Academic Pediatrics最新文献

{"title":"Exploring Shared Decision-Making Training in Pediatrics: A Scoping Review","authors":"Vanessa I. Orellana-Villazon MD, MPH, MSc ,&nbsp;Jennifer E. deSante-Bertkau MD, MBE ,&nbsp;Noah Smith BS ,&nbsp;Melissa Previtera MLIS ,&nbsp;Ellen A. Lipstein MD, MPH","doi":"10.1016/j.acap.2025.102805","DOIUrl":"10.1016/j.acap.2025.102805","url":null,"abstract":"<div><h3>Background</h3><div>Shared decision-making (SDM) is crucial in pediatric care, but its implementation poses unique challenges. Training health care professionals in pediatric SDM is essential, yet little is known about the current state of these training programs.</div></div><div><h3>Objective</h3><div>Review existing pediatric-specific SDM training programs to understand the current state of training and identify areas for improvement.</div></div><div><h3>Data Sources</h3><div>Medline, PsycINFO, CINAHL, Education Research Complete, and LILACS.</div></div><div><h3>Eligibility Criteria</h3><div>We included original research publications in English, Spanish, and German that focused on SDM training involving pediatric health care professionals or evaluated SDM training within pediatric settings.</div></div><div><h3>Data Extraction</h3><div>We used a custom Covidence template to extract data on publication year, author, SDM focus, participants, curriculum design, teaching strategies, evaluated outcomes, and how the curriculum incorporated children's participation.</div></div><div><h3>Results</h3><div>Nineteen studies met the inclusion criteria. Most programs were from North America and published after 2018. Training approaches varied widely, with many focusing on specific clinical contexts. Only 2 curricula explicitly considered children as participants in the SDM process. Evaluation methods and outcomes varied across Kirkpatrick levels, with most programs reporting positive results in participant satisfaction, skill improvement, and patient outcomes.</div></div><div><h3>Limitations</h3><div>Only papers in English, Spanish, and German were included in the search.</div></div><div><h3>Conclusions</h3><div>While progress has been made in developing pediatric SDM training programs, there is a need for more consistency in content and evaluation methods. Future pediatric SDM training programs should prepare health care professionals with the skills necessary to involve children in the SDM process when appropriate.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102805"},"PeriodicalIF":3.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586839","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":"Child, Parent, and Contextual Correlates of School Readiness Among Children With Low Birth Weight","authors":"Genevieve G. Guyol MD, MAT ,&nbsp;Erika G. Cordova-Ramos MD ,&nbsp;Mei Elansary MD, MPhil ,&nbsp;Timothy C. Heeren PhD ,&nbsp;Jonathan S. Litt MD, MPH, ScD ,&nbsp;Margaret G. Parker MD, MPH","doi":"10.1016/j.acap.2025.102808","DOIUrl":"10.1016/j.acap.2025.102808","url":null,"abstract":"<div><h3>Objective</h3><div>Among US children with low birth weight (LBW) 1) determine prevalence of school readiness; and 2) examine associations between school readiness and medical factors (special health care needs, birth weight), sociodemographic characteristics (child race and ethnicity, household income, parental education, household language), community supports (early intervention/special education, outside childcare, medical home, neighborhood amenities), parent factors (mental health, emotional support, family resilience), and parenting practices (bedtime, mealtime, storytelling routines; daily screentime).</div></div><div><h3>Methods</h3><div>We studied 1421 children 3 to 5 years with birth weight &lt;2500g from the 2016–19 National Survey of Children’s Health. We calculated the prevalence of school readiness overall and in individual domains (early learning skills, physical health/motor development, social-emotional development, and self-regulation). We investigated associations between predictors and school readiness with logistic regression.</div></div><div><h3>Results</h3><div>Thirty percent of children with LBW were on-track for school readiness. Domain-specific readiness ranged from 45% in early learning skills to 87% in physical health/motor development. More complex special health care needs (average marginal effect [AME] −17%, 95% confidence interval [CI] −30%, −9%), parental education high school or less (AME −16%, 95% CI −15%, −4%), and early intervention/special education (AME −14%, 95% CI −26%, −5%) were negatively associated with school readiness. Parental emotional support (AME 12%, 95% CI 0.9%, 24%) and &lt;1 hour of daily screentime (AME 16%, 95% CI 6%, 29%) were positively associated with school readiness.