Academic Pediatrics最新文献

{"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}

{"title":"What I Didn’t Learn in Residency","authors":"Javier Arredondo Montero MD, PhD","doi":"10.1016/j.acap.2025.102891","DOIUrl":"10.1016/j.acap.2025.102891","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 8","pages":"Article 102891"},"PeriodicalIF":2.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668953","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":"Children and Firearms in the United States: Parent and Child Reports on Firearms Use, Storage, and Training","authors":"David C. Schwebel PhD ,&nbsp;D. Leann Long PhD ,&nbsp;Anna Johnston MA ,&nbsp;Casie H. Morgan PhD","doi":"10.1016/j.acap.2025.102890","DOIUrl":"10.1016/j.acap.2025.102890","url":null,"abstract":"<div><h3>Objective</h3><div>To explore reasons for having firearms, plus firearms storage, training, and use, among firearm-exposed children aged 10–12, and evaluate parent-child agreement in reporting.</div></div><div><h3>Methods</h3><div>Survey research was conducted as part of a larger randomized trial. Children aged 10–12, all exposed to firearms and living in the Southeastern United States, and a parent were recruited from community sources. They independently responded to surveys via tablet about family demographics (parents) and firearms use, storage, and training (parents and children). Descriptive data were examined and parent-child comparisons made.</div></div><div><h3>Results</h3><div>One hundred sixty-three parent-child dyads participated. Consistent with inclusion criteria, both parents (M<!--> <!-->=<!--> <!-->4.4, SD<!--> <!-->=<!--> <!-->5.1) and children (M<!--> <!-->=<!--> <!-->5.3, SD<!--> <!-->=<!--> <!-->11.9) reported high numbers of firearms in the home, with protection (82% parents; 73% children) the most common reason. Both parents (76%) and children (78%) reported children knew where some firearms were stored, but about half (parents 55%; children 41%) reported children were unaware of the storage location for all. Over half of parents (55%) and many children (30%) reported some firearms were kept unlocked. Most parents (81%) and children (73%) reported children had firearm safety training from adult family, but few (&lt;10%) from community or online sources. Both parents (44% hunt; 68% shoot) and children (47%; 60%) reported children hunt and shoot at least annually, occasionally unsupervised.</div></div><div><h3>Conclusions</h3><div>Understanding how children engage with firearms guides effective prevention. Results reveal children regularly engage in hunting and shooting, occasionally unsupervised; children are sometimes unaware where firearms are stored in their own homes; and children rarely have formal firearms safety training.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 8","pages":"Article 102890"},"PeriodicalIF":2.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668923","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":"Circles","authors":"Maren E. Olson MD, MPH, MEd","doi":"10.1016/j.acap.2025.103117","DOIUrl":"10.1016/j.acap.2025.103117","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 8","pages":"Article 103117"},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668924","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":"Comparing Two Training Approaches to Scaling Up the Safe Environment for Every Kid (SEEK) Approach","authors":"Howard Dubowitz MD, MS ,&nbsp;Rose Belanger PhD ,&nbsp;Laurence Magder PhD ,&nbsp;Hannah Kim ,&nbsp;Lisa Saldana PhD ,&nbsp;Lawrence Palinkas PhD","doi":"10.1016/j.acap.2025.103115","DOIUrl":"10.1016/j.acap.2025.103115","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the impact of 2 common continuing medical education training modalities—independent online (IND) and a Maintenance of Certification-4 activity (MOC)—and primary care practice characteristics on scaling up (ie, the adoption, implementation, and sustainment) of the Safe Environment for Every Kid (SEEK) approach.</div></div><div><h3>Methods</h3><div>This longitudinal, multisite study involved 44 practices across the United States, 25 of whom were randomized to one of 2 training modalities. We ascertained the extent to which primary care professionals (PCPs) in each practice completed the assigned training (ie, “dose”). Practice personnel were surveyed up to 4 times over a 2-year period regarding their views on changing their practice, evidence-based practices, and their leadership. Predictors included training modality and dose and practice characteristics. Outcomes were startup, fidelity, and sustainment regarding SEEK.</div></div><div><h3>Results</h3><div>Only 31% of MOC and 25% of IND practices had most (≥75%) PCPs complete their training; 15% and 17% had an intermediate status with 50%–74%. Approximately half the practices achieved startup and most implemented SEEK with fidelity and sustained this for 2 years. There were few differences between the IND versus MOC practices; more training was associated with greater fidelity, especially in the IND practices. Practices that had greater baseline commitment and sense of efficacy were more likely to start implementing SEEK and do so with fidelity.</div></div><div><h3>Conclusions</h3><div>The findings support the simpler IND training approach and the value of sound preparation to foster commitment and a sense of efficacy. Improved strategies for encouraging PCPs to complete such training are needed. The study offers a valuable example of evaluating widely used training modalities as well as the scaling up of an evidence-based practice such as SEEK.