Academic Pediatrics最新文献_第6页

Redesigning Primary Care Via Health Systems and Communities. 通过卫生系统和社区重新设计初级保健。

IF 2.8 3区医学

Academic Pediatrics Pub Date : 2026-09-15 DOI: 10.1016/j.acap.2026.103429

Kelly J Kelleher, Rose Hardy, Laura Chavez

{"title":"Redesigning Primary Care Via Health Systems and Communities.","authors":"Kelly J Kelleher, Rose Hardy, Laura Chavez","doi":"10.1016/j.acap.2026.103429","DOIUrl":"10.1016/j.acap.2026.103429","url":null,"abstract":"Objective: Traditional primary care practices have not adequately adapted to the clear consensus on the importance of community and social factors in child health.Methods: We describe how primary care can improve child and community health through community partnerships that integrate social care into healthcare systems. Specifically, we discuss a National Academy of Medicine heuristic for social care integration into practice and provide examples of primary care/social care integration. Practices/clinicians may feasibly address community and social factors through individual-level social care integration into practice. Larger groups of practices, health systems, and integrated networks can address community-level social integration efforts into medical care.Results: Successful social care integration and related partnerships are contingent on a) an asset-based community development approach, b) maximizing community and partner participation, c) employing data driven improvement processes, and d) developing sustainable workforce and finance supports for the partnership activities.Conclusions: Best outcomes for children and families will require a transformed primary care approach that addresses community needs through integration of social care and partners. Primary care change is hard, but accommodation and advocacy changes should be accessible to almost all primary care. Direct assistance and alignment activities likely require significant resources and the participation of larger networks and health systems. These last two activities may also require alternative payment models.","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103429"},"PeriodicalIF":2.8,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978403","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

Executive Summary: Improving the Health and Lives of Children: A Special Issue in Honor of Benard P. Dreyer, MD. 执行摘要：改善儿童健康和生活：纪念贝纳德·p·德雷尔医学博士的特刊

IF 2.8 3区医学

Academic Pediatrics Pub Date : 2026-09-15 DOI: 10.1016/j.acap.2026.103421

Arthur H Fierman, Jean L Raphael, Peter G Szilagyi

引用次数: 0

Redesigning Pediatric Preventive Care to Advance Child Health. 重新设计儿童预防保健以促进儿童健康。

IF 2.8 3区医学

Academic Pediatrics Pub Date : 2026-09-14 DOI: 10.1016/j.acap.2026.103430

Colin J Orr, Adam Schickedanz, Tumaini R Coker

{"title":"Redesigning Pediatric Preventive Care to Advance Child Health.","authors":"Colin J Orr, Adam Schickedanz, Tumaini R Coker","doi":"10.1016/j.acap.2026.103430","DOIUrl":"10.1016/j.acap.2026.103430","url":null,"abstract":"Pediatric preventive care, beginning at birth and extending through young adulthood to support the health of children, is a cornerstone of pediatric primary care, supporting the physical, developmental, and mental health of children through periodic health supervision visits, also known as \"well-child care\". Pediatric preventive care visits provide opportunities to monitor growth and development, identify physical and mental health conditions early, deliver disease prevention and health promotion services, offer anticipatory guidance and education to improve child safety and well-being, and provide psychosocial support for children, families, and caregivers. Pediatric preventive care has played a pivotal role in reducing childhood morbidity and mortality through vaccination, improved nutrition, early identification of developmental delays, and prevention of unintentional injuries. However, the landscape of child health, along with the epidemiology of childhood illness, has shifted. Children now face more risk for developing complex chronic conditions, for earlier onset of diseases typically seen in adulthood, and through the strong influence of social and environmental factors on health. At the same time, demographic changes in the US child population and a pediatric workforce capacity that has been slow to adapt, adds pressures to the existing model of pediatric preventive care. It is essential to reimagine pediatric preventive care to ensure it continues to meet the evolving needs of children and families. In this review, we discuss evidence-based strategies, innovations, and future directions, to redesign pediatric preventive care to ensure alignment with current health needs of children and families.","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103430"},"PeriodicalIF":2.8,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972186","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

Leveraging Pediatric Primary Care to Support Early Relational Health and Enhance Early Child Development: A Review. 利用儿科初级保健支持早期关系健康和加强早期儿童发展：综述。