</div></div><div><h3>Conclusions</h3><div>Less than one-third of US children with LBW were on-track for school readiness. Future work should focus on improving school readiness among this population.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 6","pages":"Article 102808"},"PeriodicalIF":3.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586900","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 of Food Hardship With Family Resilience and Connection: Does Participation in Supplemental Nutrition Assistance Program Modify This Association?","authors":"Madeline Frank MPH, MSW ,&nbsp;Anna E. Austin PhD, MPH","doi":"10.1016/j.acap.2025.102807","DOIUrl":"10.1016/j.acap.2025.102807","url":null,"abstract":"<div><h3>Objective</h3><div>The aims of this nationally representative cross-sectional study were to examine 1) the association of food hardship with family resilience and connection among families with children ages 6 to 17 years and 2) whether participation in Supplemental Nutrition Assistance Program (SNAP) benefits modified this association.</div></div><div><h3>Methods</h3><div>We used 2019–21 data from the National Survey of Children’s Health. We conducted multivariable generalized linear regression to calculate risk ratios (RRs) and 95% confidence intervals (CIs) examining the association of food hardship with an established measure of family resilience and connection. Then, among households with incomes &lt;200% of the federal poverty level (FPL), we examined whether the association of food hardship with family resilience and connection differed among households participating and not participating in SNAP. We adjusted analyses for household characteristics and participation in other social safety net programs.</div></div><div><h3>Results</h3><div>Families who experienced food hardship were less likely (RR = 0.73, 95% CI 0.69, 0.76) to have high family resilience and connection compared to families who did not experience food hardship. SNAP participation did not modify this association among households with incomes &lt;200% FPL (RR = 0.71, 95% CI 0.65, 0.78 for SNAP-participating households; RR = 0.71, 95% CI 0.65, 0.77 for nonparticipating households).</div></div><div><h3>Conclusions</h3><div>Results add to evidence demonstrating that food hardship is a risk factor for lower family resilience and connection. Results highlight the need for further programs and policies, in addition to SNAP, to support families experiencing food hardship and promote family resilience and connection.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102807"},"PeriodicalIF":3.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568814","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":"Pediatric Match and the Pathway to Pediatrics: Strategies to Strengthen the Pathway","authors":"Colin J. Orr MD, MPH ,&nbsp;Eva Catenaccio MD ,&nbsp;Erin P. Fraher PhD, MPP ,&nbsp;Harold K. Simon MD, MBA ,&nbsp;Christopher J. Stille MD, MPH ,&nbsp;Adam L. Turner MPH ,&nbsp;Laurel K. Leslie MD, MPH","doi":"10.1016/j.acap.2025.102809","DOIUrl":"10.1016/j.acap.2025.102809","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102809"},"PeriodicalIF":3.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543514","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":"Association of Food Insecurity with Mental Health Outcomes in Parents and Children During the COVID-19 Pandemic","authors":"Madison McCarthy BA ,&nbsp;Kathryn S. Cain MD ,&nbsp;Stephanie C. Meyer MD, MS ,&nbsp;Kimberly Montez MD, MPH ,&nbsp;Deepak Palakshappa MD, MSHP ,&nbsp;Callie L. Brown MD, MPH","doi":"10.1016/j.acap.2025.102804","DOIUrl":"10.1016/j.acap.2025.102804","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102804"},"PeriodicalIF":3.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469869","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":"Teaching Pediatrics Residents a Communication Framework for Delivering Difficult News: A Randomized Controlled Trial of Practice Methods","authors":"Jennifer Sedler MD ,&nbsp;Harvey Cohen MD, PhD ,&nbsp;Barbara Sourkes PhD ,&nbsp;Seth Hollander MD ,&nbsp;Caroline E. Rassbach MD, MAEd","doi":"10.1016/j.acap.2025.102802","DOIUrl":"10.1016/j.acap.2025.102802","url":null,"abstract":"<div><h3>Objectives</h3><div>1) Improve resident skills in delivering difficult news (DDN) by educating pediatric residents using a communication framework with validity evidence, the m-SPIKES (an acronym for modified setting, perception, involvement, knowledge, empathy, and summarize/strategize) framework. 