Academic Pediatrics最新文献

{"title":"Changes in screen time behaviours from before (2019) to after (2022) the COVID-19 pandemic among Brazilian adolescents.","authors":"Bruno da Costa, Marcus Lopes, Gabrielli de Mello, Bruno Oliveira, Jean-Philippe Chaput, Kelly Silva","doi":"10.1016/j.acap.2025.102885","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102885","url":null,"abstract":"<p><strong>Objectives: </strong>Compare prepandemic (2019) and postpandemic (2022) engagement in five screen-based activities (studying, working, watching videos, playing video games, and using social media/chat applications) among independent samples of Brazilian adolescents using a repeated cross-sectional design; and 2) Examine within-individual changes in these same screen-based activities over the same period using a nested longitudinal cohort design DESIGN: Repeated cross-sectional study with a nested cohort.</p><p><strong>Methods: </strong>Data were collected in 2019 and 2022, involving a total of 2,008 adolescents who participated in the repeated cross-sectional study, with 333 forming a nested cohort sample. Zero-inflated multilevel gamma regression models and multilevel linear models were used to analyze the data.</p><p><strong>Results: </strong>In the repeated cross-sectional analysis, adolescents spent more minutes per day in 2022 versus 2019 for studying (+21.3 min; 95%CI: 11.0, 31.6), watching videos (+12.8 min; 95%CI: 1.1, 24.5), and playing video games (+22.9 min; 95%CI: 12.8, 33.1). The longitudinal analysis revealed significant average daily increases from 2019 to 2022 in studying (+53.8 min; 95%CI: 34.7, 72.9) and working (+130.2 min; 95%CI: 110.4, 149.9). For these same adolescents, significant decreases were observed for watching videos (-26.4 min; 95%CI: -48.0, -4.9) and playing video games (-28.6 min; 95%CI: -46.2, -11.8). Social media use remained stable.</p><p><strong>Conclusions: </strong>ST among Brazilian adolescents was higher in 2022 compared to 2019, with increases in studying, working, watching videos, and playing video games. Longitudinal data indicated a shift from recreational ST to educational and work-related ST. These findings highlight the need for targeted interventions to promote balanced ST and mitigate potential negative health impacts.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102885"},"PeriodicalIF":3.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627685","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":"Effect of price on WIC-eligible caregiver participation in a produce program: A randomized trial.","authors":"Priyanka Joshi, Brittany J Van Remortel, Janakiram Rameswaran, Danielle L Cullen","doi":"10.1016/j.acap.2025.102884","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102884","url":null,"abstract":"<p><strong>Objectives: </strong>This pilot randomized trial examined the associations between price, participation of WIC-eligible families in a produce delivery program and reported healthy eating behaviors.</p><p><strong>Methods: </strong>Fifty caregivers of WIC-eligible children from an urban primary care center enrolled in an 8-week produce delivery program. Participants received free produce boxes for the first 4 weeks and were randomized to a cost of $5 or $10 per box for the remaining 4 weeks. Weekly orders were tracked, and longitudinal surveys were conducted to assess the program's impact on healthy eating.</p><p><strong>Results: </strong>Forty-three caregivers (86%) participated in the study. An average of 35.3 (SD 5.74) participants ordered weekly during the free period with a significant drop-off to 18.3 (SD 0.96) ordering weekly during the paid period (P < 0.001); most (73%) participants paid with SNAP benefits. There was no significant difference in average orders between the $5 and $10 groups (12.25 [SD 4.4] vs. 14.5 [SD 5.63], P = 0.19). Participation was significantly associated with an increase in reported produce access (53% vs. 97%, P < 0.001) and ability to eat healthy (34% vs. 61%, P = 0.04).</p><p><strong>Conclusion: </strong>Our study found that participation in a delivery-produce program decreased significantly with introduction of cost and use of food assistance benefits to purchase produce was common among sustained participants. Participants reported improvements in healthy eating and ability to access produce. Future study is needed to further evaluate price points to optimize program sustainability and participation and the impact of produce delivery programs on childhood produce intake.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov, NCT05153577.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102884"},"PeriodicalIF":3.