Academic Pediatrics最新文献

{"title":"Transforming Educational Innovation into Scholarship: Reporting Standards to Guide Practice.","authors":"Audrey M Uong, Carolyn M Wilhelm, Elizabeth R Hanson","doi":"10.1016/j.acap.2025.103137","DOIUrl":"https://doi.org/10.1016/j.acap.2025.103137","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103137"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994221","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":"Virtual Reality Upstander Training to Disrupt Microaggressions.","authors":"Whitney Cameron, Francis J Real, Liam Fleck, Matthew Kelleher, Danielle E Weber, Courtney A Gilliam, Ndidi Unaka","doi":"10.1016/j.acap.2025.103144","DOIUrl":"https://doi.org/10.1016/j.acap.2025.103144","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103144"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994256","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":"Intended Outcomes and Core Components of Primary Care-Based Literacy Promotion as Defined by Experts.","authors":"Lilian Mekhail, Rylee Sant'Angelo, Jennifer C Dillon, Juline Hanna, Usha Ramachandran, Maria B Pellerano, Nikki Shearman, Alan L Mendelsohn, Thomas I Mackie, Manuel E Jimenez","doi":"10.1016/j.acap.2025.103141","DOIUrl":"10.1016/j.acap.2025.103141","url":null,"abstract":"<p><strong>Objective: </strong>Primary care-based literacy promotion enhances caregiver-child shared reading and child language outcomes, yet variation in implementation may dilute its impact. This study examines expert perspectives on intended outcomes of literacy promotion, as well as its core components, those necessary to achieve intended outcomes, and components that are recommended but adaptable to context.</p><p><strong>Methods: </strong>We purposively sampled healthcare and policy experts in primary care-based literacy promotion from the U.S. and Canada for online, in-depth interviews. Interviews were recorded, transcribed verbatim, and analyzed iteratively engaging emergent and a priori codes based on the COmponents and Rationales for Effectiveness Fidelity Method and the team's prior work to identify themes.</p><p><strong>Results: </strong>We achieved saturation after 22 interviews with 24 participants (16 U.S. participants, 8 Canadian). We identified four themes: 1) Traditionally, literacy promotion focused on enhancing preliteracy skills and school readiness. Over time, this outcome has evolved to include fostering early relational health as a foundational goal; 2) Core components include a trusted clinician delivering a strength-based, family-centered message, while modeling developmentally-informed shared reading; 3) Components that are adaptable to setting and context include literacy-rich clinical environments and community resource referrals; 4) Experts diverged on whether providing a children's book during literacy promotion is essential, but there was congruence that book provision alone is insufficient.</p><p><strong>Conclusion: </strong>Experts identified strength-based, family-centered guidance from a trusted clinician with developmentally-focused modeling as core to support intended outcomes of early relational health and school readiness. This understanding can inform training and healthcare improvement activities aimed at optimizing primary care-based literacy promotion.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103141"},"PeriodicalIF":2.8,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977588","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":"The Brown Envelope.","authors":"Saba Fatima","doi":"10.1016/j.acap.2025.103138","DOIUrl":"https://doi.org/10.1016/j.acap.2025.103138","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103138"},"PeriodicalIF":2.8,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977610","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":"Penicillin Allergy Delabeling in Pediatric Primary Care: A Multisite Qualitative Study.","authors":"Eileen J Carter, Elizabeth Monsees, Sharon Hwang, Tara Schmidt, Mary Lou Manning, Cliff O'Callahan, Rana E El Feghaly, Monika Pogorzelska-Maziarz","doi":"10.1016/j.acap.2025.103139","DOIUrl":"https://doi.org/10.1016/j.acap.2025.103139","url":null,"abstract":"<p><strong>Objective: </strong>Allergy societies recommend penicillin allergy (PA) delabeling via history alone or following direct challenge (DC) in children at low risk for true PA. Recent studies demonstrate the safety of PA delabeling in pediatric primary care. We aimed to identify primary care practitioners' attitudes towards PA delabeling, and perceived barriers and enablers to PA delabeling.</p><p><strong>Methods: </strong>We conducted semi structured interviews (n=11) and focus groups (n=3) with 29 primary care practitioners of two health systems in the northeast United States. We coded transcripts using content analysis and mapped barriers and enablers to the Capability, Opportunity, and Motivation COM-B model of behavior.