2) Determine whether small-group practice with peer role-play or Rapid cycle deliberate practice (RCDP) simulation is a more effective practice modality for improving DDN.</div></div><div><h3>Methods</h3><div>Institutional review board-exempt single-institution pilot randomized controlled trial involving 28 pediatric residents. Residents attended an educational intervention that consisted of a large-group didactic session to learn the m-SPIKES framework followed by randomization into either peer role-play or RCDP groups for small-group practice. The residents completed pre- and postsurveys regarding self-efficacy in DDN using a Likert scale and were evaluated for fundamental communication skills and mastery of m-SPIKES by trained faculty during a simulation with a standardized patient before and after the educational intervention. Data were analyzed using bivariate inferential statistical analysis with <em>t</em> tests.</div></div><div><h3>Results</h3><div>After the educational intervention, residents in both cohorts were found to have significantly increased self-efficacy in DDN, fundamental communication skills, and overall mastery of the use of m-SPIKES (<em>P</em> ≤ .001). The 2 cohorts had similar improvements in self-efficacy (<em>P</em> = .223) and fundamental communication skills (<em>P</em> = .306); however, the peer role-play showed a significant improvement in mastery of m-SPIKES when compared to the RCDP group (<em>P</em> = .046).</div></div><div><h3>Conclusions</h3><div>While this educational intervention demonstrated a significant improvement in DDN skills for all residents in both the peer role-play and RCDP groups, more studies are needed to determine whether the use of RCDP is advantageous in communication education.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102802"},"PeriodicalIF":3.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434236","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":"A Year in (Re)View from the Association of Pediatric Program Directors: 40th Anniversary Edition","authors":"Michael Weisgerber MD, MS ,&nbsp;Megan Aylor MD ,&nbsp;Sarah Hilgenberg MD","doi":"10.1016/j.acap.2025.102803","DOIUrl":"10.1016/j.acap.2025.102803","url":null,"abstract":"<div><div>Academic Pediatrics has been the official journal of the Association of Pediatric Program Directors (APPD) since 2009. The <em>View from the APPD</em> section of the journal provides an important venue to highlight APPD members’ scholarship regarding issues impacting residency and fellowship training. Since 2020, the annual commentary (Re)View from the APPD summarizes articles published in <em>View</em> over the past year including their alignment with overall APPD mission, values, and organizational priorities. The APPD’s mission is to ensure the health and well-being of all children and serve pediatric programs by leading: 1) the advancement of medical education; 2) the development of a diverse workforce; 3) the cultivation of an inclusive clinical learning environment; and 4) the promotion of educational innovation and research. This year’s annual commentary falls during the APPD’s 40th Anniversary, an occasion to look back (hindsight is 20/20) and sum up (20<!--> <!-->+<!--> <!-->20<!--> <!-->=<!--> <!-->40) this year’s outstanding APPD mission-aligned work published in the <em>View</em>!</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102803"},"PeriodicalIF":3.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434235","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":"Serious Neurologic Events With Seasonal Influenza in Young Children","authors":"Brooke P. Quertermous MD ,&nbsp;Derek J. Williams MD, MPH ,&nbsp;Jean Bruce BS ,&nbsp;Mert Sekmen BA ,&nbsp;Yuwei Zhu MD, MS ,&nbsp;Carlos G. Grijalva MD, MPH ,&nbsp;James W. Antoon MD, PhD, MPH","doi":"10.1016/j.acap.2025.102801","DOIUrl":"10.1016/j.acap.2025.102801","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to determine the population-based incidence of influenza-associated serious neurologic events in children &lt;5 years of age.