Academic Pediatrics最新文献_第3页

National Trends in Severe ADHD and Treatment Among U.S. Children, 2016-2024. 2016-2024年美国儿童严重ADHD和治疗的全国趋势

IF 2.8 3区医学

Academic Pediatrics Pub Date : 2026-09-28 DOI: 10.1016/j.acap.2026.103474

Chengke Li, Qi Chen, Chenxi Li, Wen-Qiang He

{"title":"National Trends in Severe ADHD and Treatment Among U.S. Children, 2016-2024.","authors":"Chengke Li, Qi Chen, Chenxi Li, Wen-Qiang He","doi":"10.1016/j.acap.2026.103474","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103474","url":null,"abstract":"Objectives: While Attention Deficit Hyperactivity Disorder (ADHD) prevalence is increasing in the United States, the trend of severe ADHD remains unclear. We aimed to examine national trends and characteristics of children with severe ADHD and the treatment among these children through 2024.Methods: We analyzed 2016-2024 National Survey of Children's Health (NSCH) data (N=326,999) for children aged 3-17 years. Outcomes included current ADHD diagnosis, severity of ADHD, and treatment among severe cases. Trends were assessed using Joinpoint regression. Multivariable log-binomial regression estimated adjusted prevalence ratios (aPRs) comparing post-COVID-19 (2023-2024) with pre-COVID-19 (2016-2019) periods.Results: ADHD prevalence increased significantly from 8.8% to 11.6% with significant change found between 2019 and 2024 (Annual Percentage Change, APC=6.0%, P=0.001), while severe ADHD remained stable across the period (1.3%-1.8%; P>0.05). Notably, severe ADHD prevalence exceeded 2.0% among non-Hispanic Black children, those from households with below-national income, and children with public insurance. Despite stable burden of severe ADHD, treatment in this group declined significantly: any treatment decreased from 93.1% to 88.8% (APC=-0.6, P=0.017), and medication use from 81.5% to 73.3% (APC=-1.6%, P=0.032). Compared with the pre-pandemic period, children in 2023-2024 were less likely to receive treatment (aPR=0.45; 95% CI, 0.28-0.84), with the largest declines among low-income households (aPR=0.37; 95% CI, 0.16-0.88) and those with lower parental education (aPR=0.08; 95% CI, 0.02-0.30).Conclusions: These findings highlight a widening gap between stable high-need ADHD burden and declining treatment prevalence, particularly among socioeconomically disadvantaged children, suggesting growing inequities in access to care for severe ADHD.","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103474"},"PeriodicalIF":2.8,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076600","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}

引用次数: 0

Defining Graduation Expectations for Managing Acute Injury in General Pediatrics. 定义普通儿科急性损伤管理的毕业期望。

IF 2.8 3区医学

Academic Pediatrics Pub Date : 2026-09-28 DOI: 10.1016/j.acap.2026.103472

Tyler Sternhagen, Adam A Vukovic, Norah O'Toole, Melissa Klein, Holly Hanson, Daniel J Schumacher

{"title":"Defining Graduation Expectations for Managing Acute Injury in General Pediatrics.","authors":"Tyler Sternhagen, Adam A Vukovic, Norah O'Toole, Melissa Klein, Holly Hanson, Daniel J Schumacher","doi":"10.1016/j.acap.2026.103472","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103472","url":null,"abstract":"Background: Acute injuries in general pediatric care are prevalent, yet regulatory body recommendations regarding acute injury training in pediatric residency are limited. We sought to define the acute injury conditions and skills that graduating general pediatricians should be expected to recognize, manage, or perform.Methods: Employing a nominal group technique, we generated a list of potential acute injury conditions and skills general pediatricians should be expected to recognize, manage, or perform. This list was prioritized by a geographically diverse cohort of general pediatrics, pediatric emergency medicine, and pediatric sports medicine physicians through a Delphi process. Participants rated the level of importance of recognition, management, or skill completion in the pediatric primary care setting using a six-point scale. Consensus criteria of 90% agreement was used for inclusion and exclusion.Results: Three iterative Delphi rounds prioritized 54 items, including 34 recognize only, 8 recognize and manage, 1 manage only, and 11 procedural applications.Conclusion: The items prioritized in this study can inform future acute care curricula, ensuring that training prepares graduating pediatricians to meet the needs of patients presenting with acute injuries.","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103472"},"PeriodicalIF":2.8,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076613","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}

