Academic Pediatrics最新文献

{"title":"Postpartum Maternal Preferences on Health-Related Social Needs Programs in the First 1000 Days.","authors":"Yonit Lax, Jeremy Silverstein, Cassidy Psihos, Dana Seag, Maria Andrea Palmar, Melisa Perez Navarrete, Zoe Bouchelle","doi":"10.1016/j.acap.2026.103479","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103479","url":null,"abstract":"<p><strong>Objective: </strong>Our objective was to qualitatively assess maternal perspectives on health related social needs screening and referral programs in the first 1000 days (pregnancy through early childhood).</p><p><strong>Methods: </strong>In this qualitative study, we conducted semi-structured interviews with 34 mothers who completed health-related social needs screening prenatally, perinataly, and/or in primary care within the prior 4 months. Using purposive sampling, we interviewed English- (74%) and Spanish-speaking (26%) mothers regarding barriers and facilitators to engagement.</p><p><strong>Results: </strong>Barriers to engaging in screening included (1) screening on the first day postpartum, and (2) lack of clarity on the purpose of screening. Facilitators to engaging in screening included (1) communication style and (2) written and verbal screening options. Barriers to resource connection included (1) a lack of verbal explanations and follow-up with resource connection, and (2) narrow resource domains that do not align with needs in the first 1000 days. Facilitators to resource connection included (1) receipt of both paper and electronic resources, and (2) reduced hand-offs.</p><p><strong>Conclusions: </strong>Mothers reported several barriers and facilitators to engaging in health-related social needs screening and resource connection across the first 1000 days. Health-related social needs programs targeting this period should consider screening at all 3 touchpoints (prenatally, perinatally, and postnatally in pediatric primary care). Programs should also consider verbal counseling and follow-up navigation for resources offered, and minimizing handoffs. This study underscores that tailored health-related social needs screening to the site of care and stage of child development may facilitate engagement.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103479"},"PeriodicalIF":2.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208094","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 association between race, ethnicity and presentation to a pediatric capable hospital.","authors":"Dara L James, Rebecca E Cash, Kenneth A Michelson, Courtney B Wolk, Elizabeth R Alpern, Carlos A Camargo, Margaret Samuels-Kalow","doi":"10.1016/j.acap.2026.103466","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103466","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric readiness is associated with improved quality of care and has known geographic variation. Less is known about disparities in patient access to hospital pediatric capabilities. Our goal was to examine associations between patient race / ethnicity and pediatric capability of the initial hospital presentation.</p><p><strong>Methods: </strong>We linked state data, combining 2019 National Emergency Department Inventory (NEDI)-USA, 2019 State Emergency Department and State Inpatient Databases (SEDD/SID), 2020 Supplemental NEDI Pediatric Emergency Care Coordinator (PECC) Survey, and the 2021 National Pediatric Readiness Program (NPRP) Survey. Primary exposure was race / ethnicity. We compared pediatric capability definitions and used logistic regressions to examine associations between race / ethnicity and pediatric capability adjusting for select covariates.</p><p><strong>Results: </strong>There were 2,281,885 ED visits in the NPRP cohort, 4,426,520 in the PECC cohort and 4,964,956 in the inpatient capability cohort. In unadjusted analyses, non-Hispanic Black and Hispanic patients had higher odds of presenting to hospitals with high NPRP scores (OR 2.02 [95% CI 1.44, 2.84] and OR 1.94 [95% CI 1.09, 3.46]), with a PECC (OR 2.30 [1.83, 2.88] and OR 3.14 [2.32, 4.26]), and with inpatient capability (2.03 [1.64, 2.51] and 2.08 [1.54, 2.81]). After adjustment, non-Hispanic Black patients had higher odds of presenting to hospitals with inpatient capability (1.47 [1.13-1.92]); in contrast Hispanic patients had higher odds of presenting to hospitals with a PECC (1.48 [1.11-1.98]).</p><p><strong>Conclusion: </strong>Non-Hispanic Black and Hispanic children were more likely to present to a hospital with a PECC, suggesting utilization of PECCs may reduce disparities in care.