Academic Pediatrics最新文献

{"title":"When the Right Call Doesn't Feel Like Enough.","authors":"Shreepada Tripathy","doi":"10.1016/j.acap.2025.103120","DOIUrl":"https://doi.org/10.1016/j.acap.2025.103120","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103120"},"PeriodicalIF":2.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856966","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":"Shared Understanding Between Parents and Clinicians Regarding Developmental Screening and Referrals.","authors":"Lindsay Schlichte-Seaberg, Sitaram Vangala, Lorena Porras-Javier, Lindsey R Thompson, Paul J Chung, Bergen Nelson, Rebecca Dudovitz","doi":"10.1016/j.acap.2025.103121","DOIUrl":"https://doi.org/10.1016/j.acap.2025.103121","url":null,"abstract":"<p><strong>Background: </strong>Lack of shared understanding between parents and clinicians regarding developmental concerns and referrals during well-child care (WCC) may hinder early intervention.</p><p><strong>Objective: </strong>To investigate discrepancies between clinicians' and parents' recall of developmental concerns and referrals, and to identify factors associated with discrepancies.</p><p><strong>Methods: </strong>This is a secondary analysis of data from the Achieving My Potential (AMP) study. English and Spanish-speaking families with children aged 12-42 months were recruited from community clinics. Data included demographics, developmental assessments, parental post-WCC surveys, and medical record abstractions. Two discrepancy types (concern and referral) were identified. Discrepancy frequencies were calculated, and logistic regressions examined characteristics associated with discrepancies.</p><p><strong>Results: </strong>Among 512 enrolled families, there were 94 (18%) concern discrepancies, of which 78% were concerns reported as discussed in parent surveys but not in the medical record. There were 43 (8%) referral discrepancies, of which 63% were referrals reported as made in the medical record but not in parent surveys. Children at moderate developmental risk had greater odds of concern (aOR 1.37; p < 0.05) and referral (aOR 2.65; p < 0.001) discrepancies. Parents' having at least a high school education was associated with lower odds of concern (aOR 0.59; p < 0.05) and referral (AOR 0.34, p < 0.001) discrepancies. Older parental age and higher family-centered care scores were associated with lower odds of referral discrepancies.</p><p><strong>Conclusions: </strong>Discrepant understanding may arise from miscommunication, misinterpretations, recall, or documentation practices. Attention to shared understanding, particularly among families at high risk for discrepancies, may support early intervention.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103121"},"PeriodicalIF":2.8,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823165","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":"Mental Health Screening and Referrals for Unaccompanied Migrant Youths at Pediatric Intake Visits.","authors":"Natan J Vega Potler, Lisa Pineda, Perry Nagin, Sebastian Villegas, Barbara Hackley, Sara Wagner, Mahad Magan, Alan Shapiro, Sarah Horwitz","doi":"10.1016/j.acap.2025.103119","DOIUrl":"https://doi.org/10.1016/j.acap.2025.103119","url":null,"abstract":"<p><strong>Background and objectives: </strong>Unaccompanied migrant youths often confront traumatic experiences elevating their risk for mental health symptoms. However, United States-based research on mental health services for this population, particularly Indigenous youths, is limited. Objectives were to examine mental health screening and referral, characteristics associated with referrals, and clinical rationale for screening result/referral discordance.</p><p><strong>Methods: </strong>All unaccompanied migrant youths with pediatric intake visits at a healthcare-legal clinic between 3/2020-2/2023 were included (N=100). Retrospective cohort data were extracted from medical chart and program registry, including pediatricians' rationale for referrals. Chi-square and t-tests were used to compare rates of screening, evaluation, and discordant referrals by sociodemographic characteristics. Logistic regression was used to identify associations with mental health referral. Exploratory analyses examined referrals by Indigenous group.</p><p><strong>Results: </strong>Youths had a mean (SD) age of 17.5 (2.5) years, most were assigned male at birth (66 [66%]), from Central America (83 [83%]), and one-third were Indigenous. Odds of mental health referral were higher for youths who were assigned female at birth (adjusted OR, 3.00 [95% confidence interval, 1.13-7.87), non-Indigenous (adjusted OR, 2.73; 95% confidence interval, 1.01-7.40), and reported more trauma types (adjusted OR, 1.38; 95% confidence interval, 1.02-1.87). One-third of referrals were for trauma or mental health symptoms identified by pediatricians, but not screeners.