引用次数: 0

Science Tells Us What Children Need. 科学告诉我们孩子需要什么。

IF 2.8 3区医学

Academic Pediatrics Pub Date : 2026-09-28 DOI: 10.1016/j.acap.2026.103431

Moira A Szilagyi, James M Perrin, Tina L Cheng, Peter G Szilagyi

引用次数: 0

Caregiver-Perceived Appropriateness of Discussing Firearm Storage in the Healthcare Setting. 护理人员认为在医疗环境中讨论枪支储存的适当性。

IF 2.8 3区医学

Academic Pediatrics Pub Date : 2026-09-23 DOI: 10.1016/j.acap.2026.103460

Erica K Sheline, Rachel L Johnson, Erin Wright-Kelly, Maya Haasz

{"title":"Caregiver-Perceived Appropriateness of Discussing Firearm Storage in the Healthcare Setting.","authors":"Erica K Sheline, Rachel L Johnson, Erin Wright-Kelly, Maya Haasz","doi":"10.1016/j.acap.2026.103460","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103460","url":null,"abstract":"Objective: Firearms are the leading cause of death for children in the US - secure storage decreases morbidity and mortality. Though effective at improving storage, healthcare providers (HCPs) seldom discuss secure storage, partly due to concern that it will damage the caregiver-provider relationship. We sought to1) Describe caregiver-perceived appropriateness of HCP firearm storage counseling, and 2) Identify variables associated with perceived appropriateness.Methods: This cross-sectional study used data from the 2025 Colorado Firearm Injury Prevention Survey (COFIPS), administered online in English and Spanish by Ipsos (June-July 2025). Adults with children <18 years old living, visiting, or staying in their home were eligible (herein caregivers). The primary outcome, perceived appropriateness of HCP discussing firearm storage, was dichotomized as \"at least sometimes\" versus \"never\" appropriate; responses of \"unsure\" were excluded. Weighted logistic regression models examined associations between perceived appropriateness and prior HCP firearm counseling, firearm access, storage practices, and beliefs. Poststratification weights were applied to produce state-representative estimates.Results: Of 627 caregivers, 586 were included in the analysis. Overall, 82.7% (95% CI: 79.3-85.6%) reported discussions were at least sometimes appropriate. Prior firearm counseling during a healthcare visit was strongly associated with perceived appropriateness (OR 7.34, 95% CI: 2.73-19.74). Among caregivers reporting an unlocked and loaded firearm in the home (least secure storage), 72.5% found these discussions appropriate.Conclusions: Most caregivers were receptive to HCP firearm storage counseling. Prior counseling was associated with increased receptivity, highlighting the benefit of repeated messaging. HCPs should consider capitalizing on clinical visits to discuss firearm safety.","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103460"},"PeriodicalIF":2.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031926","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}

引用次数: 0

Factors Linked to Successful Emergency Department Referral to Primary Care for Pediatric Patients without a Primary Provider. 对没有主治医生的儿科患者成功转诊至初级保健的相关因素

IF 2.8 3区医学

Academic Pediatrics Pub Date : 2026-09-23 DOI: 10.1016/j.acap.2026.103464

Sebastián Gualy, Panteha Hayati Rezvan, Tatiana Campuzano, Jeanine E Hall, Ameer Mody, Mia Kanak

