Academic Pediatrics最新文献

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Advancing Research on Mobile Screen Media and Young Children’s Cognitive Skills 推进移动屏幕媒体与幼儿认知技能的研究。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2025-01-01 DOI: 10.1016/j.acap.2024.06.018

Daniel Ewon Choe PhD, Aubrey B. Golden BA, Madeline R. Olwert BA

引用次数: 0

PROFESSIONAL DEVELOPMENT IN THE PROGRAM COORDINATOR POPULATION: MAKING A SOUND INVESTMENT IN A CRUCIAL ASSET

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2025-01-01 DOI: 10.1016/j.acap.2024.102640

Meredith Feldman BS , Amy Vezetti BA , Veronica Sapp BS , Joyce Stroud BS , Kelly Maas MPHE, C-TAGME , Danielle Harvey C-TAGME , Denise Abels C-TAGME , Christine Rockwell NA , Nancy Baumgartner AA

引用次数: 0

EMBRACING DIVERSITY: A BLUEPRINT FOR INCLUSIVE RESIDENT HOLIDAY SCHEDULING

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2025-01-01 DOI: 10.1016/j.acap.2024.102687

Melissa Rubin MD , Shyam Desai MD , Micha Thompson MD , Nicole Meyers MD , Suzanne Friedman MD , Marina Catallozzi MD, MSCE

引用次数: 0

Caregiver and Provider Perceptions of Health Disparities in the Neonatal Intensive Care Unit: A Qualitative Study 护理人员和医护人员对新生儿重症监护室健康差异的看法：定性研究。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2025-01-01 DOI: 10.1016/j.acap.2024.07.015

Yasmeen Midgette DO, MS , Elizabeth Halvorson MD, MS , Allison Chandler PhD , Aylin Aguilar BS , Ashley E. Strahley MPH , Yorjannys Gomez BS , Rebekah Lassiter , Modupeola Akinola MBBS , Shannon Hanson PhD , Kimberly Montez MD, MPH

Objectives

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.

Methods

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.

Results

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.

Conclusions

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.

目标：描述护理人员的经历及其对新生儿重症监护病房差异化护理的看法；(2) 探讨新生儿重症监护病房跨专业医护人员对潜在偏见和差异化护理看法的看法：这项定性研究在东南部一家四级新生儿重症监护病房进行。半结构式访谈评估了护理人员和医疗服务提供者对新生儿重症监护病房护理的看法。有目的的抽样确保≥50%的护理人员自我认同为少数种族和/或少数族裔。对访谈进行了录音、逐字记录和音频验证。结果：23 名护理人员和 14 名医疗服务提供者接受了访谈，其中包括 5 名新生儿科医生、6 名护士和 3 名住院医师。护理人员主要讲英语（85%）；96%为母亲，平均年龄为 32 岁。新生儿主要是少数民族（62%）。护理人员主要为白人（71%）和女性（71%）。研究提出了五个主题：（1）护理人员、医疗服务提供者和医疗团队之间无效的、有偏见的沟通可能会导致差异的产生；（2）语言障碍和缺乏口译人员在感知负面护理方面起着重要作用；（3）缺乏护理人员的参与和在决策中的作用可能会对新生儿重症监护室的结果产生负面影响，尤其是那些不能在床边的护理人员；以及（4）多种偏见可能会影响新生儿的健康差异：我们的研究强调了在新生儿重症监护室提供护理服务时同时考虑提供者和种族及/或少数民族护理人员认知差异的重要性。作为为数不多的比较护理人员和医疗服务提供者对新生儿重症监护室护理差异的看法的定性研究之一，本研究为相关文献增添了新的内容。

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引用次数: 0

Differences in the Oral Health of Children With Medical Complexity 医疗复杂性儿童口腔健康的差异。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2025-01-01 DOI: 10.1016/j.acap.2024.07.019

Kristina E. Malik MD , Sharon Scarbro MS , Justin Yu MD, MS , Katherine Chin DDS, MS , Patricia A. Braun MD, MPH , James A. Feinstein MD, MPH

Objective

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.

Methods

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.

Results

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%; P < 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.

Conclusions

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. Understanding potentially modifiable targets could further help families of CMC prioritize dental needs and potentially reduce negative effects on overall health.

目标：有医疗复杂性的儿童（CMC）是有特殊健康护理需求的儿童（CSHCN）中的一个子群体，他们有最严重的医疗状况和残疾，有因口腔健康不良而受到负面影响的风险。CSHCN 的口腔健康不良率很高，包括龋齿。本研究旨在比较儿童医护人员（CMC）和儿童保健工作者（CSHCN）的口腔健康状况：这是对 2016-17 年全国儿童健康调查数据的横断面分析。使用经过验证的算法确定了 CMC 和 CSHCN。主要结果是口腔健康状况；次要结果包括牙科服务使用情况。双变量分析比较了医疗复杂性状况的患病率和服务使用情况。多变量逻辑回归根据复杂性评估口腔健康结果，并对影响变量进行调整：在 16178 名 1-17 岁的 CSHCN 中，6% 为 CMC，94% 为非 CMC CSHCN。结论：尽管接受预防性牙科服务的比例很高，但每五名儿童保健工作者中就有一人口腔健康状况较差，包括龋齿。在对社会经济因素进行调整后，医疗复杂性仍与牙齿状况一般或较差有关。了解潜在的可改变目标可以进一步帮助 CMC 家庭优先考虑牙科需求，并有可能减少对整体健康的负面影响。