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621112","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":"Population-based surveillance of suicidality among adolescents who do not endorse suicide risks and implications for screening.","authors":"Eunice M Areba, Michelle A Mathiason, Patricia I Jewett, Lindsay A Taliaferro, Iris W Borowsky","doi":"10.1016/j.acap.2025.102886","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102886","url":null,"abstract":"<p><strong>Objective: </strong>Suicide screening guidelines based on findings from aggregated data conceal subpopulation vulnerabilities. Risk factors for a suicide attempt (SA), such as suicidal ideation (SI), may differ in frequency or be absent in certain ethnoracial youth subgroups. Thus, accurate identification of suicide risk remains a challenge, and guidelines are inconsistent.</p><p><strong>Methods: </strong>This cross-sectional study used data from the 2019 and 2022 waves of the Minnesota Student Survey of 8^th, 9^th, and 11^th graders. Students in 12 ethnoracially diverse groups self-reported their race and ethnicity, past-year SI and SA, and past two-week symptoms of depression and anxiety. We used stratified chi-squared tests by sex and ethnoracial group for bivariate analyses. Logistic regression models adjusted for food insecurity, unstable housing and mental health treatment, examined odds of SA.</p><p><strong>Results: </strong>About 3.0% of male students attempted suicide in the past-year. Of these youth, 35.9% denied depressive symptoms, 39.8% denied anxiety symptoms, and 14.8% denied SI, especially Somali (47.8%) and multiracial (26.3%) male students. Among the 7.3% of female students who attempted suicide during the preceding year, 25.4% denied depressive symptoms, 24.6% denied anxiety symptoms, and about 8.0% denied SI, especially Somali (29.7%) and Black (12.5%) female students. Students who reported depressive or anxiety symptoms, especially male students, had increased odds of SA.</p><p><strong>Conclusions: </strong>A higher proportion of male, certain Black subgroups, and multiracial students reported a past-year SA without endorsing symptoms of depression, anxiety or SI. Future research should assess for whom screening tools work, mitigate screening limitations, and normalize minoritized experiences.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102886"},"PeriodicalIF":3.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621113","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":"Disparities in Caregiver-reported Knowledge, Attitudes, Behaviors, and Clinical Guidance regarding Primary Prevention of Peanut Allergy.","authors":"Christopher Warren, Alanna Stinson, Waheeda Samady, Lucy Bilaver, Sai Nimmagadda, Ruchi Gupta","doi":"10.1016/j.acap.2025.102874","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102874","url":null,"abstract":"<p><strong>Objective: </strong>Significant differences have been observed in the prevalence of peanut allergy across different US racial and ethnic groups. We aimed to characterize current patterns of infant peanut introduction across racial, ethnic, and socioeconomic strata, and their clinical, behavioral and attitudinal correlates.</p><p><strong>Methods: </strong>Surveys assessing parental knowledge, attitudes and infant feeding behavior were administered to a US population-based sample of 3062 parents/caregivers of children aged 7-42 months. Complex survey-weighted test statistics estimated differences across relevant racial/ethnic, household income, and caregiver educational attainment strata.</p><p><strong>Results: </strong>Cumulative rates of peanut introduction in the first 11 months of age were significantly higher among White, non-Hispanic caregivers (F=7.7; p<.001), caregivers with higher annual household incomes (F=5.6; p<0.001) and caregivers reporting higher educational attainment (F=2.5; p=0.002). Similar racial, ethnic, and socioeconomic differences emerged regarding perceived safety of peanut introduction during the first year, as well as the perceived effectiveness of early dietary introduction for peanut allergy prevention. Caregivers reporting lower household incomes and educational attainment were less likely to think peanut introduction during the first year was safe or effective in peanut allergy prevention than those reporting higher socioeconomic status. Similarly, caregivers of non-Hispanic Black children, those with lower incomes, and those with lower educational attainment were less likely to report receiving timely guidance from their child's primary care provider regarding peanut allergy prevention.</p><p><strong>Conclusions: </strong>Differences in the timing of peanut introduction may contribute to observed racial, ethnic, and socioeconomic disparities in peanut allergy prevalence. Equitable FA prevention guidance from providers could address these disparities.