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103466"},"PeriodicalIF":2.8,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129068","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":"Pre-Pandemic Trends Re-emerge in Pediatric Pedestrian Injury.","authors":"Cassandra Peitzman, Matt Hall, Elizabeth Alpern, Paul Aronson, Alexandra T Geanacopoulos, Monika K Goyal, Colleen Kays Gutman, Jeanine Hall, Samaa Kemal, Mark I Neuman, Alon Peltz, Christina Rojas, Kristen Shanahan, Harold K Simon, Jordee M Wells, Mark Zamani, Margaret Samuels-Kalow","doi":"10.1016/j.acap.2026.103443","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103443","url":null,"abstract":"<p><strong>Objective: </strong>To quantify changes in the rates and demographic distribution of pediatric pedestrian injuries before and after the COVID-19 pandemic.</p><p><strong>Methods: </strong>We used interrupted time series analysis to characterize pre- and post-2020 trends in volume, age, race/ethnicity, day/night timing, and severity of pedestrian injuries among children aged ≤15 seen in academic pediatric emergency departments within the Pediatric Health Information System (2016-2023).</p><p><strong>Results: </strong>A total of 19,958 visits for pedestrian injury were identified. Annual volumes fell from a mean of 2,743 (CI 95% = 2,499, 2,988) to 1,789 in 2020, or an estimated 897 fewer than expected (95% CI = 612, 1180), then increased by 259 visits/year (95% CI = 200, 317) to 2,570 by 2023. This pattern was primarily driven by school-aged adolescent children (aged 10-15), whose visit volumes fell from 1,331 in 2016-2019 to 765 in 2020, then rebounded to 1,334 by 2023. The proportion of non-White children fell from 73.4% in 2016-2019 to 66.8% in 2020, then increased by 2.2%/year through 2023 to 72.9%. Daytime presentations similarly fell from 73.7% to 69.6% in 2020, then rebounded to 72.5% by 2023. No pandemic-associated changes were seen in mean Child Opportunity Index or income.</p><p><strong>Conclusions: </strong>The COVID-19 pandemic was associated with large but temporary decreases in overall pediatric pedestrian trauma volumes and percent non-White patients, especially during the day and among school-aged children. These patterns suggest that routine daily traffic exposure may contribute differently to pedestrian risk across age groups and racial/ethnic categories with potential implications for targeted safety interventions.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103443"},"PeriodicalIF":2.8,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129080","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":"Implementation Of A Multidisciplinary Team Review Model For Children With Medical Complexity Undergoing Orthopedic Surgery.","authors":"Juliana Mariani, John B Emans, Richard D Goldstein, Elizabeth D Blume, Jay Berry, Benjamin J Shore, Daniel Hedequist, Rachel L DiFazio","doi":"10.1016/j.acap.2026.103471","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103471","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103471"},"PeriodicalIF":2.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118247","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":"Black and African American Residents' Perspectives of Racial Affinity Groups in a Pediatric Residency Program.","authors":"Desiree Yeboah, Courtney Gilliam, Jimmy Beck, Krysta S Barton, Abena Knight, H Mollie Grow, Jason Deen, Sahar N Rooholamini","doi":"10.1016/j.acap.2026.103467","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103467","url":null,"abstract":"<p><strong>Purpose: </strong>Racial affinity groups have emerged in residency training programs as part of inclusion and anti-racism efforts; however, their use in medical education is less studied. This study explores Black/African American pediatric residents' perspectives on racial affinity groups during residency training.</p><p><strong>Method: </strong>We conducted semi-structured interviews with Black/African American pediatric resident physicians, including recent graduates, at a large, university-affiliated pediatric residency program. We generated themes using reflexive thematic analysis and a conceptual framework of counter-spaces.</p><p><strong>Results: </strong>We identified 3 major themes and 9 subthemes from 12 interviews. Themes include: (1) Centering Shared Experiences, (2) Transforming Experiences into Collective Learnings, and (3) Missed Opportunities to Further Learning and Connection. Residents perceived participation in racial affinity groups as opportunities to explore their shared experiences with racism, bias, and microaggressions, develop kinship bonds, and learn together and from one another. Inconsistent institutional support, time constraints during residency training, and the complexities of addressing intersecting identities were perceived as challenging aspects of their experiences.