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引用次数: 0

Piloting Home Produce Delivery to Improve Food Security, Budget, and Diet in Families with Children: A Mixed-Methods Study 试行家庭农产品配送以改善有子女家庭的食品安全、预算和饮食：混合方法研究。

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2025-01-01 DOI: 10.1016/j.acap.2024.07.017

Laura M. Plencner MD , Janet Nalubega Ross PhD , Matthew Hall PhD , Emily A. Hurley PhD , Jean L. Raphael MD , Evelyn Donis De Miranda MPA , Jeffrey D. Colvin MD, JD

Background

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.

Objective

Evaluate the acceptability and potential impact of delivering produce through home visiting programs on FI, diet, and budget tradeoffs.

Methods

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.

Results

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%, P < 0.01) (Table 2). Budgetary tradeoffs decreased in the post-program period (pre: 71.4%, post: 48.1%, P = 0.03). Fifteen participants were interviewed. Themes included 1) saved money, 2) increased fruit and vegetable consumption, and 3) interest in future participation.

Conclusion

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.

背景：食物无保障（FI）家庭中很少有儿童能达到水果和蔬菜（"农产品"）的膳食建议。其中的障碍包括经济承受能力、可及性和可取性。送农产品到家可以减少食物无保障家庭，增加农产品消费，减少预算权衡：评估通过家访计划提供农产品对家庭收入、饮食和预算权衡的可接受性和潜在影响：在这项前瞻性的前后混合方法研究中，有 51 名参与家访项目的家长报名参加。参加者在项目前后完成了有关 FI（18 项粮食安全量表）、农产品消费和预算权衡的调查。使用 McNemar 检验和加权卡方对前后调查进行比较。访谈指南以社会认知理论和之前发布的框架为基础。访谈以英语或西班牙语进行，并完成了主题分析：29名参与者（56.9%）完成了两项调查。大多数参与者为女性（96.3%）和西班牙裔（79.3%）（表 1）。调查后，食品安全状况有所改善，报告食品安全状况良好的参与者人数增加（调查前：6.9%，调查后：31.0%），报告食品安全状况极差的参与者人数减少（调查前：20.7%，调查后：6.9%，p＜0.05）：6.9%，p 结论：这项试点研究发现，通过家访计划提供农产品的干预措施可以为参与者所接受，并有可能改善食物安全指数和家庭预算。新内容：在这项前瞻性的混合方法试点研究中，家庭配送农产品是可以接受和可行的，并有可能改善食品安全和家庭预算；农产品消费的潜在变化证据不一。预算权衡的变化是食品计划的一项新成果。

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引用次数: 0

WHAT DETERS MEDICAL STUDENTS FROM PURSUING A CAREER IN PEDIATRICS?

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2025-01-01 DOI: 10.1016/j.acap.2024.102643

Christopher Chow-Parmer MD , Kim Hoang MD , Lynne Huffman MD

引用次数: 0

Maternal Education and Child Self-Regulation: Do Maternal Self-Regulation and Responsiveness Mediate the Association? 母亲教育与儿童自我调节：母亲的自我调节和反应能力是否能调节两者之间的关系？

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

Pub Date : 2025-01-01 DOI: 10.1016/j.acap.2024.03.012

Bisola E. Duyile PhD , Jennifer LoCasale-Crouch PhD , Tessa B. NeSmith MS, MEd , Khara L.P. Turnbull PhD , Eve Colson MD , Michael J. Corwin MD , Mayaris Cubides Mateus PhD , Emma Forbes MPH , Nicole Geller MPH , Tim Heeren PhD , Fern R. Hauck MD , Brianna Jaworski BS , Ann Kellams MD , Stephen Kerr MPH , Rachel Y. Moon MD

Objective

To examine the mediating role of observed maternal responsiveness and maternal self-regulation on the association between maternal education and children’s self-regulation.

Methods

English-speaking mother-child dyads (n = 189) were recruited from a previous study and were eligible if the child was kindergarten eligible at the start of the 2020 to 2021 or 2021 to 2022 school year. Key measures included: Difficulties in Emotion Regulation Scale—Short Form for maternal emotional self-regulation, Culturally Affirming and Responsive Experiences for maternal responsiveness, and the Head-Toes-Knees-Shoulders for child self-regulation. The association between years of maternal education and child self-regulation was examined with linear regression, and the mediation analyses utilized 4 subsequent steps examining their relations. These steps were checked through a series of linear regressions, and beta weights were used to describe associations. Each potential mediator was examined separately.