IF 2.8 3区医学

Academic Pediatrics Pub Date : 2026-09-14 DOI: 10.1016/j.acap.2026.103428

Erin Roby, Caitlin F Canfield, Daniel Shaw, Manuel Jimenez, Mary McCord, Juliana Gutierrez, Alan Mendelsohn

{"title":"Leveraging Pediatric Primary Care to Support Early Relational Health and Enhance Early Child Development: A Review.","authors":"Erin Roby, Caitlin F Canfield, Daniel Shaw, Manuel Jimenez, Mary McCord, Juliana Gutierrez, Alan Mendelsohn","doi":"10.1016/j.acap.2026.103428","DOIUrl":"10.1016/j.acap.2026.103428","url":null,"abstract":"Several decades of converging research in the fields of pediatrics, child development, and neuroscience demonstrate that the first years of life set the stage for children's school readiness and have lasting impacts on health, learning, and well-being across the lifespan. Early childhood is therefore an ideal time to deliver preventive interventions to reduce disparities in child development that emerge due to poverty, toxic stress, and other adversities. Early Relational Health (ERH), which includes parent-child interactions and relationships supports child development and can serve as a protective factor in the pathway between poverty/early stress and child outcomes. It is also the focus of recent policy statements and recommendations from key experts and leaders within the early childhood landscape. In the current paper, we describe interventions and strategies that use primary care alone or as a point of entry to other programs to promote ERH in order to enhance early child development. Primary care offers early contact and relationship building with families, provides near universal reach, and is low cost compared to other platforms, and layering and linking programs helps to address diverse family needs and preferences. We highlight challenges and bright spots in these endeavors and note the need for additional advocacy for the promotion of ERH that leverages a strong evidence base and converging policy recommendations.","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103428"},"PeriodicalIF":2.8,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972128","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

Medicaid and the Financing of Pediatric Healthcare: Strengths and Opportunities. 医疗补助和儿科医疗融资：优势和机遇。

IF 2.8 3区医学

Academic Pediatrics Pub Date : 2026-09-14 DOI: 10.1016/j.acap.2026.103425

Heather E Hsu, Charles J Homer, Nathan T Chomilo, James M Perrin

{"title":"Medicaid and the Financing of Pediatric Healthcare: Strengths and Opportunities.","authors":"Heather E Hsu, Charles J Homer, Nathan T Chomilo, James M Perrin","doi":"10.1016/j.acap.2026.103425","DOIUrl":"10.1016/j.acap.2026.103425","url":null,"abstract":"Medicaid provides health insurance coverage for nearly half of all US children, offering broad service coverage for low-income individuals with minimal waiting periods and copays. The Children's Health Insurance Program (CHIP) insures children from households with incomes above Medicaid thresholds, but with less comprehensive benefits. Both Medicaid and CHIP typically reimburse at about 70% of Medicare payment rates. Unlike Medicare, which has full federal funding, Medicaid is a federal-state partnership. States receive 50-77% of their total Medicaid budgets from federal sources but retain administrative flexibility that results in widespread variation in eligibility and payments. The Medicaid Early and Periodic Screening, Diagnosis, and Treatment statute limits state variation in benefits by requiring states to cover screenings and all medically necessary coverable services for youth up to age 21 years, even if unavailable to older adults. Beyond facilitating healthcare access, Medicaid and CHIP have demonstrated substantial benefits in improving long-term health outcomes, increasing adult earnings, reducing public costs, and promoting health equity. With its many successes, Medicaid could serve as the base for a national health program available to all children. A more comprehensive national child health program should establish uniform enrollment and eligibility with adequate financing at least to match Medicare payment levels. Universal enrollment at birth would be standard, allowing families to opt out if they prefer commercial insurance. Payment should incentivize prevention, health promotion, and outcomes, with benefits grounded in Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) standards. The federal government or states could pilot innovative payment and care delivery approaches to enhance child health outcomes nationwide.","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103425"},"PeriodicalIF":2.8,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972134","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

Benard Dreyer's Professional Life: Justice at the Crossroads. 贝纳德·德雷尔的职业生涯：十字路口的正义。

IF 2.8 3区医学

Academic Pediatrics Pub Date : 2026-09-14 DOI: 10.1016/j.acap.2026.103422

Andrew D Racine

引用次数: 0

Advancing Pediatric Social Care: A Review of the Evidence and Roadmap for Research, Practice, and Policy. 推进儿科社会护理：研究、实践和政策的证据和路线图综述。