{"title":"Factors Linked to Successful Emergency Department Referral to Primary Care for Pediatric Patients without a Primary Provider.","authors":"Sebastián Gualy, Panteha Hayati Rezvan, Tatiana Campuzano, Jeanine E Hall, Ameer Mody, Mia Kanak","doi":"10.1016/j.acap.2026.103464","DOIUrl":"10.1016/j.acap.2026.103464","url":null,"abstract":"Introduction: Prior studies on post-emergency Department (ED) referrals to primary care have found limited success. This study identifies factors associated with establishing primary care for pediatric ED patients without a pediatrician referred to a federally qualified health center (FQHC) network.Methods: We conducted a retrospective review of ED patients without a pediatrician referred to an FQHC network in 2023 via an established electronic referral program, examining demographic, operational, and clinical differences between patients who completed appointments within one year of their ED Index visit and those who did not. Types of care provided at the first FQHC visit were examined.Results: Of 414 referrals, 140 families scheduled appointments (35.5%) and 106 (75.7% of scheduled) completed appointments within one year. In unadjusted analyses, patients who completed appointments received scheduler calls sooner (median 2 vs. 3 days; p < 0.001) and required fewer contact attempts (median 1 vs. 2; p = 0.002). Respiratory and neurologic diagnoses were associated with higher scheduling and completion rates (p < 0.05). After adjustment, shorter time to scheduler contact and fewer contact attempts remained associated with completion (both p < 0.001). Among completers, 56.6% received subspecialty referrals, 40.6% had labs ordered, and 6.6% had imaging ordered at their first visit.Discussion: Around one-quarter of referred pediatric ED patients completed FQHC appointments despite expressed interest and need for ongoing care. Only modifiable operational factors, specifically timing of outreach and scheduling, were associated with appointment completion, suggesting primary care access may be improved by programmatic improvements in these areas.","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103464"},"PeriodicalIF":2.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031934","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}

引用次数: 0

Characteristics of Youth Who Use School-Based Health Centers Only Once. 仅使用一次校本保健中心青少年的特征

IF 2.8 3区医学

Academic Pediatrics Pub Date : 2026-09-23 DOI: 10.1016/j.acap.2026.103461

Samira Soleimanpour, Melissa Saphir, Sandy Ng, Kale Jenks, Sara Geierstanger

{"title":"Characteristics of Youth Who Use School-Based Health Centers Only Once.","authors":"Samira Soleimanpour, Melissa Saphir, Sandy Ng, Kale Jenks, Sara Geierstanger","doi":"10.1016/j.acap.2026.103461","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103461","url":null,"abstract":"Objective: School-based health centers (SBHCs) deliver healthcare on or near school campuses. Little is known about youth who use SBHCs infrequently. This study compared youth with a single SBHC visit to those with multiple visits over a 12-month observation period to understand differences in clients' demographic characteristics and healthcare needs.Methods: Electronic health records of 3,742 adolescent clients who used eight California SBHCs (2021-2024) were analyzed using Chi-square tests and mixed-effects logistic regression to estimate effects of age, gender, race/ethnicity, and diagnoses on the odds of having a single visit during a 12-month observation period.Results: One-third (36.1%) of participants had a single SBHC visit in the 12-month observation period. Younger clients (AOR: 2.63; CI: 2.19-3.16) and males (AOR: 1.98; CI: 1.67-2.35) were more likely to have a single visit. Clients were significantly more likely to have a single visit if they had diagnoses related to reproductive health (AOR: 1.93; CI: 1.58-2.37) or sports physicals (AOR: 1.51; CI: 1.01-2.27) during their initial (or only) visit. Clients were less likely to have a single visit if they received a diagnosis related to behavioral health (AOR: 0.36; CI: 0.29-0.46), social determinants of health (SDOH; AOR: 0.35; CI: 0.28-0.44), or injury/pain (AOR: 0.70; CI: 0.50-0.98).Conclusions: SBHCs appear to appropriately engage youth in follow-up care for behavioral health and SDOH concerns. Clients' single visits, particularly for sports physicals, may represent opportunities to further engage youth in ongoing preventive care. Further research should confirm whether single-visit clients receive the level of care they need.","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103461"},"PeriodicalIF":2.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031905","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}

引用次数: 0

Housing-Based Socioeconomic Status at Birth and Infant Mortality in a Population-Based Cohort. 以人口为基础的队列中以住房为基础的出生时社会经济地位和婴儿死亡率。

