The intersectionality of professional and personal identity formation in a virtual pre-health pathway program.

Background And Purpose: To describe the development and implementation of professional and personal identity formation content in a virtual pre-health pathway program.

Educational Activity And Setting: Content within a six-week pre-health program for underrepresented and/or disadvantaged college students was redesigned to a virtual format with enhanced focus on professional and personal identity formation. Sessions on personal identity formation were also enhanced through a partnership with local mental health clinicians specializing in trauma-informed care and culturally relevant practices and strategies.

Use of the Child Opportunity Index to Examine Racial Variations in Outpatient Antibiotic Prescribing to Children.

To examine further racial and ethnic variations in antibiotic prescribing to children, we used the Child Opportunity Index. Black children were less likely to be prescribed an antibiotic. Low- and moderate-opportunity areas were associated with greater rates of antibiotic prescribing, after adjusting for race and other factors.

Preparing the Bowel (Microbiome) for Surgery: Surgical Bioresilience.

The preparation of the bowel for radical surgery is a corner stone of elective colorectal practice. The evidence for this intervention is of variable quality and it is often contradictory, yet there is now a global move toward the adoption of oral antibiotic therapy for the reduction of perioperative infective complications, such as surgical site infections. The gut microbiome is a critical mediator of the systemic inflammatory response to surgical injury, wound healing, and perioperative gut function.

Antipsychotic Medications for Low-Income Preschoolers: Long Duration and Psychotropic Medication Polypharmacy.

Objective: This study aimed to evaluate prescribing patterns of antipsychotic medication and factors that predict duration of use among low-income, preschool-age children.

Methods: State Medicaid claims from 2012 to 2017 were used to identify antipsychotic medication use for children <6 years old. and codes were used to describe child diagnoses.

Recommendations and Guidelines for the Use of Simulation to Address Structural Racism and Implicit Bias.

Simulation-based education is a particularly germane strategy for addressing the difficult topic of racism and implicit bias due to its immersive nature and the paradigm of structured debriefing. Researchers have proposed actionable frameworks for implicit bias education, particularly outlining the need to shift from recognition to transformation, with the goal of changing discriminatory behaviors and policies. As simulation educators tasked with training health care professionals, we have an opportunity to meet this need for transformation.

High-level psychotropic polypharmacy: a retrospective comparison of children in foster care to their peers on Medicaid.

Background: The use of antipsychotic medication and psychotropic polypharmacy has increased in the United States over the last two decades especially for children from low-income families and those in foster care. Although attention has been paid to providing greater insight, prescribing patterns remain concerning since there is a lack of evidence related to safety and efficacy. High-level psychotropic polypharmacy has not been described.

Disparities in ADHD Diagnosis and Treatment by Race/Ethnicity in Youth Receiving Kentucky Medicaid in 2017.

Background: Kentucky has among the highest rate of attention deficit/hyperactivity disorder (ADHD) and stimulant use in the United States. Little is known about this use by race/ethnicity and geography. This article describes patterns of diagnosis of ADHD and receipt of stimulants and psychosocial interventions for children aged 6-17 years receiving Kentucky Medicaid in 2017 and identifies factors associated with diagnosis and treatment.

Trends in diagnosis of bipolar and disruptive mood dysregulation disorders in children and youth.

Objective: Rates of pediatric bipolar disorders have increased and some are concerned about diagnostic accuracy. Disruptive mood dysregulation disorder (DMDD) was added to the DSM-5 in 2013. The purpose of this study was to assess diagnostic trends of bipolar disorders and DMDD and to identify predictors of receiving the DMDD diagnosis since implementation of DSM-5.

Culturally Effective Care for Refugee Populations: Interprofessional, Interactive Case Studies.

Introduction: Within health sciences education literature, the majority of reported student experiences with refugee populations are limited to traditional, professionally independent, elective courses and extracurricular volunteer opportunities. A simulated patient exercise is a learning opportunity that helps participants engage with material in real time in a realistic environment, demanding higher levels of learning. This session utilized a simulated patient facilitator in interprofessional small groups to explore common health needs and barriers to care among refugee populations.

Longitudinal Trends in the Diagnosis of Attention-Deficit/Hyperactivity Disorder and Stimulant Use in Preschool Children on Medicaid.

