Academic Pediatrics最新文献

{"title":"Feasibility, Acceptability, and Appropriateness of Screening and Referring for Social Risks in a Community Hospital Setting","authors":"Jana C. Leary MD, MS ,&nbsp;Hannah Bagley BS ,&nbsp;Frank P. Giacchetto BS ,&nbsp;Kayley Pate BS ,&nbsp;Amy M. Foote BSN, RN, CPN ,&nbsp;Jennifer E. Murzycki MD, PhD ,&nbsp;Karen M. Freund MD, MPH ,&nbsp;Arvin Garg MD, MPH ,&nbsp;Christopher P. Landrigan MD, MPH","doi":"10.1016/j.acap.2025.102872","DOIUrl":"10.1016/j.acap.2025.102872","url":null,"abstract":"<div><h3>Objective</h3><div>In response to American Academy of Pediatrics and Centers for Medicare &amp; Medicaid Services recommendations, a growing number of hospitals are implementing inpatient social care systems, but nearly all pediatric studies to date have been conducted in children’s hospitals. In 2022, a university–affiliated community hospital implemented a pediatric inpatient social risk screening and referral system. We aimed to assess the feasibility, acceptability, and appropriateness of this system in the community hospital setting.</div></div><div><h3>Methods</h3><div>We used a concurrent mixed methods approach from March to December 2023, surveying parents of hospitalized children and clinicians who perform or respond to screening, to assess implementation outcomes—feasibility, acceptability, and appropriateness—using validated measures based on 5-point Likert scales. We concurrently performed semistructured interviews assessing clinician and parent experiences with implementation and performed a thematic analysis.</div></div><div><h3>Results</h3><div>Forty-three parents (67%) and 31 clinicians (78%) completed surveys, and 20 interviews (11 parents and 9 clinicians) were performed. Among parents and clinicians, respectively, 95% and 97% rated implementation as feasible, 97% and 93% as acceptable, and 95% and 97% as appropriate. Interview themes emerged regarding <em>feasibility</em>: 1) community/hospital resources enable social care, 2) challenging limitations in social service personnel; <em>acceptability</em>: 1) value added to inpatient care, 2) positive impact on families’ health, 3) inadequate expectation-setting concerns; and <em>appropriateness</em>: 1) natural fit within workflows, 2) desire for different modality/timing options.</div></div><div><h3>Conclusions</h3><div>Implementation of a pediatric inpatient social care system was feasible, acceptable, and appropriate in a community hospital setting; however, challenges and key areas for improvement were identified that can serve as leverage points for future implementation strategies.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 7","pages":"Article 102872"},"PeriodicalIF":3.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259311","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":"Initiating Human Papillomavirus Vaccination at Age 9: Strategies for Success From 5 US Health Systems","authors":"Elizabeth L. Ciemins PhD, MPH, MA ,&nbsp;Alicia Rooney MPH, MSW ,&nbsp;Jason A. Yaun MD ,&nbsp;Kunal Saxena PhD ,&nbsp;Jordana K. Schmier MA ,&nbsp;Amanda F. Dempsey MD, PhD, MPH ,&nbsp;Kristin Oliver MD, MHS","doi":"10.1016/j.acap.2025.102869","DOIUrl":"10.1016/j.acap.2025.102869","url":null,"abstract":"<div><h3>Objective</h3><div>The study objective was to explore how health systems have successfully initiated human papillomavirus (HPV) vaccination routinely at age 9 with the goal of sharing best practices with health systems nationwide. The ultimate goal is to increase HPV vaccination rates to address the persistent high prevalence of HPV resulting from suboptimal vaccination, with strong interest and support for vaccination initiation at age 9.</div></div><div><h3>Methods</h3><div>Guided by the Consolidated Framework for Implementation Research, a mixed methods study was conducted in 5 US health systems using surveys and interviews to learn about best practices associated with successful HPV vaccination initiation among 9-year-old children. Survey responses were quantified and summarized. Content and rapid qualitative analysis along with data reduction methods were applied to summarize content from the interviews and extract common themes.</div></div><div><h3>Results</h3><div>A total of 497 surveys were completed and 10 interviews were conducted at 5 geographically and structurally diverse US health systems. Participants included pediatricians, nurses, clinic managers, quality and population health leaders, and immunization strategists. Successful interventions identified included sharing data on vaccination rates, obtaining leadership and staff buy-in/ownership, electronic health record updates and education/training for providers and staff, and early preparation and education for patients and families.