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102874"},"PeriodicalIF":3.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621111","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":"Caregiver and Pediatric Clinician Perspectives on Artificial Intelligence for Language Services.","authors":"Gabriella Ficerai-Garland, Peyton Groves, Elena A Puccio, Sabrina Bruno, Henry Hoffman, Nadia Pineda Villegas, María Cecilia Q Dancisin, Alisa Khan, K Casey Lion, Diego Chaves-Gnecco, Mona Diab, Maya I Ragavan","doi":"10.1016/j.acap.2025.102887","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102887","url":null,"abstract":"<p><strong>Objective: </strong>Children and caregivers who use languages other than English (LOE) for pediatric healthcare experience inequities and poorer overall health. Advancement of large language models has raised questions about future use of artificial intelligence (AI) for language access. This study explored perspectives of caregivers who use LOE and pediatric clinicians on using AI to address unmet needs in healthcare translation and interpretation.</p><p><strong>Methods: </strong>We conducted semi-structured individual interviews with caregivers of pediatric patients who use LOE and pediatric clinicians about the use of AI language technologies in healthcare. A phone interpreter or fluent team member was used for LOE interviews. Recordings were transcribed, translated as needed, coded, and analyzed using inductive thematic analysis.</p><p><strong>Results: </strong>20 caregivers using 11 different LOE and 22 clinicians participated. Themes were consistent across participants, though clinicians were more familiar with the concept of AI. Participants reported use of technologies (e.g., Google Translate) for written communication and situations where verbal interpretation was perceived to be inadequate. They were concerned about AI accuracy, privacy, and loss of empathy, but hoped it could provide real-time document translation and more convenient verbal communication. Ease of use, validation, and equitable creation and access were critical for use.</p><p><strong>Conclusions: </strong>Caregivers and clinicians were open to using AI to fill gaps in translation and interpretation; however, robust validation of AI technology and complementary use with human interpreters and translators is needed. Future research, practice, and policy should focus on integrating AI while investing in human translation and interpretation.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102887"},"PeriodicalIF":3.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585546","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":"Characteristics of Graduating Pediatric Residents Starting Chief Resident Positions, 2009-2023.","authors":"Mary Pat Frintner, Tylar W Kist, Elizabeth A Gottschlich, Hilary M Haftel","doi":"10.1016/j.acap.2025.102880","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102880","url":null,"abstract":"<p><strong>Objective: </strong>Examine proportion of graduating pediatric residents starting a chief resident position after residency and characteristics associated with starting a chief position.</p><p><strong>Methods: </strong>We analyzed 15 years of AAP survey data collected from national random samples of residents graduating from 2009 to 2023. Residents were asked about the position they were starting directly following residency and their demographic and program characteristics. We used χ² linear association to examine trends in starting a chief position across years and multivariable logistic regression to examine associations of demographic and program characteristics with starting a chief resident position compared to those starting other positions.</p><p><strong>Results: </strong>Response rate averaged across years was 53.4%. Overall, 983 of 7812 residents reported starting chief resident positions; the proportion was stable across years (12.8% in 2009, 11.7% in 2023, p=0.41). In multivariable analysis, starting a chief resident position was associated with several characteristics. The strongest associations were medical school location and race and ethnicity. Residents who graduated from a US medical school had higher odds than international graduates of starting a chief position (adjusted odds ratio [aOR]=1.52, 95% confidence interval [CI]=1.20-1.94). Residents who identified as Asian (aOR=0.54, 95% CI=0.43-0.66), Other race and ethnicity (aOR=0.57, CI=0.36-0.91), and Hispanic (aOR=0.74, CI=0.57-0.95) had lower odds than white residents of starting a chief position. Black residents also had a lower odds than white residents but it was not significantly different (aOR=0.77, CI=0.55-1.07).