</p><p><strong>Conclusion: </strong>Kinship and collective learning were consistent elements embedded throughout Black/African American pediatric residents' perspectives on participating in racial affinity groups. Residency leadership considering the implementation of racial affinity groups into curricular efforts should consider ways to provide consistent institutional support, address residency time constraints, and incorporate conversations about intersectionality in these experiences.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103467"},"PeriodicalIF":2.8,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118120","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":"Higher citation rates of network research publications in Pediatrics education.","authors":"Alan Schwartz","doi":"10.1016/j.acap.2026.103475","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103475","url":null,"abstract":"<p><strong>Objective: </strong>Publications of medical education research networks have been associated with higher rigor and higher-level outcomes. We sought to determine whether they also receive more citations than comparable papers.</p><p><strong>Methods: </strong>We compared citation rates for pediatric education articles published from studies by the Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network (APPD LEARN) with other pediatric education papers, non-pediatric education papers, non-education pediatric papers, and non-education non-pediatric papers, controlling for journal, issue, and numbers of co-authors using a Poisson model.</p><p><strong>Results: </strong>We matched 50 APPD LEARN papers with 79 other pediatric education articles, 472 non-pediatric non-education articles, and 200 non-pediatric education articles. APPD LEARN articles had a significantly higher citation rate than other pediatric education articles in the same issues (adjusted incidence rate ratio 1.53, 95% CI 1.37-1.72, p<.001). Higher number of authors was also associated with higher citation rates (adjusted incidence rate ratio 1.38, 95% CI 1.35-1.41, p<.001). Non-Pediatric education articles were more highly cited than Pediatric education articles (marginal mean difference 10.6, 95% CI 9.7 - 11.4, p<.001) and Pediatric non-education articles were more highly cited than non-Pediatric non-education articles (marginal mean difference 1.7, 95% CI 1.1 - 2.3, p<.001).</p><p><strong>Discussion: </strong>Our results are consistent with the hypothesis that network-based medical education papers receive more citations than comparable non-network-based papers.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103475"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118310","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":"Careers Across the Lifespan: How Do You Want to Live Your One Life?","authors":"Janet R Serwint, Renee Jenkins-Woodard","doi":"10.1016/j.acap.2026.103437","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103437","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103437"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118117","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":"Treat us like humans: Lived experience solutions to improve health care for multiply marginalized children with disabilities.","authors":"Verenea Serrano, Kristyn Felman, Debbi Simmons Harris, Karen Kuhlthau, Diana M Cejas, Jenny Ruiz, Jessica M Jarvis, Amy Houtrow","doi":"10.1016/j.acap.2026.103483","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103483","url":null,"abstract":"<p><strong>Objective: </strong>Multiply marginalized children with disabilities experience discrimination and inequity and consequently disparities in access to health care, health outcomes, and mortality. We gathered information about the health care experiences of multiply marginalized children with disabilities to describe lived experience-based solutions for improving health care and outcomes for this population.</p><p><strong>Methods: </strong>A qualitative exploratory study using focus group and individual interviews with multiply marginalized young adults with disabilities and the caregivers of multiply marginalized children with disabilities in the United States and territories. We asked how services could be changed to better support their health and well-being using an initial deductive approach combined with ongoing inductive thematic analysis.</p><p><strong>Results: </strong>The study team conducted 5 focus groups and 4 individual interviews with 33 young adults and caregivers in English, Spanish, and ASL. Negative health care experiences include biased and discriminatory professional behavior, barriers to access, and the necessity and burden of advocacy. Proposed solutions focused on professional growth, mental health, disability-centered design, and lived experience leadership. An underlying sentiment was the desire for equitable treatment.