, parent-reported child's health status, child's age, and child's insurance.</p><p><strong>Results: </strong>Findings showed no significant differences in health care access across groups. However, children with both noncitizen parents and from Spanish-only households were more likely to have had well-child visits and general doctor visits than children with both citizen parents and in English-only households. Additionally, parents of children with both noncitizen parents were more likely to feel respected by doctors than those with both citizen parents. Conversely, compared to parents with both citizen parents, parents of children with one citizen and one noncitizen parent were less likely to report that doctors spent enough time with their children and less likely to express high satisfaction with their children's health care.</p><p><strong>Conclusion: </strong>Patterns of health care access, utilization, and experiences among Latino children in immigrant families in California are improving, which are likely associated with recent inclusive health policies in the state.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102856"},"PeriodicalIF":3.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144324","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":"The Current State of Behavioral Health Training for Pediatric Residents.","authors":"Rachel Herbst, Andrea Meisman, Francis J Real","doi":"10.1016/j.acap.2025.102859","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102859","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102859"},"PeriodicalIF":3.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144340","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":"Differences between Individual Social Risks, Social Needs, and Community-level Social Risk among Pediatric Patients.","authors":"Matthew S Pantell, David M Mosen, Nathan Tran, Laura M Gottlieb, Matthew P Banegas","doi":"10.1016/j.acap.2025.102851","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102851","url":null,"abstract":"<p><strong>Objective: </strong>We sought to explore relationships between community-level social determinants of health (SDOH), individual-level social risk factors, and individual-level social needs - whether families desire help addressing social risk factors - among children's families in a large, diverse patient population in the Pacific Northwest.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of children ages 0-18 who received care at Kaiser Permanente Northwest, an integrated healthcare system serving patients in Oregon and Southwest Washington, between December 1, 2017 - December 31, 2019. Social data came from the Your Current Life Situation survey as recorded in patient electronic medical records, and included information on housing instability, food insecurity, transportation needs, and financial hardships. We used Chi-squared tests to compare rates of social risks, social needs, and NDI quartiles.</p><p><strong>Results: </strong>The sample included 2,313 children. Among the 59.6% of families endorsing at least one social risk, 66.9% desired assistance addressing at least one social need. Both individual-level social risks and social needs varied significantly by NDI quartile, with the highest social risk and social needs rates being in the highest NDI quartiles (most social disadvantage). However, among families in the lowest NDI quartile (most social advantage), 42.1% of families endorsed at least one risk and 23.3% of families endorsed at least one social need.</p><p><strong>Conclusions: </strong>In a diverse sample of pediatric patients, we found that a community-level SDOH index inadequately identified families endorsing social risks and social needs. Our findings support policies that incentivize individual-level social risk and social need data collection in clinical settings.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102851"},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121179","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":"Implementing Sudden Cardiac Death Risk Screening within a Pediatric Primary Care Network.","authors":"Naveed Rabbani, Margaret Fry, Louis Vernacchio, Emily Trudell Correa, Susannah Kisvarday, Jonathan Hatoun, Michael Day, Mark E Alexander","doi":"10.1016/j.acap.2025.102850","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102850","url":null,"abstract":"<p><strong>Background: </strong>In 2021, the American Academy of Pediatrics (AAP) recommended universal, history-based sudden cardiac death risk screening, representing an expansion from history- and exam-based screening for sports preparticipation. We studied the implementation of universal cardiac risk screening within a large pediatric primary care network to better understand optimal workflow design, screening positivity rate, and potential system-based effects that may arise from expanded screening.</p><p><strong>Methods: </strong>We adapted the AAP guidelines to a three-question screener implemented into the electronic health record as a patient portal questionnaire with a back-up paper-based workflow. A non-interruptive alert provided clinical decision support. Screening positivity rates and rates of follow-up actions were measured. Screening rates were compared across patient demographics using a multivariable model.