</div></div><div><h3>Conclusions</h3><div>Programs to initiate HPV vaccination at age 9 can be successfully implemented in US health systems by identifying and addressing barriers and utilizing multitiered interventions at the patient/family, provider/staff, and organization levels.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 7","pages":"Article 102869"},"PeriodicalIF":3.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259313","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 Between Adverse Childhood Experiences and Health–Related School Absenteeism: Results From a National Survey of Youth","authors":"Rebecca K. Tsevat MD, MS ,&nbsp;Margaret M. Nkansah MD, MS ,&nbsp;Michelle Shankar MD, MHS ,&nbsp;Kristen Choi PhD, PMHNP-BC, FAAN ,&nbsp;Nicholas J. Jackson PhD, MPH ,&nbsp;Shannon M. Thyne MD ,&nbsp;Bahareh Gordon MD ,&nbsp;Rebecca N. Dudovitz MD, MSHS","doi":"10.1016/j.acap.2025.102864","DOIUrl":"10.1016/j.acap.2025.102864","url":null,"abstract":"<div><h3>Objective</h3><div>Adverse childhood experiences (ACEs) and school absenteeism are both linked to poor health and educational outcomes. However, little is known about whether ACEs contribute to school absenteeism for health reasons. We examined the association between ACEs and health–related school absenteeism in a nationally representative sample.</div></div><div><h3>Methods</h3><div>This cross-sectional study used data from the 2021 to 2022 National Health Interview Survey. Parents of participants reported on 7 ACEs and missed school days in the past 12 months due to illness, injury, or disability (“health-related absences”). Weighted logistic regressions tested whether exposure to ACEs was associated with any health-related absences as well as health–related chronic absenteeism (defined as missing at least 10% of school days), adjusting for covariates. We then tested whether general health status mediated the relationship between ACEs and absenteeism.</div></div><div><h3>Results</h3><div>The unweighted sample included 10,794 youth ages 6 to 17. One quarter (24.3%) reported 1 or more ACE, and participants had 3.24 health-related absences on average. Exposure to at least 1 ACE was associated with increased odds of health-related absenteeism (Adjusted Odds Ratio (AOR) 1.53, 95% Confidence Interval (CI) 1.35–1.73) and health–related chronic absenteeism (AOR 2.43, 95% CI 1.80–3.28). General health status accounted for 6.9% of the relationship between ACEs and any health-related absenteeism and 13.1% of the relationship between ACEs and health–related chronic absenteeism (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>ACEs are associated with health-related absenteeism, and this association is partially mediated by general health status. Health systems and schools might focus jointly on preventing and mitigating the health and life course risks associated with both ACEs and absenteeism.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 8","pages":"Article 102864"},"PeriodicalIF":2.8,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259340","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":"Impact of Interventions to Improve Human Papillomavirus Vaccine Uptake on Other Vaccines Due: A Secondary Analysis of a Randomized Trial","authors":"Robert M. Jacobson MD ,&nbsp;Jeph Herrin PhD ,&nbsp;Gregory Jenkins MS ,&nbsp;Joan M. Griffin PhD ,&nbsp;Jennifer L. St. Sauver PhD ,&nbsp;Kathy L. MacLaughlin MD ,&nbsp;Xuan Zhu PhD, MS ,&nbsp;Lila J. Finney Rutten PhD","doi":"10.1016/j.acap.2025.102870","DOIUrl":"10.1016/j.acap.2025.102870","url":null,"abstract":"<div><h3>Objective</h3><div>We sought to determine if our recent trial of human papillomavirus (HPV) vaccine uptake improved influenza, meningococcal ACWY, and tetanus-diphtheria-acellular pertussis (Tdap) vaccine uptake.</div></div><div><h3>Methods</h3><div>We conducted a secondary analysis of our 4-year factorial stepped–wedge cluster-randomized trial of 6 primary care practices affiliated with the Mayo Clinic. We restricted our analysis to those adolescents 11- to 12-years-old due for at least 1 of 3 vaccines in addition to HPV. Trial arms included 1) usual care, 2) mailed reminder-recall letters to parents of empaneled adolescents following their birthdays alerting parents to the need for HPV vaccination and other vaccines due, 3) monthly confidential audit-feedback reports to providers sent via intracampus mail comparing rates of HPV vaccination for that provider with others, and 4) both interventions. Outcomes included receipt of influenza, meningococcal ACWY, and Tdap vaccines during the study step.