Objectives: To describe trends in the diagnosis of attention-deficit/hyperactivity disorder (ADHD) and prescribing of stimulants in preschool-age children receiving Medicaid and to identify factors associated with the receipt of psychosocial care.

Study Design: Data were extracted from 2012-2016 Kentucky Medicaid claims for children aged <6 years. ADHD was identified using International Classification of Diseases, Tenth Revision codes F90.

Engaging the Transgender Community to Improve Medical Education and Prioritize Healthcare Initiatives.

Unlabelled: Phenomenon: Transgender patients experience discrimination, limited access to care, and inadequate provider knowledge in healthcare settings. Medical education to address transgender-specific disparities is lacking. Research that engages transgender community members may help address health disparities by empowering patients, increasing trust, and informing medical curricula to increase competence.

Changes in medical student implicit attitudes following a health equity curricular intervention.

Purpose: This study assessed the: (1) effect of an LGBTQI + health equity curriculum (eQuality) on implicit attitudes among first (M1) and second year (M2) medical students and (2) utility of dedicated time to explore implicit bias.

Method: Implicit biases were assessed at baseline using implicit association tests (IAT) for all M2s and a random sample of first years (M1A). These students were then debriefed on strategies to mitigate bias.

Interprofessional LGBT Health Equity Education for Early Learners.

Introduction: The eQuality project at the University of Louisville aims to train future physicians to deliver equitable quality care for all people by creating an integrated educational model utilizing the competencies identified in the AAMC's . This foundational interprofessional health equity session for early learners addresses knowledge and attitude milestones relating to interprofessional collaboration, professionalism, and systems-based practice competencies for lesbian, gay, bisexual, and transgender (LGBT) populations.

Methods: First-year medical students were assigned to interprofessional teams of approximately 10 health sciences students each.

Mental Health Issues in Foster Care.

Children in foster care have exceptional needs due to their histories of abuse, neglect, and increased exposure to violence. The rates of psychiatric symptoms and disorders, such as attention-deficit/hyperactivity disorder, posttraumatic stress disorder, and reactive attachment disorder, are much higher in children in foster care; furthermore, the rate of these children receiving psychotropic medications is 3 times that of children who are not in foster care. Pediatricians, in their role of providing a medical home, play a central role in safeguarding the physical and mental health of these children.

The Role of Stigma in Parental Help-Seeking for Perceived Child Behavior Problems in Urban, Low-Income African American Parents.

Significant numbers of children have diagnosable mental health problems, but only a small proportion of them receive appropriate services. Stigma has been associated with help-seeking for adult mental health problems and for Caucasian parents. The current study aims to understand factors, including stigma, associated with African American parents' help-seeking behavior related to perceived child behavior problems.

First We Have to Engage Them: A Mixed Methods Assessment of Low-Income Parents' Preferences for and Barriers to Receiving Child Health Promotion Information.

Introduction: The aim of this study is to understand low-income parents' preferences for and barriers to receiving child health promotion information.

Methods: A mixed-methods approach was used. Data were collected in an urban pediatric primary care setting serving predominantly low-income African American families.

Health promotion in pediatric primary care: importance of health literacy and communication practices.

Health literacy has been shown to predict health behaviors and outcomes above the effects of education or socioeconomic status. Much remains unknown about the health literacy of parents and the role it plays in children's health outcomes or in health disparities. The current study explored the health communication needs and health literacy indicators in a diverse sample of parents (n = 75) to identify potential areas for future interventions.

An exploratory study of 2 parenting styles and family health behaviors.

Objective: To examine the relationships between 2 parenting styles and family nutrition and physical activity.

Methods: Parents of elementary/primary school children in the southeastern United States (N = 145) completed surveys regarding family relationships and health behaviors.

Results: Parents exhibiting a laissez-faire parenting style reported lower levels of family nutrition and physical activity.

Evaluation of an innovative tool for child sexual abuse education.

Child sexual abuse poses a serious threat to public health and is often unreported, unrecognized, and untreated. Prevention, early recognition, and treatment are critically important to reduce long-term effects. Little data are available on effective methods of preventing child sexual abuse.