Academic Pediatrics最新文献

{"title":"Associations Between Residency Program Size and Readiness for Unsupervised Practice in Pediatrics","authors":"Daniel J. Schumacher MD, PhD, MEd ,&nbsp;Ariel S. Winn MD ,&nbsp;Joni Hemond MD ,&nbsp;Carol Lynn O’Dea MD ,&nbsp;Karla L. Garcia MD ,&nbsp;Ann E. Burke MD, MBA ,&nbsp;Monique M. Naifeh MD, MPH ,&nbsp;Jason Zurawick MD ,&nbsp;Benjamin Kinnear MD, MEd ,&nbsp;Catherine Michelson MD, MMSc ,&nbsp;David A. Turner MD ,&nbsp;Abigail Martini MSMEd ,&nbsp;Alan Schwartz PhD, JD ,&nbsp;for the Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network (APPD LEARN) Crosswalk Study Group","doi":"10.1016/j.acap.2025.102806","DOIUrl":"10.1016/j.acap.2025.102806","url":null,"abstract":"<div><h3>Objective</h3><div>This study sought to determine differences in program-reported entrustable professional activity (EPA) entrustment-supervision levels based on residency program size.</div></div><div><h3>Methods</h3><div>At the end of the 2021 to 2022, 2022 to 2023, and 2023 to 2024 academic years, entrustment-supervision levels for the 17 General Pediatrics EPAs were determined by clinical competency committees for graduating pediatric residents at 48 pediatrics residency programs. Programs were categorized as small, medium, large, and very large. The authors fitted a main-effects mixed-effects logistic regression model to predict the likelihood that a graduating resident was deemed ready to execute each EPA without supervision, with program size and EPA as fixed effects and program as a random effect. A second model also included the interaction between program size and EPA as a predictor.</div></div><div><h3>Results</h3><div>A total of 33,335 entrustment-supervision levels were reported for 2285 graduating pediatrics residents. Small programs were more likely to report residents as ready for unsupervised practice than multiple larger-sized program groups for 4 EPAs (health screening, well newborn, recognize/refer surgical problems, and manage information).</div></div><div><h3>Conclusions</h3><div>Characteristics of small programs may lead them to be more likely to entrust graduating residents with unsupervised practice in certain areas.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102806"},"PeriodicalIF":3.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597746","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":"Prevalence and Trends in Pediatric-Onset Chronic Conditions in the United States, 1999–2018","authors":"Lauren E. Wisk PhD ,&nbsp;Niraj Sharma MD, MPH","doi":"10.1016/j.acap.2025.102810","DOIUrl":"10.1016/j.acap.2025.102810","url":null,"abstract":"<div><h3>Objective</h3><div>We sought to provide an updated estimate of the current prevalence and recent trends (over the past two decades) in pediatric-onset conditions among a nationally-representative sample of youth to identify opportunities for prevention and intervention.</div></div><div><h3>Methods</h3><div>We performed a secondary data analysis of nationally-representative data on 236,412 participants (ages 5–25 years) from the 1999 to 2018 National Health Interview Survey. Chronic conditions (CCs) and functional limitations (FLs) were self-reported by the participant or a qualified proxy-respondent. We employed multivariate linear probability models to estimate annual average increase in CC/FL prevalence and differences in prevalence across sociodemographic characteristics.</div></div><div><h3>Results</h3><div>The prevalence of children (5–17 years) with a CC/FL has risen from 22.57% in 1999/2000 to 30.21% in 2017/2018 – an adjusted annual increase of 0.24% points per year (<em>P</em> <!-->&lt;<!--> <!-->.0001) or about 130,000 additional children per year. The prevalence of young adults (18–25 years) with a CC/FL has risen similarly (adjusted annual increase of 0.33% points per year, <em>P</em> <!-->&lt;<!--> <!-->.0001). Asthma and mental/behavioral health conditions were some of the leading CC and FL (respectively) contributors to this increase for both age groups. We estimate that approximately 1.2 million youth with a CC or FL currently turn 18 each year.</div></div><div><h3>Conclusions</h3><div>The US is currently seeing an unprecedented number of youth with pediatric-onset conditions. It is incumbent for the US health system to seek ways to treat these patients in pediatric settings and eventually matriculate them into adult care.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 4","pages":"Article 102810"},"PeriodicalIF":3.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586842","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":"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}