IF 2.8 3区医学

Academic Pediatrics Pub Date : 2026-09-23 DOI: 10.1016/j.acap.2026.103468

Mark W Kaczor, Roland C Hentz, Chung-Il Wi, Jane E Brumbaugh

{"title":"Housing-Based Socioeconomic Status at Birth and Infant Mortality in a Population-Based Cohort.","authors":"Mark W Kaczor, Roland C Hentz, Chung-Il Wi, Jane E Brumbaugh","doi":"10.1016/j.acap.2026.103468","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103468","url":null,"abstract":"Objective: Socioeconomic status (SES) impacts infant mortality risk, yet measuring individual-level SES in large health datasets remains challenging. We evaluated the association between individual-level SES, measured via the HOUsing-based SocioEconomic Status (HOUSES) index, and infant mortality within a population-based cohort.Methods: This retrospective cohort study used the Rochester Epidemiology Project (REP) medical records-linkage system to evaluate live births from 2010 to 2021. The primary exposure was individual-level SES at birth, quantified into quartiles (Q1=lowest SES, Q4=highest SES) using the HOUSES index, which is derived from real property tax assessor data. The primary outcome was infant mortality (death <365 days). Survival probabilities across HOUSES quartiles during the initial 365 days post-birth were evaluated using Kaplan-Meier curves and log-rank tests. Multivariable Cox proportional hazards models estimated adjusted hazard ratios (aHR) for infant mortality.Results: Among 79,444 infants with HOUSES data, overall infant mortality was 0.42% (n=332). Kaplan-Meier analysis demonstrated significantly lower survival probability across lower HOUSES quartiles (log-rank p, 0.011). After adjusting for prematurity and congenital anomalies, infants in the lowest HOUSES quartile (Q1) experienced a significantly increased risk of mortality compared to those in the highest quartile (Q4; reference group) (aHR: 1.41; 95% CI: 1.03-1.92; p, 0.031).Conclusions: Lower housing-based SES at birth is independently associated with an increased risk of infant mortality. The HOUSES index represents an objective, scalable tool to identify at-risk families and address social drivers of health in clinical and epidemiological research.","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103468"},"PeriodicalIF":2.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031923","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}

引用次数: 0

Continuous Medicaid During COVID-19 and Children's Health, Development, and Academic Outcomes. COVID-19期间的持续医疗补助与儿童健康、发展和学业成绩。

IF 2.8 3区医学

Academic Pediatrics Pub Date : 2026-09-23 DOI: 10.1016/j.acap.2026.103463

Erica L Eliason, Aditi Vasan

{"title":"Continuous Medicaid During COVID-19 and Children's Health, Development, and Academic Outcomes.","authors":"Erica L Eliason, Aditi Vasan","doi":"10.1016/j.acap.2026.103463","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103463","url":null,"abstract":"Objectives: Medicaid can improve children's health, development, and education, and may reduce racial-ethnic inequities. This study estimates the association between implementing continuous Medicaid eligibility under the Families First Coronavirus Response Act (FFCRA) and children's health, healthcare access, development, and academic outcomes overall and by race-ethnicity.Methods: We used National Survey of Children's Health data and difference-in-difference models to compare outcomes among children in states newly implementing continuous eligibility under the FFCRA to states with prior policies overall and by race-ethnicity. Outcomes included developmental and behavioral measures, health and healthcare access, and academic outcomes.Results: In adjusted models overall, newly implementing continuous eligibility under the FFCRA was associated with a 2.5 percentage point (pp) (95% CI: 0.6, 4.5) increase in children with insurance that allowed them to access healthcare providers. In subgroup analyses, continuous Medicaid was also associated with improvements in general health by 2.1 pp (95% CI: 0.7, 3.6) and decreases in referral difficulties by 2.0 pp (95% CI: -3.8, -0.2) among Hispanic children and decreases in behavioral problems by 3.9 pp (95% CI: -7.5, -0.4) among non-Hispanic White children. We found no changes in other outcomes.Conclusions: The FFCRA was associated with increases in insurance that allowed children to access providers and additional improvements in health and care access for Hispanic children, as well as decreases in behavioral problems among non-Hispanic White children. National 12-month continuous eligibility, which began in January 2024, could yield additional benefits due to its longer policy duration and implementation outside of the pandemic context.","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103463"},"PeriodicalIF":2.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031857","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}

引用次数: 0

Reported Problems and Adherence in Using ADHD Medications Among Adolescents and Their Caregivers. 在青少年及其照顾者中使用ADHD药物的报告问题和依从性。

IF 2.8 3区医学

Academic Pediatrics Pub Date : 2026-09-23 DOI: 10.1016/j.acap.2026.103462

Jenny Guy, Jada Johnson, Delesha Carpenter, Kathleen C Thomas, Imelda Coyne, Izabela E Annis, Nacire Garcia, Betsy Sleath