</p><p><strong>Results: </strong>Participants perceived PA delabeling to benefit children and shared prior attempts to delabel PAs in primary care. Barriers to PA delabeling included a lack of skills and training to delabel (capability), perceived caregiver resistance to delabel, inadequate time, staff, and space to delabel (opportunity), which led to mixed desires among practitioners to delabel (motivation). To enable PA delabeling in primary care, participants recommended partnership with allergists to implement a delabeling protocol, tools to engage caregivers in delabeling, innovative workflows and infrastructures to facilitate delabeling, and an amplification of reasons for delabeling to occur in pediatric primary care.</p><p><strong>Conclusion: </strong>Primary care practitioners perceived PA delabeling as beneficial to children's health, and specified intervention targets (enablers) to facilitate delabeling. To propel PA delabeling in pediatric primary care, interventions are needed to optimize practitioner skills, secure caregiver interest, and ensure the necessary resources, time, and space for practitioners to delabel.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103139"},"PeriodicalIF":2.8,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977615","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":"Characterizing How Pediatric Clinicians Create Choice Awareness When Performing Shared Decision-Making.","authors":"Holly Hoa Vo, Jeffrey D Robinson, Douglas J Opel","doi":"10.1016/j.acap.2025.103140","DOIUrl":"https://doi.org/10.1016/j.acap.2025.103140","url":null,"abstract":"<p><strong>Objective: </strong>To characterize how clinicians create choice awareness when performing shared decision-making (SDM).</p><p><strong>Methods: </strong>We conducted a secondary analysis of a cross-sectional observational study designed to characterize the decision-making processes of parents and clinicians across a range of medical decisions in different pediatric settings. For the observational study, clinicians were recruited from 6 pediatric specialties (craniofacial, hematology and oncology, hospital medicine, neonatology, pulmonary, and sports medicine) at a single US children's hospital. We videotaped inpatient care conferences and outpatient problem-oriented encounters. We then conducted individual post-encounter interviews with parents and clinicians about the decisions they made in those encounters. For the secondary analysis, we identified all videotaped encounters that included a decision in which the clinician stated in their post-encounter interview that there were multiple options and they were performing SDM. With this sample, we used conversation analysis to characterize how clinicians created choice awareness.</p><p><strong>Results: </strong>There were 34 shared decisions from 21 videotaped encounters included in analysis. We found 2 overarching approaches clinicians used to create choice awareness: (1) presenting one option and recommending it as the next step in management without making other options explicit, though allowing those options to emerge as needed (single-option approach) or (2) making it explicit up-front that there were multiple options (multiple-options approach). Though both approaches could facilitate SDM, the multiple-options approach does so most unambiguously.</p><p><strong>Conclusions: </strong>There is variation in how pediatric clinicians create choice awareness, an essential element of SDM. Further standardization of communicating choice awareness can improve implementation of SDM.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103140"},"PeriodicalIF":2.8,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977621","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":"Identification of child-maltreatment-related emergency department visits from electronic health records.","authors":"Margaret L Holland, Amy A Hunter, Nina Livingston, Kirsten Bechtel","doi":"10.1016/j.acap.2025.103135","DOIUrl":"https://doi.org/10.1016/j.acap.2025.103135","url":null,"abstract":"<p><strong>Objectives: </strong>Since the implementation of ICD-10-CM in 2015, emergency department (ED) records using expanded child maltreatment codes have been used to estimate the prevalence of child maltreatment in the US. This study compares the efficacy of ICD-10-CM codes with other search strategies in identifying child maltreatment.</p><p><strong>Materials and methods: </strong>This study was conducted at Yale-New Haven Children's Hospital (YNHCH) and Connecticut Children's Medical Center (CCMC). We examined ED visits for confirmed or suspected child maltreatment concerns from 1/1/2019 to 8/31/2020 among children under 18 years old. Cases were identified using three search strategies: (1) ICD-10-CM codes, (2) keywords in provider notes, and (3) chief complaints. After cases were identified, ED provider notes were reviewed by clinicians to determine if a concern for maltreatment was indicated. Sensitivity and positive predictive values were calculated for each search strategy.