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort of children &lt;5 years of age enrolled in a Medicaid program during the 2016 to 2017 through 2019 to 2020 influenza seasons. Serious influenza-associated neurologic events were defined as a neurologic event resulting in hospitalization. Population-based incidence of serious influenza-associated neurologic events was calculated by dividing the number of events by the total accrued follow-up time and expressed per 100,000 influenza person-weeks. Incidence estimates were stratified by neurologic event category, age, sex, neurologic comorbidity, influenza season, and antiviral use.</div></div><div><h3>Results</h3><div>A total of 79,727 influenza cases among 70,258 unique children were included. The overall incidence of serious influenza-associated neurologic events was 38.0 (95% confidence interval [CI] 27.5–51.2) per 100,000 person-weeks of influenza. The most common serious neurologic event was seizure (34.5 per 100,000 influenza person-weeks of influenza, 95% CI 24.5–47.1) whereas encephalitis and ataxia/movement disorders were least common (0.9 per 100,000 influenza person-weeks of influenza, 95% CI 0.02–4.9). Incidence rates were generally higher in children &lt;2 years and significantly more common in children with neurologic conditions compared to those without neurologic conditions. Incidence rates were similar among those with and without influenza antiviral use.</div></div><div><h3>Conclusions</h3><div>Our findings reveal that serious neurologic complications are uncommon in young children with influenza but markedly higher in those with underlying neurologic conditions. These data emphasize the importance of preventing, identifying, and treating influenza in this vulnerable population.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102801"},"PeriodicalIF":3.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426643","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":"Cost of Intentional Drug Overdose and Other Self-Harm Among Youth in the United States, 2021","authors":"Laura M. Prichett PhD, MHS ,&nbsp;Nancy S. Weinfield PhD ,&nbsp;Michael J. Miller RPh, DrPH, FAPhA ,&nbsp;Brian R.E. Schultz MD ,&nbsp;Barry S. Solomon MD, MPH ,&nbsp;Eileen M. McDonald MS ,&nbsp;Leticia M. Ryan MD, MPH","doi":"10.1016/j.acap.2025.102800","DOIUrl":"10.1016/j.acap.2025.102800","url":null,"abstract":"<div><h3>Objective</h3><div>To quantify the annual direct health care cost of intentional overdose and other types of self-harm resulting in emergency department and/or inpatient encounters among youth in the United States.</div></div><div><h3>Methods</h3><div>Using the 2021 Nationwide Emergency Department Sample and National Inpatient Sample datasets, produced by the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project, we determined nationally representative cross-sectional frequencies and costs for specific types of self-harm encounters among 8- to 21-year-old pediatric and young adult patients.</div></div><div><h3>Results</h3><div>The total combined 1-year cost of all self-harm encounters was $869 million (95% confidence interval [CI] $841M–$897M). The majority of this cost was due to intentional overdose–related encounters, which totaled $530 million (95% CI $512M–$547M). Of this total, $232 million (95% CI $223M–$241M) was paid by public insurers and $296 million (95% CI $281M–$312M) was paid by private insurers. Encounters by females accounted for 79% of the intentional overdose costs ($420 million, 95% CI $404M–$435M).</div></div><div><h3>Conclusions</h3><div>Based on 2021 data, preventing youth intentional overdose could save the US health system up to $530 million, annually. As we collectively work to prevent suicide deaths among young people, it is important to recognize the needs of the larger group of youth who are engaging in serious self-harm and nonfatal suicidal acts, the majority of whom are young females. Prevention of intentional overdose in this population should be a priority, both in terms of upstream public health efforts and promotion of evidence-based methods of safer storage.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102800"},"PeriodicalIF":3.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426639","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 Evolving Landscape of Using Telehealth to Address Pediatric Mental Health in a Postpandemic Era","authors":"Natoshia R. Cunningham PhD ,&nbsp;Samantha L. Ely BA ,&nbsp;Brittany N. Barber Garcia PhD","doi":"10.1016/j.acap.2025.102791","DOIUrl":"10.1016/j.acap.2025.102791","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102791"},"PeriodicalIF":3.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416171","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}