</p><p><strong>Conclusion: </strong>One in eight graduating pediatric residents report starting chief resident positions, more commonly among US medical school and white graduates.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102880"},"PeriodicalIF":3.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576883","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":"Social Factors Associated with Sudden Unexpected Infant Death.","authors":"Stephanie Anne Deutsch, Claire E Loiselle, Jobayer Hossain, Allan De Jong","doi":"10.1016/j.acap.2025.102883","DOIUrl":"10.1016/j.acap.2025.102883","url":null,"abstract":"<p><strong>Objectives: </strong>To characterize social factors associated with sudden unexpected infant death (SUID), we examined distribution of social factors across infant race, ethnicity, cause of death (medical, injury-related, unknown) and investigator-derived death grouping utilizing a multi-jurisdictional case registry.</p><p><strong>Methods: </strong>Retrospective analysis of Centers for Disease Control and Prevention SUID and Sudden Death in the Young Case Registry for infant deaths occurring 2015-2020, including child death review team-compiled clinical and investigative information RESULTS: Of 2212 infants who experienced SUID, social factors including caregiver criminal history, substance use, and intimate partner violence were associated with lower odds of medical cause of death versus other causes. Over one-third (n=226, 36%) of infants with injury-related deaths had caregivers with substance use concerns; caregiver substance use was common among SUID overall (n=753, 34%). Utilizing an investigator-derived schema, both injury-related deaths and undetermined deaths were grouped together and social factors compared across that cohort versus deaths from medical causes; no statistically significant differences in social factors were identified across groups.</p><p><strong>Conclusion: </strong>Utilizing a multi-jurisdictional registry, relationships between social factors and cause of death among infants experiencing SUID were identified; social factors (caregiver criminal history, substance use, intimate partner violence) were associated with lower odds of medical cause of death versus other causes. Distribution of social factors among infants experiencing SUID may contribute to emerging disparities and requires further study; efforts are needed to improve social factor data quality. SUID prevention efforts should address impact of social factors on fatality vulnerability and advocacy for social policy change.</p><p><strong>Clinical trial registration: </strong>N/A.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102883"},"PeriodicalIF":3.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12252576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caregiver perspectives on the continuum of social needs care: A qualitative study in pediatric primary care.","authors":"Hanae Fujii-Rios, Melissa R Lutz, Jillian Heckman, Kristin Topel, Rama E Imad, Cameron Lee, Suzanne M Grieb, Barry S Solomon","doi":"10.1016/j.acap.2025.102878","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102878","url":null,"abstract":"<p><strong>Background: </strong>In response to new regulatory requirements, health systems are scaling up or implementing new health-related social needs (HRSN) screening programs.</p><p><strong>Objectives: </strong>To explore caregivers' experiences with and preferences for (1) HRSN screening, (2) electronic medical record (EMR) documentation of HRSN, and (3) community resource referral mechanisms including the use of a patient-facing, web-based community resource platform.</p><p><strong>Methods: </strong>Focus groups and semi-structured interviews were conducted with caregivers of pediatric patients with the preferred language of English or Spanish receiving primary care in an academic practice in Baltimore, Maryland. Data collection occurred until thematic saturation was reached, and qualitative analysis followed an iterative thematic analysis approach.</p><p><strong>Results: </strong>Seventy-five caregivers participated between June 2023 to February 2024. Themes included: (1) approval and perceived value of universal and frequent screening, with varied preferences in screening modality; (2) fear of negative repercussion and stigma surrounding screening process and EMR documentation; (3) emphasis on importance of transparency, trust and responsiveness when navigating HRSN with families; (4) preference for in-person assistance; (5) value of an online navigation tool as a supplemental resource with potential to enhance autonomy and real-time equitable access to resources; and (6) hesitancy in receiving resources due to sense of altruism.