Publications by authors named "Dudovitz R"

Introduction: Lack of knowledge of Early Intervention (EI) is a barrier to developmental delay (DD) management. We aimed to examine the feasibility of measuring pediatricians' knowledge of EI, determine the distribution of EI knowledge, and determine factors associated with increased EI knowledge.

Methods: We conducted an exploratory cross-sectional study with a convenience sample from a local American Academy of Pediatrics chapter to administer a survey with 10 multiple-choice questions regarding the EI referral process, evaluation process, eligibility criteria and fee structure.

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COVID-19 highlighted the importance of schools for child health, as emerging data suggest that pandemic-related school closures may have led to worsening child health and exacerbated health disparities. This study examines school-aged children's well-being, and characterizes changes in school-related needs, from 2021 to 2022. This is a secondary analysis of a longitudinal cohort study, where a nationally representative sample of parents of school-aged children were surveyed in June 2021 and 2022.

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Background And Objectives: Early intervention services can improve outcomes for children with developmental delays. Health care providers, however, often struggle to ensure timely referrals and services. We tested the effectiveness of telephone-based early childhood developmental care coordination through 211 LA, a health and human services call center serving Los Angeles County, in increasing referral and enrollment in services.

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Background: Burnout among healthcare providers is a significant crisis in our healthcare system, especially in the context of the COVID-19 pandemic. The aim of this study was to understand what motivates healthcare workers and students to volunteer in their community as well as examine how volunteering relates to burnout. These findings can help health organizations better meet the needs of healthcare workers, as well as provide insights for non-profits that rely on volunteer professionals.

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Background: Environmental and social factors, including lack of access to asthma care, contribute to persistent inequities in asthma outcomes among children from historically marginalized ethnoracial groups. Telemedicine, which expanded rapidly during the coronavirus disease 2019 (COVID-19) pandemic, may be an approach to augment access to pediatric asthma care.

Objectives: We sought to describe characteristics of pediatric (0-17 years) telemedicine users with asthma and characterize use trends throughout the COVID-19 pandemic.

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Background: Studies suggest increasing mental health care needs among children but limited capacity to meet those needs, potentially leaving some needs unmet. There are no recent national studies examining the receipt of mental health treatment among children. We sought to identify the correlates of treatment receipt in a nationally representative sample of children in the United States.

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Introduction: Addressing persistent racial inequities in preterm birth requires innovative health care approaches. The Los Angeles County Maternity Assessment and Management Access Service Synergy Neighborhood program (MAMA's) is a perinatal medical home program designed to alleviate the impacts of chronic stress by addressing social determinants of health. It reduced odds of preterm birth rates in Black participants, yet it is unclear which program components most contributed to this reduction.

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Background: Positive childhood experiences PCEs) are supportive relationships and environments associated with improved health when aggregated into composite scores. Adverse childhood experiences (ACEs), a reciprocal measure to PCEs, are associated with worse health in aggregate scores when disaggregated into measures of specific ACE types (hereafter domains). Understanding the associations between specific PCE domains and health, while accounting for ACEs, may direct investigations and intervention planning to foster PCE exposure.

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Objectives: To better understand impacts of the COVID-19 pandemic and resulting economic and social disruptions on families, we analyzed qualitative data capturing perspectives from parents of young children.

Methods: This study analyzes interviews of parents of children aged 1-3.5 years at enrollment, recruited from four primary care systems serving mainly lower-income Hispanic families in Los Angeles, California.

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Importance: Intergenerational cycles of adversity likely increase one's risk of criminal legal system involvement, yet associations with potential contributors, such as parents' adverse childhood experiences (ACEs) and positive childhood experiences (PCEs), have not been explored.

Objective: To investigate the association of parents' ACEs and PCEs with their adult children's involvement in US legal systems, from arrest to conviction.

Design, Setting, And Participants: The study team analyzed data from the Panel Study of Income Dynamics (PSID), a nationally representative cohort study of families in the US.

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Purpose: School-based health centers (SBHCs) may mitigate barriers to health care access and improve students' academic outcomes, but few studies test this hypothesis. We examined whether school attendance improved after students received care at an SBHC.

Methods: We conducted a secondary analysis of data from 17 SBHCs affiliated with a single large urban school district and demographic and attendance data from SBHC users (N = 14,030) and nonusers (N = 230,046) from August 2015-February 2020.