</p><p><strong>Conclusion: </strong>Most unaccompanied migrant youths had mental health referrals, one-third of which were for mental health symptoms undetected by screeners at pediatric visit. Findings highlight sociodemographic differences in mental health referrals, with non-Indigenous and female youths having higher odds of referral.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103119"},"PeriodicalIF":2.8,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823104","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":"Corrigendum to “Anti-Asian American, Native Hawaiian, and Pacific Islander Racism in Academic Pediatrics: Recommendations for Training, Research, and Clinical Practice” [Academic Pediatrics, Volume 24, 2024, S147-S151]","authors":"Joyce R. Javier MD, MPH, MS ,&nbsp;Lois Takahashi PhD","doi":"10.1016/j.acap.2024.102614","DOIUrl":"10.1016/j.acap.2024.102614","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 7","pages":"Article 102614"},"PeriodicalIF":3.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702153","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":"Validity Evidence for Level of Supervision Scales with Pediatric Subspecialty-Specific Entrustable Professional Activities.","authors":"Angela S Czaja, Alan Schwartz, Scott H James, Cary Sauer, Jay J Mehta, Jennifer Kesselheim, Pnina Weiss, David A Turner, Diane E J Stafford, Brad Robinson, Jennifer Rama, Sarah Pitts, Mary E Moffatt, Scott Moerdler, Kathleen A McGann, Vanessa McFadden, John Mahan, Michelle A Lopez, Melissa L Langhan, Daniel S Kamin, Ruchika Karnik, Deborah Hsu, Pam High, Bruce Herman, Roshan P George, Jill J Fussell, Christiane E L Dammann, Megan Curran, Patricia R Chess, Donald L Boyer, Tandy Aye, Richard B Mink","doi":"10.1016/j.acap.2025.103116","DOIUrl":"https://doi.org/10.1016/j.acap.2025.103116","url":null,"abstract":"<p><strong>Objectives: </strong>To generate validity evidence based on Messick's framework for use of supervision scales in assessment of the Entrustable Professional Activities (EPAs) specific to each pediatric subspecialty.</p><p><strong>Methods: </strong>From 2018-2022, we asked clinical competency committees (CCC) from fellowship programs in the United States representing 14 pediatric subspecialties to submit supervision ratings for each EPA for each fellow. Program directors reported the ease of use and time required to assign ratings and familiarity of CCCs with EPAs. Internal consistency for each EPA was assessed through Cronbach's alpha. Mixed effects models were performed to estimate growth in supervision levels across fellowship years. Correlations between adjusted supervision levels and reported milestone ratings for essential subcompetencies were estimated.</p><p><strong>Results: </strong>We collected EPA-based supervision ratings for 3,312 fellows. Most program directors reported that the scales were easy to use and took little time to assign the levels. Internal consistency for each subspecialty-specific EPA was high (alpha 0.89-0.97), as was the inter-EPA consistency within each subspecialty. There was consistent growth in supervision levels across the fellowship training years among all subspecialties. Additionally, there was a positive relationship between supervision levels and milestone-based competencies critical for the performance of the related EPAs (coefficients 0.68-0.80).</p><p><strong>Conclusions: </strong>These data provide strong validity evidence for using the subspecialty-specific EPAs supervision scales to assess pediatric fellows. Ongoing evaluation of their use in supporting individualized learning as well as high-stake decisions will be essential.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103116"},"PeriodicalIF":3.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700277","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":"Police Avoidance and Depressive Symptoms Among Black Youth","authors":"Dylan B. Jackson PhD, MS, BS ,&nbsp;Rebecca L. Fix PhD, MS, BA ,&nbsp;Lindsey Webb PhD, MHS, MS, BS ,&nbsp;Kristin Mmari DrPH, MA, BA ,&nbsp;Tamar Mendelson PhD, MA, BA ,&nbsp;Alexander Testa PhD, MA, MPP, BA ,&nbsp;Monique Jindal MD, MPH ,&nbsp;Sirry Alang PhD, MA, BSc ,&nbsp;Lisa Bowleg PhD, MA, MPP, BS","doi":"10.1016/j.acap.2025.103111","DOIUrl":"10.1016/j.acap.2025.103111","url":null,"abstract":"<div><h3>Objective</h3><div>Police violence is a public health crisis that disproportionately impacts Black youth, worsens their mental health, and potentially heightens their efforts to circumvent police surveillance (ie, police avoidance). Even so, the link between Black youths’ police avoidance and depressive symptoms has yet to be empirically examined. The present study examined this association, adjusting for police violence stress and diverse police exposures. Heterogeneity by youth sex was also assessed.