</p><p><strong>Conclusion: </strong>Qualitative findings highlight the nuanced nature of HRSN screening, documentation, and referral in pediatric primary care. Practices and health systems should engage caregivers in these processes to ensure approaches are culturally responsive and recognize the feeling of vulnerability some face in disclosing unmet social needs.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102878"},"PeriodicalIF":3.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568115","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":"A Scoping Review of Patient Safety Checklists in Pediatrics.","authors":"K Zouaidi, T W Miner, M F Walji, K N Ray, E Kalenderian, D B Rindal, K J Suda","doi":"10.1016/j.acap.2025.102882","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102882","url":null,"abstract":"<p><strong>Objective: </strong>To examine the utilization and effectiveness of safety checklists in pediatric clinical care.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using Medline to identify studies related to the development and/or implementation of patient safety checklists in pediatrics. All study designs were included for citations published through September 2023.</p><p><strong>Results: </strong>Following abstract and full-text screening, 74 studies remained for data extraction and analysis. Pediatric surgery emerged as the main setting for checklists use (n=35), followed by Intensive Care Units (n=21), and Emergency Departments (n=9). Of the 74 reviewed papers, 37 (50%) designed and developed checklists. The co-design with stakeholders was the most frequently employed design method, with 25 studies reporting its use. However, only 2 studies included inputs from patients or parents/guardians. Of the 74 studies, 34 (46%) assessed the impact of checklists on patient safety outcomes and quality of care. Among these, 27 (79%) studies reported a reduction in incidents and adverse events, along with an improvement in quality of care when checklists were used. Six studies (18%) found no impact of checklist use on quality and safety of care, while one (3%) found that the checklist negatively impacted patient outcomes.</p><p><strong>Conclusion: </strong>The review underscores the use of checklists across a wide variety of pediatric care settings. Pediatric safety checklists are valuable tools for improving care quality and safety. Future work needs to be done using rigorous study designs to develop more conclusive, generalizable.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102882"},"PeriodicalIF":3.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568114","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":"Changes in Children's Receipt of Fluoride Varnish During Medical Visits and the COVID-19 Pandemic.","authors":"Ashley M Kranz, Annie Yu-An Chen, Yuji Mizushima, Kun Li, Andrew W Dick, Kimberley H Geissler","doi":"10.1016/j.acap.2025.102881","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102881","url":null,"abstract":"<p><strong>Objective: </strong>Primary care medical providers are recommended to apply fluoride varnish to the teeth of young children to prevent tooth decay. The COVID-19 pandemic interrupted care delivery in health care settings and may have differentially impacted patients with different types of insurance. The objective of this study was to examine changes in children's receipt of fluoride varnish in the medical office during 2014-2022.</p><p><strong>Methods: </strong>Using all-payer claims data from Massachusetts (2014-2022), we examined children's receipt of fluoride varnish during medical visits over time overall and by insurance-type. Because rates were highest in 2019, this was used as the reference year. We examined if results were driven by receipt (or non-receipt) of medical visits.</p><p><strong>Results: </strong>Following growth from 2014 to 2019, the probability of a child receiving fluoride varnish in 2022 compared to 2019 was 2.4 (95% confidence interval (CI)= -3.5 to -1.3) percentage points (pp) lower for a child with private insurance and 6.0 (95% CI= -8.0 to -4.0) pp lower for a child with Medicaid, representing declines of 15% and 37%, respectively. We did not observe a similar decline in children's receipt of medical visits during this time and our findings on fluoride varnish receipt were similar when we controlled for receipt of medical visits.</p><p><strong>Conclusions: </strong>Fluoride varnish receipt among young children declined precipitously during the COVID-19 pandemic and was not explained by declines in well-child medical visits. Declines were greater for children with Medicaid, erasing nearly a decade of progress in promotion of this evidence-based preventive service.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102881"},"PeriodicalIF":3.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568116","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}