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 8","pages":"Article 103115"},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668948","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":"Clinician and Care Manager Perspectives on Addressing Chronic School Absenteeism in Primary Care Settings","authors":"Michelle Shankar MD, MHS ,&nbsp;Pearl Teiko BA ,&nbsp;Eleanor Wertman MPH ,&nbsp;Jessica Haughton MPH, MA ,&nbsp;Kori B. Flower MD, MS, MPH ,&nbsp;Michael J. Steiner MD, MPH ,&nbsp;Rushina Cholera MD, PhD","doi":"10.1016/j.acap.2025.102889","DOIUrl":"10.1016/j.acap.2025.102889","url":null,"abstract":"<div><h3>Objectives</h3><div>To characterize primary care clinician and care manager perceptions and practice regarding chronic absenteeism.</div></div><div><h3>Methods</h3><div>In this qualitative study, we developed a semistructured interview guide using the Consolidated Framework for Implementation Research. We conducted Zoom interviews (July to August 2023) with primary care clinicians and care managers affiliated with a child-focused alternative payment model serving Medicaid- and Children’s Health Insurance Program-enrolled children in a 5-county region of central North Carolina. Interviews were recorded, transcribed, and analyzed iteratively using a rapid qualitative analytic approach.</div></div><div><h3>Results</h3><div>We interviewed 12 participants including 6 clinicians and 6 care managers serving families across urban, rural, academic, and community settings. Key themes included a lack of systematic and universal approaches to discussing school attendance, limited infrastructure for school-health system collaboration resulting in caregiver burden, importance of family engagement, and leveraging unique spheres of influence for multidisciplinary collaboration.</div></div><div><h3>Conclusions</h3><div>Clinicians and care managers support addressing chronic absenteeism but perceive provider, patient, and system-level barriers to identifying and addressing underlying needs. Perceived facilitators include leveraging strong relationships with families and multidisciplinary collaboration. Health system efforts to operationalize chronic absenteeism as a health metric and to coordinate services across health, education, and social sectors may improve long-term health and academic outcomes.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 8","pages":"Article 102889"},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668925","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 Screen Time Behaviors from Before (2019) to After (2022) the COVID-19 Pandemic Among Brazilian Adolescents","authors":"Bruno da Costa PhD ,&nbsp;Marcus V.V. Lopes PhD ,&nbsp;Gabrielli T. de Mello PhD ,&nbsp;Bruno N. Oliveira MSc ,&nbsp;Jean-Philippe Chaput PhD ,&nbsp;Kelly Silva PhD","doi":"10.1016/j.acap.2025.102885","DOIUrl":"10.1016/j.acap.2025.102885","url":null,"abstract":"<div><h3>Objective</h3><div>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 repeated cross-sectional study with a nested cohort.</div></div><div><h3>Methods</h3><div>Data were collected in 2019 and 2022, involving a total of 2008 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.</div></div><div><h3>Results</h3><div>In the repeated cross-sectional analysis, adolescents spent more minutes per day in 2022 versus 2019 for studying (+21.3 minutes; 95% CI: 11.0, 31.6), watching videos (+12.8 minutes; 95% CI: 1.1, 24.5), and playing video games (+22.9 minutes; 95% CI: 12.8, 33.1). The longitudinal analysis revealed significant average daily increases from 2019 to 2022 in studying (+53.8 minutes; 95% CI: 34.7, 72.9) and working (+130.2 minutes; 95% CI: 110.4, 149.9). For these same adolescents, significant decreases were observed for watching videos (−26.4 minutes; 95% CI: −48.0, −4.9) and playing video games (−28.6 minutes; 95% CI: −46.2, −11.8). Social media use remained stable.</div></div><div><h3>Conclusions</h3><div>Screen time (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.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 8","pages":"Article 102885"},"PeriodicalIF":2.8,"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 Women, Infants, and Children-Eligible Caregiver Participation in a Produce Program: A Randomized Trial","authors":"Priyanka Joshi MD, MSHP ,&nbsp;Brittany J. Van Remortel MD, MPH ,&nbsp;Janakiram Rameswaran MSN, MPH, CPNP-AC ,&nbsp;Danielle L. Cullen MD, MPH, MSHP","doi":"10.1016/j.acap.2025.102884","DOIUrl":"10.1016/j.acap.2025.102884","url":null,"abstract":"<div><h3>Objective</h3><div>This pilot randomized trial examined the associations between price, participation of women, infants, and children (WIC)-eligible families in a produce delivery program and reported healthy eating behaviors.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>P</em>&lt;.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], <em>P<!--> </em>=<!--> <!-->.19). Participation was significantly associated with an increase in reported produce access (53% vs 97%, <em>P</em>&lt;.001) and ability to eat healthy (34% vs 61%, <em>P<!--> </em>=<!--> <!-->.04).</div></div><div><h3>Conclusions</h3><div>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.</div></div><div><h3>Clinical Trial Registration</h3><div>ClinicalTrials.gov, NCT05153577</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 8","pages":"Article 102884"},"PeriodicalIF":2.8,"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}