</div></div><div><h3>Results</h3><div>Among trial participants, 8698 adolescents were due for ≥1 dose HPV and at least 1 of the other vaccines. The parent reminder-recall resulted in a clinically and statistically significant increase in uptake of the other vaccines (odds ratios ranging from 1.44–1.86, all 95% confidence intervals above 1.13) as it did in combination with the provider audit-feedback. Provider audit-feedback alone had no statistically significant impact.</div></div><div><h3>Conclusions</h3><div>The parent reminder-recall substantially improved uptake of all 3 vaccines, whereas the provider audit-feedback did not. This made sense as the reminder-recall treated all vaccines as equally recommended without a focus on the HPV vaccine due, while the audit-feedback only reported the provider’s success with HPV vaccine uptake.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 7","pages":"Article 102870"},"PeriodicalIF":3.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259312","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":"Professional Development Rotation for Residents: An Innovative Approach to Integrating Career Exploration and Personal Development","authors":"H. Mollie Grow MD, MPH ,&nbsp;Monisha M. Gonzales MD ,&nbsp;Sahar N. Rooholamini MD, MPH ,&nbsp;Tiana L. Won MD ,&nbsp;Richard Shugerman MD ,&nbsp;Heather A. McPhillips MD, MPH","doi":"10.1016/j.acap.2025.102867","DOIUrl":"10.1016/j.acap.2025.102867","url":null,"abstract":"<div><h3>Objective</h3><div>To describe how residents utilized a professional development rotation (PDR), its influence on different domains of professional development, and potential effects on professional identity formation (PIF).</div></div><div><h3>Methods</h3><div>This qualitative study used semistructured, one-on-one virtual interviews with pediatric residents and recent graduates who participated in a second-year PDR. Recruitment occurred via email with a purposeful sampling strategy until sufficiency was achieved. Three study team members reviewed and coded each interview using Dedoose (v.8.3.41) software. All authors met over sequential meetings to review coded texts using applied thematic analysis until achieving consensus on final study themes. An accompanying brief survey cataloged demographics, rotation components completed, and overall rotation ratings.</div></div><div><h3>Results</h3><div>Twenty-two participants completed the study: 12 residents (current third year) and 10 recent (&lt;1 year) graduates. In the survey, the majority (77%) rated the rotation more valuable than others for career development and all engaged in multiple types of activities. Five major themes emerged in thematic analysis: 1) PDR was highly valued for providing protected time; 2) meetings with mentors were particularly influential to career development and emerging identity; 3) reflecting on strengths, skills, and/or reconnecting with interests most contributed to ongoing PIF; 4) back-up call was the biggest barrier to full participation; 5) unstructured time for personal development provided the strongest sense of rejuvenation.</div></div><div><h3>Conclusions</h3><div>A dedicated rotation for professional development that encompassed personal development approaches was highly valued during residency and influenced career planning, mentorship connections, sense of personal renewal, and PIF.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 8","pages":"Article 102867"},"PeriodicalIF":2.8,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259314","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":"ADHD Medication and Depressive Symptoms in Adolescents: A Retrospective Longitudinal Study","authors":"Landon B. Krantz MD, MHS ,&nbsp;Tanya E. Froehlich MD, MS ,&nbsp;Andrew F. Beck MD, MPH ,&nbsp;Stephen P. Becker PhD ,&nbsp;Melinda C. MacDougall MS ,&nbsp;Shelley Ehrlich MD, ScD, MPH ,&nbsp;Chidiogo U. Anyigbo MD, MPH ,&nbsp;Samuel Eggers MD, MPH ,&nbsp;William B. Brinkman MD, MEd, MSc","doi":"10.1016/j.acap.2025.102863","DOIUrl":"10.1016/j.acap.2025.102863","url":null,"abstract":"<div><h3>Objective</h3><div>To examine whether higher attention-deficit/hyperactivity disorder (ADHD) medication coverage was associated with lower depressive symptoms among adolescents who live in underresourced neighborhoods and/or identify as a member of a minoritized group.