</div></div><div><h3>Methods</h3><div>Data come from the Survey of Police-Adolescent Contact Experiences (SPACE), a recent, cross-sectional, non-probability survey of Black youth (around 52% male) aged 12–21 in Baltimore City.</div></div><div><h3>Results</h3><div>Police avoidance was significantly associated with depressive symptoms, above and beyond stress relating to police violence and diverse exposures to police violence (eg, police violence news; direct, witnessed, and/or intrusive police stops). Notably, the association between police avoidance and depressive symptoms was significantly larger among male (v. female) participants.</div></div><div><h3>Conclusions</h3><div>Findings suggest that Black youths’ police avoidance is an understudied but important factor associated with their depressive symptoms, particularly for young Black males.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 8","pages":"Article 103111"},"PeriodicalIF":2.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676405","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":"Major Depressive Disorder and Cardiovascular Disease Risk in Children and Adolescents.","authors":"Jessica Muha, Susan C Campisi, Kimberley Tsujimoto, Eric Tu, Sri Mahavir Agarwal, Alene Toulany, Chloe A Hamza, Daphne J Korczak","doi":"10.1016/j.acap.2025.103112","DOIUrl":"https://doi.org/10.1016/j.acap.2025.103112","url":null,"abstract":"<p><strong>Objective: </strong>Major Depressive Disorder (MDD) in youth is an independent risk factor for premature cardiovascular disease (CVD). While previous research has considered individual CVD risk factors in relation to depression, this study examined the association between depression and CVD risk among children and adolescents with MDD using a validated composite measure.</p><p><strong>Methods: </strong>Youth with MDD were recruited through an outpatient psychiatry program and underwent semi-structured psychiatric diagnostic assessment to confirm diagnosis. Healthy control participants were recruited from community settings. All participants completed the Center for Epidemiological Studies Depression Scale for Children to assess depressive symptoms. The Continuous Metabolic Syndrome score, a validated measure for cardiometabolic risk assessment in youth, was computed using aggregated standardized z-scores of CVD risk factors including fasting blood glucose, body mass index, blood pressure, fasting triglycerides and high-density lipoprotein cholesterol. Hierarchical multiple regression models tested the association between depression (diagnosis and symptoms) and CVD risk while accounting for covariates.</p><p><strong>Results: </strong>Participants (N=277; 73.6% female) had a mean age of 15.2 (SD=1.8) years. Cardiovascular disease risk was significantly higher among youth with depression (n=196, mean =0.77, SD=2.98) compared with healthy controls (n=81, mean=-0.39, SD=2.77; p=.002). Depression diagnosis and depressive symptoms were associated with increased CVD risk (β=0.40, p=.004; β=0.15, p=.02, respectively), after adjusting for covariates.</p><p><strong>Conclusions: </strong>Adolescents with MDD demonstrate increased cardiovascular disease risk compared with healthy youth, highlighting early evidence of association between depression and cardiovascular disease. Consequently, childhood and adolescence may serve as crucial periods for preventive intervention targeting cardiovascular health among youth with depression.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103112"},"PeriodicalIF":3.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668950","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":"Please Don't Give Me a Shot: Rethinking Oppositional Defiant Disorder.","authors":"Rupinder K Legha","doi":"10.1016/j.acap.2025.103114","DOIUrl":"https://doi.org/10.1016/j.acap.2025.103114","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103114"},"PeriodicalIF":3.