Academic Pediatrics最新文献

{"title":"Sexual Identity Is Associated With Adverse Childhood Experiences in US Early Adolescents","authors":"Julia H. Raney MD ,&nbsp;Shayna Weinstein MPH ,&nbsp;Alexander Testa PhD ,&nbsp;Kyle T. Ganson PhD, MSW ,&nbsp;Zain Memon ,&nbsp;David V. Glidden PhD ,&nbsp;Fiona C. Baker PhD ,&nbsp;Claire D. Brindis DrPH ,&nbsp;Jason M. Nagata MD, MSc","doi":"10.1016/j.acap.2024.07.022","DOIUrl":"10.1016/j.acap.2024.07.022","url":null,"abstract":"<div><h3>Objective</h3><div>To determine disparities in adverse childhood experiences (ACEs) by sexual identity in a national cohort of early adolescents.</div></div><div><h3>Methods</h3><div>We analyzed cross-sectional data from year 2 of the Adolescent Brain Cognitive Development study (N = 10,934, 2018–20, ages 10–14 years). Disparities in ACE scores across lesbian, gay, or bisexual (LGB), not sure, and heterosexual adolescents were assessed using multinomial logistic regression analyses. Logistic regressions estimated the associations between sexual identity and each individual ACE. Analyses were adjusted for potential confounders.</div></div><div><h3>Results</h3><div>In adjusted models, LGB adolescents had a higher risk of experiencing 2, 3, or ≥4 ACEs (relative risk ratios [RRR] = 1.57, 95% Confidence Interval (CI) 1.01–2.42), 3 (RR = 1.78, 95% CI 1.100–2.88), or ≥4 ACEs (RRR = 3.20, 95% CI 1.92–5.32), and not sure adolescents had a higher risk of having ≥4 ACEs (RRR = 2.17, 95% CI 1.22–3.87), compared to heterosexual adolescents. LGB and not sure adolescents had higher risks of reporting emotional abuse (“yes” OR = 4.21, 95% CI 1.84–9.61; “maybe” OR = 6.20, 95% CI 2.91–13.19) and parent mental illness (“yes” OR = 1.95, 95% CI 1.48–2.57; “maybe” OR = 1.63, 95% CI 1.21–2.18) compared to heterosexual adolescents.</div></div><div><h3>Conclusions</h3><div>LGB adolescents and those questioning their sexual identity were at greater risk of having higher ACE scores, with LGB adolescents experiencing the highest risk of experiencing ACEs. LGB adolescents also had higher odds of reporting emotional and parent mental illness. Recognizing this heightened risk of ACEs in early adolescence is critical for designing clinic and school-based interventions.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 1","pages":"Article 102555"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972305","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":"A National Survey to Assess LGBTQ+ Curricular Needs in Pediatrics Residency Programs","authors":"Lauren T. Roth MD ,&nbsp;Pamela Carpenter MEd ,&nbsp;Alan Schwartz PhD, JD ,&nbsp;Brian Lurie MD, MPH","doi":"10.1016/j.acap.2024.07.016","DOIUrl":"10.1016/j.acap.2024.07.016","url":null,"abstract":"<div><h3>Objective</h3><div>Despite incremental increases in lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ+) health education, there are no uniform training requirements in graduate medical education and the extent to which pediatrics residency programs incorporate LGBTQ+ curricula remains unknown. We aimed to assess the current state of LGBTQ+ health education in pediatrics residency programs.</div></div><div><h3>Methods</h3><div>We surveyed all 202 Accreditation Council for Graduate Medical Education (ACGME)-accredited categorical pediatrics program directors (PDs) in the United States. PDs were contacted via the Association for Pediatrics Program Directors (APPD) listserv with a link to an anonymous electronic survey.</div></div><div><h3>Results</h3><div>We had a 53.4% response rate (107/202) with representation from all regions, sizes, and settings. Only 7.5% of programs have robust LGBTQ+ curricula, but many (71%) offer some sessions. About half (54.2%) believe their residents are not at all or somewhat prepared to care for LGBTQ+ patients after training. Many PDs are not at all or somewhat confident their residents learn about gender affirming care (49.5%) or are aware of community resources for LGBTQ+ youth (54.2%). In 91% of programs, 0–25% of faculty educate trainees about LGBTQ+ health. The majority (74.8%) of PDs are very or moderately likely to implement a standardized LGBTQ+ health curriculum. The most prominent barriers were inadequate time (55.1%) and lack of faculty training (51.4%).</div></div><div><h3>Conclusion</h3><div>Many pediatrics programs have implemented some LGBTQ+ health education; however, PDs lack confidence in residents’ abilities to independently care for LGBTQ+ youth after training. An accessible and standardized curriculum is not only needed but desired by programs.