{"title":"Reported Problems and Adherence in Using ADHD Medications Among Adolescents and Their Caregivers.","authors":"Jenny Guy, Jada Johnson, Delesha Carpenter, Kathleen C Thomas, Imelda Coyne, Izabela E Annis, Nacire Garcia, Betsy Sleath","doi":"10.1016/j.acap.2026.103462","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103462","url":null,"abstract":"Objective: To identify and describe medication-related problems reported by adolescents with ADHD and their caregivers, and to examine how demographic factors are associated with reported problems and medication adherence.Method: Adolescents aged 11 to 17 years with ADHD and their caregivers were recruited from two pediatric clinics in North Carolina. Adolescents completed interviews while caregivers completed questionnaires. Bivariate analyses and multivariable linear regressions were conducted.Results: Among 90 adolescents taking ADHD medication, 91% reported at least one medication-related problem. The most common problems included appetite suppression, dislike of medication, difficulty remembering doses, and feeling \"out of it.\" Adolescent- and caregiver-reported problems were moderately correlated (r = 0.43, p < 0.001). Older adolescents reported fewer problems with ADHD medications than younger adolescents (standardized beta=-0.27, p<0.05). Adolescents with higher trust in their providers also reported fewer problems (standardized beta= -0.22, p< 0.05). Adolescent- and caregiver-reported adherence were significantly correlated (r = 0.30, p < 0.005). Caregivers with more years of education were more likely to report lower adolescent ADHD medication adherence (standardized beta = -2.6, p<0.01), whereas adolescents who disliked taking medication reported significantly lower adherence (standardized beta= -0.22, p <0.05).Conclusion: Medication-related problems and adherence challenges are common among adolescents with ADHD. Factors such as age, provider trust, caregiver education, and medication attitude influence these outcomes. These findings highlight the importance of discussing medication experiences, side effects, and treatment preferences with adolescents and caregivers during ADHD medication management.","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103462"},"PeriodicalIF":2.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031865","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}

引用次数: 0

"The resources are so far, and you need them right here": Perspectives on Emergency Care for Youth who Experience Violence. “资源有限，而你现在就需要它们”：对遭受暴力的青年的紧急护理的看法。

IF 2.8 3区医学

Academic Pediatrics Pub Date : 2026-09-23 DOI: 10.1016/j.acap.2026.103465

Samaa Kemal, Jennifer A Hoffmann, Stephanie Loo, Diana Madden, Elizabeth R Alpern, Margaret Samuels-Kalow

{"title":"\"The resources are so far, and you need them right here\": Perspectives on Emergency Care for Youth who Experience Violence.","authors":"Samaa Kemal, Jennifer A Hoffmann, Stephanie Loo, Diana Madden, Elizabeth R Alpern, Margaret Samuels-Kalow","doi":"10.1016/j.acap.2026.103465","DOIUrl":"10.1016/j.acap.2026.103465","url":null,"abstract":"Objective: In caring for youth who experience violence, variability in available emergency department (ED) resources and conditions that impact comprehensive care delivery (i.e., care coordination, connection to community resources) is not well understood. This study explored conditions that impact care delivery in pediatric and general EDs for youth who experience self-directed or interpersonal violence.Methods: Semi-structured interviews with pediatric and general ED physicians and nurses were conducted to understand conditions that impact comprehensive care delivery in the ED for youth who experience violence. Participants were recruited from the National ED Inventory database from October 2023-May 2024. Recurring themes were identified using a constant comparative analytical approach.Results: 13 interviews were conducted (8 participants from pediatric EDs and 5 from general EDs). Five major themes were found: 1) imbalance of perceived needs and available resources; 2) consequences of this mismatch negatively affecting both patients and providers; 3) challenges to care provision from the legal system and sociopolitical environments; 4) negative impact of provider implicit biases on care provision; 5) lack of consensus among providers on the appropriate role of the ED in injury prevention efforts and post-discharge care coordination.Conclusions: Pediatric and general EDs perceive many challenges when caring for youth who experience violence with particular emphasis on the mismatch between needs and resources and non-clinical influences on providers' care provision. To improve comprehensive care for these youth, EDs may consider increasing pediatric-specific training, building awareness of clinical and community-based resources, and advocacy to expand specialized pediatric care in all settings.","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103465"},"PeriodicalIF":2.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031929","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}

引用次数: 0