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668952","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":"Health-Related and Social Drivers of Chronic Absenteeism in an Urban School District","authors":"Michelle Shankar MD MHS ,&nbsp;Gemma Joseph-Lumpkin MBA EdD ,&nbsp;Deena K. Costa PhD RN FAAN ,&nbsp;Morine Cebert PhD, FNP-C ,&nbsp;Ada M. Fenick MD ,&nbsp;Mona Sharifi MD MPH ,&nbsp;Sakinah C. Suttiratana PhD MPH MBA","doi":"10.1016/j.acap.2025.103113","DOIUrl":"10.1016/j.acap.2025.103113","url":null,"abstract":"<div><h3>Objective</h3><div>School attendance is an indicator of child well-being and function across health, education, and social domains. In the 2022–23 school year, 28% of US children were chronically absent from school, contributing to national declines in academic performance. The objective of this study was to characterize health-related and social reasons for chronic absenteeism in an urban public school district.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional mixed-methods study in collaboration with a northeastern US urban school district, utilizing a community-based participatory research (CBPR) approach. We analyzed secondary data from surveys administered by school district representatives to caregivers of chronically absent students. Visits were conducted between December 2022 and June 2023. We analyzed quantitative data using descriptive statistics and applied qualitative summative content analysis to transcribed responses to open-ended questions.</div></div><div><h3>Results</h3><div>The sample included 5223 first-time survey records, each representing one student. A majority of home visit records (71%) selected “Health” and 18% selected “Social” as the primary reason for school absences. Nearly 10% of families reported having both health and social barriers to attendance. Qualitative analysis further described health-related barriers to attendance as acute illness, chronic disease, and mental/behavioral health needs. Social barriers included family-related challenges, transportation difficulties, and housing or financial instability.</div></div><div><h3>Conclusion</h3><div>Health-related and social barriers were commonly reported reasons for chronic absenteeism in an urban school district. Our findings present a call to action for pediatricians and pediatric health systems to recognize the interrelatedness of school attendance and health, positioning them as key players in addressing chronic absenteeism.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 8","pages":"Article 103113"},"PeriodicalIF":2.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668949","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":"National Landscape of Underrepresented in Medicine Visiting Medical Student Programs in Pediatrics.","authors":"Tyler K Smith, Rebecca Blankenburg, Ann E Burke, Emma A Omoruyi, Wendla Sensing, Tiffany Ruan, David D Williams, Onyi Oligbo, Lahia Yemane","doi":"10.1016/j.acap.2025.102888","DOIUrl":"https://doi.org/10.1016/j.acap.2025.102888","url":null,"abstract":"<p><strong>Objective: </strong>Underrepresented in medicine visiting medical student programs (UIM-VMSPs) have gained popularity across specialties as an intervention to diversify residency programs; however, no study has explored the national landscape of these programs in pediatrics. This study aimed to characterize program components, residency rank and match outcomes, benefits, challenges, and lessons learned about UIM-VMSPs in pediatrics nationally.</p><p><strong>Methods: </strong>In September-December 2023, the authors conducted a national, cross-sectional, mixed methods study surveying program leaders of UIM-VMSPs identified on the Association of Pediatric Program Directors website. The authors used descriptive statistics to analyze the data and conventional content analysis for free-text question responses.</p><p><strong>Results: </strong>Of the 73 programs listed, 53 (73%) completed the survey. Thirty-three programs (62%) were created after 2020. In defining UIM for program participation, 46 programs (87%) reported using race and ethnicity alone or in combination with other identities. The most common program components were a clinical rotation (96%) and meeting with residency program leadership (91%). Fifty programs (94%) provided stipends with 21(42%) providing $2000. The biggest benefits identified were UIM recruitment with 25 programs (47%) matching at least one UIM-VMSP student thus far and demonstrating institutional commitment to DEI for current residents, faculty, staff, and UIM-VMSP participants. Participants highlighted three themes for lessons learned: (1) importance of comprehensive structuring of the program, (2) aligning selection criteria across the UIM-VMSP and residency program, and (3) gathering participant feedback.</p><p><strong>Conclusions: </strong>These study findings can be used by residency programs, regardless of specialty, to create or enhance their own UIM-VMSPs.</p>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"102888"},"PeriodicalIF":3.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668951","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}