IF 2.8 3区医学

Academic Pediatrics Pub Date : 2026-09-14 DOI: 10.1016/j.acap.2026.103427

Danielle Cullen, Arvin Garg

{"title":"Advancing Pediatric Social Care: A Review of the Evidence and Roadmap for Research, Practice, and Policy.","authors":"Danielle Cullen, Arvin Garg","doi":"10.1016/j.acap.2026.103427","DOIUrl":"10.1016/j.acap.2026.103427","url":null,"abstract":"Over the past decade, research and clinical innovations have advanced social care models in pediatric healthcare settings, yielding important lessons and illuminating critical gaps for further inquiry. In this review, we synthesize the state of the science in pediatric social care and offer recommendations for practice, research, and policy. In practice, social care models must be rooted in the existing evidence-base, ensuring that implementation reflects what is known to be effective while remaining adaptable to emerging insights. The next phase of research should develop patient-and family-centered outcome measures and contextually sensitive strategies that center family priorities and local realities. Implementation science, equity-driven frameworks, and rigorous evaluation in social care research will be essential to ensuring that resulting social care practices are not only effective but also sustainable and scalable. At the policy level, redirecting incentives toward addressing social needs-not merely screening- and strengthening social safety-net programs will be critical to achieving meaningful impact. The integration of social care into pediatric practice is imperative to improve child health, population health, and equity. By grounding efforts in evidence and advocating for comprehensive social supports, pediatricians can help transform social care from a promising innovation into a standard of high-quality, equitable healthcare.","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103427"},"PeriodicalIF":2.8,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972016","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 Role of Professional Organizations in Faculty Development. 专业组织在教师发展中的作用。

IF 2.8 3区医学

Academic Pediatrics Pub Date : 2026-09-14 DOI: 10.1016/j.acap.2026.103439

Elena Fuentes-Afflick, Tina L Cheng

引用次数: 0

"Generation to Generation: Naming Racism and Reclaiming Our Future in Pediatrics". “一代又一代：为种族主义命名，为儿科重塑未来”

IF 2.8 3区医学

Academic Pediatrics Pub Date : 2026-09-07 DOI: 10.1016/j.acap.2026.103436

Tiffani J Johnson, Christine Liverpool, April McNeill-Johnson, Joseph L Wright

引用次数: 0

Health Literacy in Pediatric Care: Evidence, Gaps, and Opportunities. 儿科护理中的健康素养：证据、差距和机遇。

IF 2.8 3区医学

Academic Pediatrics Pub Date : 2026-09-06 DOI: 10.1016/j.acap.2026.103432

Alyssa Coffin, Alexander F Glick, H Shonna Yin

{"title":"Health Literacy in Pediatric Care: Evidence, Gaps, and Opportunities.","authors":"Alyssa Coffin, Alexander F Glick, H Shonna Yin","doi":"10.1016/j.acap.2026.103432","DOIUrl":"https://doi.org/10.1016/j.acap.2026.103432","url":null,"abstract":"Health literacy is a foundational component of providing accessible pediatric care, influencing whether families can understand, access, and use health information. As families increasingly rely on online health resources, health literacy skills applied to digital information, or e-health literacy, has become an evolving dimension of pediatric health literacy. The concept of health literacy extends beyond an individual's abilities, intersecting with the demands placed on individuals by healthcare systems. There is a growing focus on organizational health literacy (OHL), which reflects how effectively systems support equitable communication, but this remains infrequently assessed or implemented. Limited parent, child, and adolescent health literacy is common and disproportionately affects families with lower income, minoritized racial/ethnic backgrounds, lower educational attainment, and who use languages other than English for care. Limited health literacy has been associated with decreased disease-specific knowledge, suboptimal health behaviors, and worse clinical outcomes. Although health literacy-informed strategies can improve comprehension and outcomes, best practices, such as teach-back, remain underutilized across pediatric care settings. The rapid expansion of digital tools offers new opportunities to enhance health literacy-informed communication but also introduces challenges related to equity, accuracy, and safety. Advancing pediatric health literacy requires coordinated efforts: embedding health literacy principles into institutional and national policies, integrating universal health literacy precautions into clinical workflows, expanding clinician and patient health literacy education, and advancing health literacy-focused research, including on digital interventions and artificial intelligence (AI)-supported communication. Prioritizing these efforts is essential to creating health literate-systems that enable all families to access, understand and use health information.","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":" ","pages":"103432"},"PeriodicalIF":2.8,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901429","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