Results

Children of mothers with higher education had significantly higher self-regulation, slope of 1.3 (95% confidence interval 0.3, 2.4, P = 0.015, beta = 0.18). Further, mothers with higher education had significantly higher observed responsiveness. The beta-weight of 0.34 (P < 0.001) supported maternal responsiveness as a mediator. Finally, in the test for direct and indirect effects, observed maternal responsiveness explained 29% (95% confidence interval 3.3%, 115%) of the association between maternal education and child self-regulation.

Conclusions

This study highlights a key mechanism related to children’s self-regulation skills and the significant role of observed maternal responsiveness in explaining the association between maternal education and child self-regulation.

研究观察到的母亲反应能力和母亲自我调节能力对母亲教育和儿童自我调节能力之间关联的中介作用。从之前的一项研究中招募了讲英语的母子二人组（n=189），如果孩子在 2020-2021 学年或 2021-2022 学年开始时符合上幼儿园的条件，则符合条件。主要测量指标包括(DERS-SF) 表示母亲的情绪自我调节能力，(CARE) 表示母亲的反应能力，(HTKS) 表示儿童的自我调节能力。通过线性回归分析了母亲受教育年限与儿童自我调节之间的关系，随后通过四个步骤对两者之间的关系进行了中介分析。这些步骤通过一系列线性回归进行检验，并使用贝塔权重来描述两者之间的关联。每个潜在的中介因素都分别进行了研究。母亲教育程度较高的儿童的自我调节能力明显较强，斜率为 1.3（95% CI 0.3，2.4，p=0.015，β=0.18）。此外，教育程度较高的母亲的观察反应性也明显较高。贝塔权重为 0.34（p<0.001），支持母亲反应性作为中介因素。最后，在直接和间接效应检验中，观察到的母亲反应性解释了母亲教育与儿童自我调节之间关联的 29% （95% CI 3.3%，115%）。这项研究强调了与儿童自我调节能力有关的一个关键机制，以及观察到的母亲反应性在解释母亲教育与儿童自我调节之间的关联方面所起的重要作用。本研究的分析表明，在母亲教育与儿童自我调节之间的关系中，起中介作用的是观察到的母亲反应能力，而不是母亲报告的自我调节能力。

{"title":"Maternal Education and Child Self-Regulation: Do Maternal Self-Regulation and Responsiveness Mediate the Association?","authors":"Bisola E. Duyile PhD , Jennifer LoCasale-Crouch PhD , Tessa B. NeSmith MS, MEd , Khara L.P. Turnbull PhD , Eve Colson MD , Michael J. Corwin MD , Mayaris Cubides Mateus PhD , Emma Forbes MPH , Nicole Geller MPH , Tim Heeren PhD , Fern R. Hauck MD , Brianna Jaworski BS , Ann Kellams MD , Stephen Kerr MPH , Rachel Y. Moon MD","doi":"10.1016/j.acap.2024.03.012","DOIUrl":"10.1016/j.acap.2024.03.012","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the mediating role of observed maternal responsiveness and maternal self-regulation on the association between maternal education and children’s self-regulation.</div></div><div><h3>Methods</h3><div>English-speaking mother-child dyads (n = 189) were recruited from a previous study and were eligible if the child was kindergarten eligible at the start of the 2020 to 2021 or 2021 to 2022 school year. Key measures included: <em>Difficulties in Emotion Regulation Scale</em>—<em>Short Form</em> for maternal emotional self-regulation, <em>Culturally Affirming and Responsive Experiences</em> for maternal responsiveness, and the <em>Head-Toes-Knees-Shoulders</em><span> for child self-regulation. The association between years of maternal education and child self-regulation was examined with linear regression, and the mediation analyses utilized 4 subsequent steps examining their relations. These steps were checked through a series of linear regressions, and beta weights were used to describe associations. Each potential mediator was examined separately.</span></div></div><div><h3>Results</h3><div>Children of mothers with higher education had significantly higher self-regulation, slope of 1.3 (95% confidence interval 0.3, 2.4, <em>P</em> = 0.015, beta = 0.18). Further, mothers with higher education had significantly higher observed responsiveness. The beta-weight of 0.34 (<em>P</em> < 0.001) supported maternal responsiveness as a mediator. Finally, in the test for direct and indirect effects, observed maternal responsiveness explained 29% (95% confidence interval 3.3%, 115%) of the association between maternal education and child self-regulation.</div></div><div><h3>Conclusions</h3><div>This study highlights a key mechanism related to children’s self-regulation skills and the significant role of observed maternal responsiveness in explaining the association between maternal education and child self-regulation.</div></div>","PeriodicalId":50930,"journal":{"name":"Academic Pediatrics","volume":"25 1","pages":"Article 102484"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140181884","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}

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IF 3 3区医学 Q1 PEDIATRICS

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IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics

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Taylor Kaldenberg BS, Marisa Roman MD, Amanda Rogers MD, Erwin Cabacungan MD, Kris Saudek MD

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