</p><p><strong>Conclusion: </strong>Advancing health equity for multiply marginalized children with disabilities is within reach. Starting points for health care professionals and system leaders include addressing biases and developing reflective and empathic practices and systems, including child and family mental health in care, and using disability-centered design to proactively and flexibly support access. Implementation should be done with lived experience leadership and the centering of human dignity for multiply marginalized children with disabilities and their families.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103483"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118404","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":"ACGME Milestone Levels for Residents Who Are Dismissed or Withdraw from Pediatric Residency Programs.","authors":"Kristin Sundy, Margaret Kihlstrom, Alan Schwartz, Eric Zwemer","doi":"10.1016/j.acap.2026.103484","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103484","url":null,"abstract":"<p><strong>Objective: </strong>Dismissal from pediatric residency is uncommon but high-stakes and labor-intensive. Performance deficits underlying the decision to dismiss are not well understood.</p><p><strong>Methods: </strong>We examined Milestone scores for categorical pediatric residents who started training between 2013 and 2021 stratified by resident status: graduated, dismissed, or withdrawn. We fit linear mixed effects models to mean Milestone ratings and compared estimated marginal means in each milestone domain between groups.</p><p><strong>Results: </strong>We obtained Milestones for 32,426 residents: 28,345 graduated on time, 99 withdrew, and 29 were dismissed. Dismissals were evenly distributed across PGY1 (34%), PGY2 (28%), and PGY3 (38%), while most instances of withdrawal occurred during PGY1 (44%) then decreased over time (PGY2, 37%; PGY3, 18%). In aggregate, dismissed residents had statistically significantly lower mean Milestone ratings than residents who graduated in all domains and at all time points. Residents dismissed in PGY2 or PGY3 had lower Milestone scores than those who graduated starting in PGY1 spring.</p><p><strong>Conclusions: </strong>Residents who were dismissed at any point in training had performance deficits present in most Milestone domains by PGY1 spring. Future work is necessary to better characterize the processes leading up to these dismissals and barriers to successful remediation of pediatric residents.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103484"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118128","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":"Examining Race-Based Puberty Information on Children's Hospital Websites.","authors":"Adeiyewunmi Ade Osinubi, J Reed Junkin, Sophia Austin, C Paula Lewis-de Los Angeles, Lisa Swartz Topor","doi":"10.1016/j.acap.2026.103482","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103482","url":null,"abstract":"<p><strong>Background: </strong>In 2022, the American Academy of Pediatrics called for dismantling race-based medicine due to its harmful impact on patient care and education. Despite this, race-based guidance regarding pubertal timing persists in the literature and patient resources. Given the role of pediatric hospital websites as sources of information for families and as data for Artificial Intelligence, we examined the presence of race-based guidance on pubertal timing in girls across U.S. pediatric hospital websites.</p><p><strong>Methods: </strong>Pediatric hospitals in the United States were identified, and each website was queried using the terms \"puberty\" and \"precocious puberty.\" Information provided on pubertal timing in girls was recorded, along with any inclusion of race-based guidance. Descriptive statistics and qualitative analysis of pediatric hospital puberty information were performed. An analysis of variance (ANOVA) test compared the prevalence of race-based information across seven U.S. regions.</p><p><strong>Results: </strong>Of 285 pediatric hospitals in the United States, 85 (29.8%) had patient-facing content on puberty, and 16 (18.8%) included race-based information. Half (8, 50%) of the pediatric hospitals that included race-based pubertal information included race as a \"risk factor\" for precocious puberty. Regional differences in the frequency of race-based pubertal information for patients on the hospital websites were not statistically significant (p=0.069).</p><p><strong>Conclusion: </strong>This study demonstrates the ongoing presence of race-based information about puberty on pediatric hospital websites. Updating the patient-facing websites of pediatric hospital to avoid race-based pubertal guidance may foster a more inclusive and equitable environment for patients and their families.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103482"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118300","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}