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, adolescents aged 12 to 18 years with ADHD completed a depression screener at their annual well visit. Patients were seen at a primary care office that predominantly serves minoritized, Medicaid-insured youth from underresourced neighborhoods. We calculated ADHD medication coverage as the percentage of days in which medication was available in the prior 36 months based on prescriptions in the electronic health record (range 0%–100%). Zero-inflated negative binomial regression models assessed whether medication coverage was associated with differences in total depression scores, measured by the Patient Health Questionnaire.</div></div><div><h3>Results</h3><div>We included 2569 adolescents (66.6% male, 70.9% Black, 86.6% Medicaid-insured) with 4145 well visits. Medication coverage was poor (mean = 18.5% days covered, standard deviation = 26.8%). Higher medication coverage was not associated with lower depression scores in the overall sample. However, after excluding patients with 0% medication coverage, there was a significant association between higher coverage and lower depression scores. Depression symptom scores were higher in patients with mental/behavioral health comorbidities, those of female sex, and those living in neighborhoods with lower opportunity scores.</div></div><div><h3>Conclusions</h3><div>Greater ADHD medication coverage was associated with a small, yet potentially clinically significant decrease in depression symptoms in our sample, underscoring the need to investigate the protective effect of ADHD medication on depression in more diverse populations.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 7","pages":"Article 102863"},"PeriodicalIF":3.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250695","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":"Adequacy of the Diagnostic Workup of Suspected Physical Abuse in Young Children: An Audit in the Paris Metropolitan Area","authors":"Flora Blangis PhD ,&nbsp;Manon Bergerat MD ,&nbsp;Slimane Allali MD, PhD ,&nbsp;Tamazoust Guiddir MD ,&nbsp;Solène Loschi MD ,&nbsp;Vincent Gajdos MD, PhD ,&nbsp;Albert Faye MD, PhD ,&nbsp;Camille de Truchis de Lays MD ,&nbsp;Romain Basmaci MD, PhD ,&nbsp;Nathanaël Beeker PhD ,&nbsp;Emmanuel Lecoeur MsC ,&nbsp;Catherine Adamsbaum MD ,&nbsp;Caroline Rey-Salmon MD ,&nbsp;Kevin Beccaria MD, PhD ,&nbsp;Elise Launay MD, PhD ,&nbsp;Martin Chalumeau MD, PhD","doi":"10.1016/j.acap.2025.102866","DOIUrl":"10.1016/j.acap.2025.102866","url":null,"abstract":"<div><h3>Objective</h3><div>An adequate diagnostic workup of suspected child physical abuse (CPA) is crucial for an accurate diagnosis and to consider differential diagnoses. We aimed to audit the actual practices in Paris area hospitals and evaluate their adherence to current clinical guidelines.</div></div><div><h3>Methods</h3><div>We used specific discharge codes suggesting CPA in the Assistance Publique-Hôpitaux de Paris clinical data warehouse to identify cases of young children &lt;2 years old hospitalized for suspected CPA in 2018–19 in 7 university hospitals. We systematically reviewed the electronic medical records to confirm the suspected CPA. We compared the observed proportion of the diagnostic tests performed to that expected according to current national and international clinical guidelines.</div></div><div><h3>Results</h3><div>Among the 97 included children (median age 5 months), 60% had intracranial injuries, 40% skin injuries, and 30% skeletal injuries; 8% died. At least one of the key diagnostic tests (radiological skeletal survey, eye fundus examination, and head computed tomography or magnetic resonance imaging) expected to be performed systematically according to guidelines was not performed in 14 (14%) of children. Bone metabolism investigation was performed in 33% of the 43 children with ≥1 unexplained fracture(s). Hemostasis and coagulation investigations were performed in 82% of the 76 children with bruises or internal bleeding.</div></div><div><h3>Conclusions</h3><div>Practices observed in the Paris area university hospitals for the diagnostic workup of suspected CPA were not always consistent with guidelines, thus leading to risk of misdiagnosis. Obstacles to the complete implementation of guidelines, such as physician’s nonadherence, must be identified and overcome.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 7","pages":"Article 102866"},"PeriodicalIF":3.