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The study identifies factors that limit effective institutional responses to domestic violence (DV) in Kyrgyzstan, in the context of recent legislative actions aimed at reducing DV through improvements in law enforcement, judicial processes, and provision of social services. The study uses qualitative, grounded theory methods to analyze interviews and focus groups with 83 professionals working in these sectors. Two major themes emerge from the analysis: (1) barriers to effective institutional responses from internal challenges and constraints, and (2) social resources and challenges identified as important to provide a better collective response.

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The success of personal non-pharmaceutical interventions as a public health strategy requires a high level of compliance from individuals in private social settings. Strategies to increase compliance in these hard-to-reach settings depend upon a comprehensive understanding of the patterns and predictors of protective social behavior. Social cognitive models of protective behavior emphasize the contribution of individual-level factors while social-ecological models emphasize the contribution of environmental factors.

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Background: Some patterns of cannabis use may presage risk for long-term negative effects. We examined associations between a novel adolescent cannabis misuse scale and early-adult life course outcomes.

Methods: We performed a secondary data analysis of a cohort of Los Angeles, CA high school students from grade 9 through age 21.

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Purpose: School social support is associated with improved adolescent wellbeing. However, positive school relationships were potentially disrupted when schools transitioned to distance learning in 2020 to mitigate the spread of COVID-19. This study investigated associations among perceived distance learning school support, mental health, social-emotional wellbeing, substance use, and delinquency among low-income, public high school students.

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Objective: Expanding access to extracurricular activities (EA) may help address the growing mental health needs of children and caregivers. Evidence supports that EA may benefit child mental health, but few studies explore whether this association is influenced by child and EA factors. Further, the impact of EA on caregivers remains unknown.

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Background And Objectives: Academic tracking is a widespread practice, separating students by prior academic performance. Clustering lower performing students together may unintentionally reinforce risky peer social networks, school disengagement, and risky behaviors. If so, mixing lower performing with high performing youth ("untracking") may be protective, leading to better adolescent health.

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Background: Adolescent behaviors and academic outcomes are thought to be shaped by school climate. We sought to identify longitudinal associations between school climate measures and downstream health and academic outcomes.

Methods: Data from a longitudinal survey of public high school students in Los Angeles were analyzed.

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Importance: Interventions directly targeting social factors, such as education, may have the potential to greatly improve health.

Objective: To examine the association of attending a high-performing public charter high school with rates of substance use disorder and physical and mental health.

Design, Setting, And Participants: This cohort study used the random school admissions lottery system of high-performing public charter high schools in low-income neighborhoods of Los Angeles, California, to examine the health outcomes of students who applied to at least 1 of 5 of these high schools.

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"Bring Change 2 Mind" (BC2M) high school clubs may destigmatize mental illness among club members, but clubs' (1) reach and impact on non-club members at the same school, (2) connection to student help-seeking attitudes, and (3) mechanisms by which they destigmatize mental illness, are unknown. This community-partnered evaluation involved pre/post surveys of predominantly Latino (72%) students at three urban public schools and focus groups and interviews with a sample of club members (n = 26/65, 40%) and all club staff (n = 7, 100%). Multivariate regressions tested relationships between variables.

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Background: Youth are arrested at high rates in the United States; however, long-term health effects of arrest remain unmeasured. We sought to describe the sociodemographic characteristics and health of adults who were arrested at various ages among a nationally representative sample.

Methods: Using the National Longitudinal Study of Adolescent to Adult Health, we describe sociodemographics and health status in adolescence (Wave I, ages 12-21) and adulthood (Wave V, ages 32-42) for people first arrested at age younger than 14 years, 14 to 17 years, and 18 to 24 years, compared to never arrested adults.

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Background: Early childhood represents a sensitive developmental period when trauma-informed care may mitigate the effects of trauma on developmental and health outcomes. However, few interventions use a low-literacy scalable approach to improve child trauma knowledge and attitudes among parents and early childcare and education caregivers.

Methods: Representatives from 24 early head start (EHS) and head start (HS) agencies attended a 2 day online train-the trainer session and then delivered a child trauma and resilience training to staff at their sites, with the option to deliver a similar training to parents.

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Background: Little is known regarding utilization of school-based health centers (SBHCs) during prolonged school closures, such as those that occurred during the COVID-19 pandemic. We sought to compare SBHC utilization before and after pandemic-related school closures across a network of SBHCs affiliated with a large Southern Californian urban school district.

Methods: We conducted a secondary analysis of encounter data extracted from electronic health records from 12 SBHCs that remained open despite school closures, including patient demographics and diagnostic and billing codes.

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