</p><p><strong>Results: </strong>Of 3841 ED records identified by search strategies, 1248 were suspected to involve maltreatment. Using ICD-10-CM codes alone had a sensitivity of 47%; the sensitivity of keywords in provider notes and chief complaints were 65% and 58%, respectively. When ICD-10-CM codes were combined with keywords in provider notes and chief complaints, the sensitivity increased to 82% and 77%, respectively.</p><p><strong>Practice implications: </strong>The use of any single method could miss 35 to 53% of cases, although time-consuming chart review was required to remove identified cases that were not associated with maltreatment. Future research should refine the search strategies and consider utilizing multiple approaches to identify cases.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103135"},"PeriodicalIF":2.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977554","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":"Access to Developmental-Behavioral Pediatrics in an Integrated Primary Care Clinic for Children in Foster Care.","authors":"Anisha P Srinivasan, Briana Tili, Julia Fleuret, Hannah Snitzer, Kathryn Carlsen, R Scott Akins, Courtney Lyles","doi":"10.1016/j.acap.2025.103133","DOIUrl":"https://doi.org/10.1016/j.acap.2025.103133","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103133"},"PeriodicalIF":2.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977494","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":"Approach to Multilevel Teaching.","authors":"Ryan Wolf, Lauren S Starnes, Andrea Triplett, Nicholas M Potisek, My-Linh Ngo","doi":"10.1016/j.acap.2025.103136","DOIUrl":"https://doi.org/10.1016/j.acap.2025.103136","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103136"},"PeriodicalIF":2.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977644","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":"Discovering What Works Well: Exploring Primary Palliative Care Education in Pediatrics Residency Programs in Canada.","authors":"Naomi Goloff, Lea Sultanem, Alexis Fong-Leboeuf, Estee Grant, Elizabeth Anne Kinsella, Joanna Humphries, Robin Williams, Daniëlle Verstegen, Erin Kwolek","doi":"10.1016/j.acap.2025.103131","DOIUrl":"https://doi.org/10.1016/j.acap.2025.103131","url":null,"abstract":"<p><strong>Background: </strong>Pediatricians require primary palliative care (PC) skills - communication, pain and symptom management, and psychosocial support - to provide care that mitigates suffering for children with serious illnesses. Residents may not develop skills adequately, and little is known about how they learn those that they do have.</p><p><strong>Objective: </strong>To explore effective primary PC learning in Canadian pediatrics residency programs.</p><p><strong>Methods: </strong>Using Appreciative Inquiry methodology, we focused on 'what is working well' to explore resident learning. We purposively sampled 17 trainees (post-graduate years 3-5), representing 13/17 programs. Participants engaged in semi-structured interviews, which we transcribed and analyzed iteratively through an inductive thematic process.</p><p><strong>Results: </strong>The findings highlighted two predominant themes: a) Embracing incidental learning in the workplace, and b) Scaffolding learning through balanced structure and autonomy. Subthemes included: Recognizing the value of informal and unexpected learning opportunities; Strategies for harnessing incidental learning; Fostering interprofessional collaboration for learning; Integrating PC throughout training; Balancing structured learning with workplace-based opportunities for skill development; and the importance of graduated responsibility in workplace learning.</p><p><strong>Conclusions: </strong>The residency learning environment provides a rich milieu to develop primary PC skills, but it is often difficult to make use of the fragmented learning opportunities. Residents rely significantly on unplanned clinical opportunities and must actively engage in planning, monitoring, and reflecting on their experiences to develop these skills. Our study underscores the importance of a multi-faceted approach to acquisition of PC skills - through experiential learning, reflective practice, graded responsibility, mentorship opportunities - spread throughout the duration of training.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103131"},"PeriodicalIF":2.8,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977639","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}