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250694","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":"Online Dialogic Reading Training Program for Pediatric Clinicians: A Randomized Controlled Study","authors":"Larntip Sutthirat MD ,&nbsp;Ketsupar Jirakran PhD ,&nbsp;Pon Trairatvorakul MD ,&nbsp;Weerasak Chonchaiya MD","doi":"10.1016/j.acap.2025.102873","DOIUrl":"10.1016/j.acap.2025.102873","url":null,"abstract":"<div><h3>Objective</h3><div>Pediatric clinicians (PC) play a pivotal role in promoting early development and literacy. Integrating dialogic reading (DR) techniques into routine pediatric care may offer long-term benefits; however, evidence supporting online DR training for PC is limited. This study evaluated the effectiveness of an online DR training program in improving DR skills, knowledge, and attitudes among PC.</div></div><div><h3>Methods</h3><div>A randomized controlled trial involving 104 participants was conducted. The intervention group received 1 weekly instructional video via a private communication application for 3 weeks. DR skills, knowledge, and attitudes were assessed at baseline, 3 weeks, and 7 weeks post baseline using a storytelling task, knowledge questionnaires, and attitude scales, respectively. Generalized estimating equations were used to analyze group differences over time.</div></div><div><h3>Results</h3><div>DR skills, knowledge, and specific technique scores improved significantly in the intervention group compared to the control group over 7 weeks (<em>P</em> &lt; .001). Additionally, the intervention group showed significant within-group improvements in DR skills, knowledge, and attitudes at both 3 and 7 weeks post baseline. However, attitudes toward DR did not differ significantly between groups.</div></div><div><h3>Conclusions</h3><div>Online DR training can effectively improve DR skills and knowledge among PC. Implementing such training in clinical practice may help clinicians more practically support early literacy development in children through caregiver engagement.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 7","pages":"Article 102873"},"PeriodicalIF":3.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250697","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":"Gili in Wonderland","authors":"Ruth Kannai MD","doi":"10.1016/j.acap.2025.102871","DOIUrl":"10.1016/j.acap.2025.102871","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 7","pages":"Article 102871"},"PeriodicalIF":3.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250696","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":"Graduating Pediatric Residents’ Preparedness to Provide Mental Health Care for Children and Adolescents","authors":"Elizabeth A. Gottschlich MA ,&nbsp;Tylar W. Kist MS ,&nbsp;Hilary M. Haftel MD, MHPE, FAAP","doi":"10.1016/j.acap.2025.102858","DOIUrl":"10.1016/j.acap.2025.102858","url":null,"abstract":"<div><h3>Objective</h3><div>Examine graduating pediatric residents’ preparedness to provide mental health care and examine program characteristics and mental health training experiences associated with such preparedness.</div></div><div><h3>Methods</h3><div>National random sample of 1000 US pediatric residency graduates from the 2022 American Academy of Pediatrics Annual Survey of Graduating Residents; 428/991 (43.2%) responded. Residents rated how well their program prepared them (5-point scale, “poor” to “excellent”) to care for children and adolescents with mental and behavioral health needs overall and 8 specific problems. Respondents provided residency program characteristics and indicated whether their continuity clinic had an on-site mental health professional and if they completed a psychiatry rotation. Multivariable logistic regression examined program characteristics and mental health training experiences associated with reported preparedness (“excellent” or “very good”) to care for patients with mental health needs overall.</div></div><div><h3>Results</h3><div>More than half of residents (51.4%) reported feeling prepared to care for mental health needs overall. Six in 10 felt prepared to care for patients with suicidal ideation or behavior (64.8%), low mood or depression (64.1%), inattention and impulsivity (59.0%), anxiety (57.2%), and signs of eating disorders (56.9%). Fewer felt prepared to address disruptive behavior and aggression (37.9%) and substance use (34.0%). Sixty-one percent had an on-site mental health professional; one third completed a psychiatry rotation. Those who had both of these training experiences were most likely to report feeling prepared.</div></div><div><h3>Conclusions</h3><div>Gaps remain in residents’ preparedness to provide mental health care, particularly around substance use and disruptive behavior and aggression.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 7","pages":"Article 102858"},"PeriodicalIF":3.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192479","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}