</p><p><strong>Results: </strong>Between March 1, 2024, and February 28, 2025, of 72,037 eligible patients, 41,433 (58%) were screened. Of these, 3,463 (8.4%) had a clinically actionable positive screen. Follow-up evaluation was ordered in 31% of cases. A multivariable model demonstrated that inactive patient portal status, teenage patient age, patient race of \"Unknown,\" and public insurance were associated with lower screening rates.</p><p><strong>Conclusions: </strong>Implementing universal history-based sudden cardiac death risk screening in a pediatric primary care network exhibited an 8.4% positivity rate after clinician review, representing a large potential burden of cardiology referrals. Over half of eligible patients were screened, and follow-up evaluation was ordered in a minority of positive cases, signaling a gap in adoption/adherence. This implementation was associated with lower screening rates in certain disadvantaged populations.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102850"},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121227","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":"Healthcare Use by Immigrant Generation in Low-Income Children with Special Healthcare Needs.","authors":"Marina Masciale, Todd Leroux, Karla Fredricks, Jean L Raphael, Claire Bocchini, Hye-Chung Kum, Michelle A Lopez","doi":"10.1016/j.acap.2025.102852","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102852","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to describe social stressors and healthcare access in children with special healthcare needs (CSHCN) from low-income households by immigrant generation and determine the association between immigrant generation and healthcare utilization.</p><p><strong>Methods: </strong>This was a retrospective cross-sectional study of CSHCN living at or below 200% of the Federal Poverty Level using the National Survey of Children's Health from 2018-2022. Exposures were demographics, immigrant generation (first-generation, second-generation, or non-immigrant), social stressors, and healthcare factors. Outcomes were 1) one or more emergency room (ER) visit and 2) one or more hospitalizations in the past year. We compared variables across generation using chi-squared testing and assessed factors associated with our outcomes using logistic regression.</p><p><strong>Results: </strong>We included 16,679 CSHCN (293 first-generation, 2,203 second-generation, 14,183 non-immigrants). Compared to second-generation and non-immigrants, more parents of first-generation CSHCN identified as Hispanic, lived in non-English speaking households, reduced work hours due to their child's health, reported poor child health, lacked insurance for their child, and lacked a medical home for their child. ER visits and hospitalization rates were similar across all three generation groups. When controlling for co-variates, immigrant generation was not associated with ER visits or hospitalizations.</p><p><strong>Conclusions: </strong>Despite having poorer health status and less access to medical homes compared to non-immigrants, CSHCN from immigrant families do not utilize the ER more often, which is potentially concerning for underutilization. Addressing social drivers of health in immigrant families and expanding public health insurance eligibility to all low-income CSHCN, regardless of immigration status, may ensure appropriate ER use.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102852"},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121253","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":"The Latino School Readiness Gap: Engaging Families in Design Thinking for Primary Care Interventions.","authors":"Jaime W Peterson, Veronica Ilene Underwood Carrasco, Maya Postigo, Alejandro Robles, Nelda Reyes, Ellen Stevenson, Katharine E Zuckerman","doi":"10.1016/j.acap.2025.102849","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102849","url":null,"abstract":"<p><strong>Objective: </strong>Among Latino families with a recent kindergartener we 1) qualitatively explored school readiness (SR) journeys and 2) used design thinking to understand their preferences, usability, and acceptability of primary care-based SR interventions (checklist, coordinator, coaching, texting, preschool, library referrals, parenting groups, and Reach out and Read).</p><p><strong>Methods: </strong>Focus groups and interviews were completed at four Oregon pediatric clinics over two sessions: 1) narrative inquiry of SR stories through journey maps, 2) SR intervention assessment through design thinking. Sessions were led by an English/Spanish bilingual-bicultural facilitator, recorded, and transcribed. Iterative team-based coding with inductive analysis was conducted in the source language.</p><p><strong>Results: </strong>Participants (N=33) were primarily Spanish-speaking (58%) mothers (76%) born in Mexico (64%) with at least a high school degree (69%), with US-born children (55%) who attended preschool (81%). Journey maps revealed a positive educational foundation of teaching values, culture, and language for kindergarten preparation, with strong beliefs that school will teach life skills. Compared to English-speaking parents, Spanish-speaking parents focused more on social-emotional development than specific early literacy or math activities, reporting less confidence in teaching cognitive skills. Parents identified a longitudinal model with SR interventions at multiple points.Themes regarding targeted SR support, hesitancy to request help, and bilingualism were integrated into a prior framework to promote SR (Figure 1).