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 1","pages":"Article 102549"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890794","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":"CREATION AND EVALUATION OF A SIMULATION-BASED TRAINING CURRICULUM FOR PEDIATRIC INTERNS: ASSESSING AN ACUTELY ILL HOSPITALIZED CHILD","authors":"Sabina Qasim DO,&nbsp;Amber Hartman DO,&nbsp;Rhett Lieberman MD, UPMC,&nbsp;Kendra Woods MD","doi":"10.1016/j.acap.2024.102659","DOIUrl":"10.1016/j.acap.2024.102659","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 1","pages":"Article 102659"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143299367","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":"Innovation in Advanced Advocacy Training Through Clinician Partnerships with Institutional Government Relations","authors":"Amanda M. Stewart MD, MPH ,&nbsp;Joshua Greenberg JD ,&nbsp;Kate Warren Barnes MSW, MBA ,&nbsp;Ariel Winn MD","doi":"10.1016/j.acap.2024.06.010","DOIUrl":"10.1016/j.acap.2024.06.010","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 1","pages":"Article 102523"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447497","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":"Advancing Research on Mobile Screen Media and Young Children’s Cognitive Skills","authors":"Daniel Ewon Choe PhD,&nbsp;Aubrey B. Golden BA,&nbsp;Madeline R. Olwert BA","doi":"10.1016/j.acap.2024.06.018","DOIUrl":"10.1016/j.acap.2024.06.018","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 1","pages":"Article 102531"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141545426","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":"PROFESSIONAL DEVELOPMENT IN THE PROGRAM COORDINATOR POPULATION: MAKING A SOUND INVESTMENT IN A CRUCIAL ASSET","authors":"Meredith Feldman BS ,&nbsp;Amy Vezetti BA ,&nbsp;Veronica Sapp BS ,&nbsp;Joyce Stroud BS ,&nbsp;Kelly Maas MPHE, C-TAGME ,&nbsp;Danielle Harvey C-TAGME ,&nbsp;Denise Abels C-TAGME ,&nbsp;Christine Rockwell NA ,&nbsp;Nancy Baumgartner AA","doi":"10.1016/j.acap.2024.102640","DOIUrl":"10.1016/j.acap.2024.102640","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 1","pages":"Article 102640"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143293201","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":"EMBRACING DIVERSITY: A BLUEPRINT FOR INCLUSIVE RESIDENT HOLIDAY SCHEDULING","authors":"Melissa Rubin MD ,&nbsp;Shyam Desai MD ,&nbsp;Micha Thompson MD ,&nbsp;Nicole Meyers MD ,&nbsp;Suzanne Friedman MD ,&nbsp;Marina Catallozzi MD, MSCE","doi":"10.1016/j.acap.2024.102687","DOIUrl":"10.1016/j.acap.2024.102687","url":null,"abstract":"","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 1","pages":"Article 102687"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143286511","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":"Caregiver and Provider Perceptions of Health Disparities in the Neonatal Intensive Care Unit: A Qualitative Study","authors":"Yasmeen Midgette DO, MS ,&nbsp;Elizabeth Halvorson MD, MS ,&nbsp;Allison Chandler PhD ,&nbsp;Aylin Aguilar BS ,&nbsp;Ashley E. Strahley MPH ,&nbsp;Yorjannys Gomez BS ,&nbsp;Rebekah Lassiter ,&nbsp;Modupeola Akinola MBBS ,&nbsp;Shannon Hanson PhD ,&nbsp;Kimberly Montez MD, MPH","doi":"10.1016/j.acap.2024.07.015","DOIUrl":"10.1016/j.acap.2024.07.015","url":null,"abstract":"<div><h3>Objectives</h3><div>1) To describe the experience of caregivers and their perceptions of disparate care in the neonatal intensive care unit (NICU) and 2) explore interprofessional NICU provider perspectives on potential biases and perceptions of disparate care.</div></div><div><h3>Methods</h3><div>This qualitative study was conducted in 1 southeastern level IV NICU. Semistructured interviews assessed caregiver and provider perspectives on NICU care. Purposive sampling ensured ≥50% of caregivers self-identified as racial and/or ethnic minorities. Interviews were recorded, transcribed verbatim, and audio verified. A coding scheme was developed, raw data were systematically coded, and emerging themes were identified using thematic analyses.</div></div><div><h3>Results</h3><div>Twenty-three caregivers and 14 providers were interviewed, including 5 neonatologists, 6 nurses, and 3 residents. Caregivers were predominantly English-speaking (85%); 96% were mothers with a mean age of 32 years. Neonates were predominantly racial and ethnic minorities (62%). Providers were predominantly White (71%) and female (71%). Five themes emerged 1) ineffective, biased communication between caregivers, providers, and health care team may contribute to disparities; 2) language barriers and lack of interpreter access play a significant role in perceived negative care; 3) lack of caregiver involvement and role in decision-making may negatively influence NICU outcomes, especially for those not able to be present at the bedside; and 4) multiple biases may affect neonatal health disparities.</div></div><div><h3>Conclusions</h3><div>Our study highlights the importance of considering both provider and racial and/or ethnic minority caregiver perceptions disparities in NICU care delivery. It adds to the literature as one of the few qualitative studies comparing perceptions of disparate NICU care among both caregivers and providers.