</p><p><strong>Conclusion: </strong>Participating families encouraged school success in their children before kindergarten and focused on social-emotional, cultural, and linguistic development. Caregivers identified a variety of acceptable and feasible clinic-based SR interventions that build on Latino families' social strengths.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102849"},"PeriodicalIF":3.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121230","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":"Heat-related illness trends at a pediatric health care system, 2012-2023.","authors":"Taylor A Merritt, Sanjna Bhatia, Courtney Solomon, Andrew Yu","doi":"10.1016/j.acap.2025.102855","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102855","url":null,"abstract":"<p><p>As extreme summer temperatures become more frequent due to a changing climate, there is an increased risk of heat-related morbidity and mortality, particularly in vulnerable populations such as children. We aimed to examine trends in heat-related illness over time and describe differences in patient characteristics and outcomes for children with \"heat-specific\" diagnoses compared to rhabdomyolysis, a severe form of heat-related illness. We conducted a retrospective study at a pediatric health care system with two large children's hospitals to identify Emergency Department encounters with a heat-related ED diagnosis from May-September from 2012 to 2023. Aggregate heat-related illness encounters, as a proportion of total ED encounters, increased 170% from 2012 (4.3 per 10,000) to 2023 (11.6 per 10,000) (p=0.01). Summer months with higher peak temperatures had higher heat-related ED volume (R2=0.44, p<0.001). Most heat-specific encounters resulted in ED discharge (96%), while most rhabdomyolysis encounters resulted in admission (63%). We found that ED volume for heat-related illness is associated with higher temperature and is increasing over time. Heat-specific diagnoses are more common than rhabdomyolysis. Given the rise in healthcare utilization from heat-related illness, it is essential for all pediatricians to understand the health implications of our changing climate.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102855"},"PeriodicalIF":3.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103059","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":"Monitoring Infant Vaccination Timeliness and Patterns: Progress and Future Directions.","authors":"Sophia R Newcomer, Alexandria N Albers, Sarah Y Michels, Jason M Glanz, Matthew F Daley","doi":"10.1016/j.acap.2025.102854","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102854","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102854"},"PeriodicalIF":3.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103060","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":"Improvement in Pediatric Resident Self-Efficacy and Documentation of Childhood Obesity Care with an Educational Intervention.","authors":"Christiana J Stark, Jeffrey Zhang, Jessica Walters, Dominick DeBlasio, JangDong Seo, Robert Siegel, Kristin Stackpole, Melissa Klein","doi":"10.1016/j.acap.2025.102846","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102846","url":null,"abstract":"<p><strong>Objectives: </strong>Childhood obesity is a public health crisis with increasing rates and long-term complications. Primary care providers are essential to address this concern; however, clinicians report inadequate training and self-efficacy.</p><p><strong>Methods: </strong>This educational study evaluated the impact of an obesity management curriculum on residents' self-efficacy and documentation. Three interactive educational sessions were presented. Residents rated their self-efficacy on caring for patients with obesity using a retrospective pre-post anchored response scale survey. Practice change was evaluated via chart review. Documentation of key history and treatment items was collected utilizing a standardized rubric over a 2-month period both before and after the education.</p><p><strong>Results: </strong>Post-education, self-efficacy ratings were higher compared to pre-education scores (p<0.0001). Chart review for 63 residents showed improvement in documentation of history and treatment items (p=0.026). Nutrition, activity, and sleep history elements improved in post-graduate level (PGY) 1 residents documentation compared to PGY2 (p<0.0001) and PGY3 residents (p=0.004). Documentation of treatment components including healthy habits counseling, SMART goals, lab testing, referrals, and follow-up increased among all PGY levels (p=0.036).</p><p><strong>Conclusions: </strong>A primary care-based curriculum improved resident self-efficacy in caring for patients with obesity. Documentation of history and treatment items increased for all residents, with greatest improvement by PGY1 residents.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102846"},"PeriodicalIF":3.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006814","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}