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 1","pages":"Article 102548"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789790","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":"Differences in the Oral Health of Children With Medical Complexity","authors":"Kristina E. Malik MD ,&nbsp;Sharon Scarbro MS ,&nbsp;Justin Yu MD, MS ,&nbsp;Katherine Chin DDS, MS ,&nbsp;Patricia A. Braun MD, MPH ,&nbsp;James A. Feinstein MD, MPH","doi":"10.1016/j.acap.2024.07.019","DOIUrl":"10.1016/j.acap.2024.07.019","url":null,"abstract":"<div><h3>Objective</h3><div>Children with medical complexity (CMC), a subgroup of children with special health care needs (CSHCN) with the most serious medical conditions and disabilities, are at risk for negative effects from poor oral health. CSHCN have high rates of poor oral health, including cavities. This study aimed to compare oral health status between CMC and CSHCN.</div></div><div><h3>Methods</h3><div>This was a cross-sectional analysis of the 2016–17 National Survey of Child Health data. CMC and CSHCN were identified using validated algorithms. The primary outcome was oral health status; secondary outcomes included dental service use. Bivariate analyses compared the prevalence and service use by medical complexity status. Multivariable logistic regression assessed oral health outcomes by complexity, adjusting for influencing variables.</div></div><div><h3>Results</h3><div>Of 16,178 CSHCN ages 1 to 17 years, 6% were CMC and 94% were non-CMC CSHCN. Compared to CSHCN, CMC had a higher prevalence of fair/poor teeth conditions (19% vs 9%; <em>P</em> &lt; 0.001) and higher odds for fair/poor teeth conditions after adjusting for socioeconomic factors (adjusted odds ratio [aOR]: 1.54; 95% confidence interval [CI]: 1.01–2.34). There was no statistically significant difference between groups when assessing cavities, toothache, or receipt of most preventive dental services.</div></div><div><h3>Conclusions</h3><div>One in 5 CMC are reported by caregivers as having poor oral health, including cavities, despite high rates of receiving preventive dental services. After adjusting for socioeconomic factors, medical complexity remained associated with fair or poor teeth conditions<strong>.</strong> Understanding potentially modifiable targets could further help families of CMC prioritize dental needs and potentially reduce negative effects on overall health.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 1","pages":"Article 102552"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890795","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":"Piloting Home Produce Delivery to Improve Food Security, Budget, and Diet in Families with Children: A Mixed-Methods Study","authors":"Laura M. Plencner MD ,&nbsp;Janet Nalubega Ross PhD ,&nbsp;Matthew Hall PhD ,&nbsp;Emily A. Hurley PhD ,&nbsp;Jean L. Raphael MD ,&nbsp;Evelyn Donis De Miranda MPA ,&nbsp;Jeffrey D. Colvin MD, JD","doi":"10.1016/j.acap.2024.07.017","DOIUrl":"10.1016/j.acap.2024.07.017","url":null,"abstract":"<div><h3>Background</h3><div>Few children in food insecure (FI) households meet dietary recommendations for fruit and vegetables (“produce”). Barriers include affordability, accessibility, and desirability. Home produce delivery may reduce FI, increase produce consumption, and decrease budget tradeoffs.</div></div><div><h3>Objective</h3><div>Evaluate the acceptability and potential impact of delivering produce through home visiting programs on FI, diet, and budget tradeoffs.</div></div><div><h3>Methods</h3><div>In this prospective pre/post mixed methods study, 51 parents engaged in home visiting programs were enrolled. Participants completed pre- and post-program surveys on FI (18-item Food Security Scale), produce consumption, and budget tradeoffs. Pre- and post-surveys were compared using McNemar’s test and weighted kappas. Interview guides were based on Social Cognitive Theory and a previously published framework. Interviews were conducted in English or Spanish; thematic analysis was completed.</div></div><div><h3>Results</h3><div>Twenty-nine (56.9%) participants completed both surveys. Most were female (96.3%) and Hispanic (79.3%) (Table 1). Food security improved in the post-period, with more participants reporting high food security (pre: 6.9%, post: 31.0%) and fewer reporting very low food security (pre: 20.7%, post: 6.9%, <em>P</em> &lt; 0.01) (Table 2). Budgetary tradeoffs decreased in the post-program period (pre: 71.4%, post: 48.1%, <em>P</em> = 0.03). Fifteen participants were interviewed. Themes included 1) saved money, 2) increased fruit and vegetable consumption, and 3) interest in future participation.</div></div><div><h3>Conclusion</h3><div>This pilot study found that an intervention for delivery of produce through home visiting programs was acceptable to participants and resulted in potential improvements in FI and household budgets. This supports future studies to further explore the impact of this novel intervention.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 1","pages":"Article 102550"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890797","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}