Racial, Ethnic, and Language Inequities in Ambulatory Pediatrics Patient Family Experience.

Objective: To determine the association of patient race, patient-provider racial congruence, patient ethnicity, and family primary language with patient family experience (PFE) survey responses.

Methods: Cross-sectional review of PFE survey responses from all ambulatory medical encounters at a large, urban children's hospital system June 1, 2020-May 31, 2022. Exposures were patient race, patient-provider racial congruence, patient ethnicity, and family primary language.

"Racism Happens Every Day, All the Time": Black Families' Outpatient Experiences of Racism Across a Large Pediatric System.

Objective: To qualitatively understand and characterize the experience of racism in outpatient pediatric healthcare settings from the perspectives of Black families.

Methods: We conducted focus groups with parents or guardians of Black children, recruited from academic primary care offices at a single pediatric institution. Focus groups were facilitated virtually by Black team members using an open-ended, semi-structured focus group guide.

The Impact of Structural Racism on Continuity of Care at Pediatric Academic Primary Care Clinics.

Objective: Using a structural racism framework, we assessed racial inequities in continuity of care, using the Usual Provider Continuity Index (UPC - the proportion of visits with the provider the patient saw most frequently out of all visits), in a set of large pediatric academic clinics.

Methods: We conducted a retrospective cohort study. Patients 12-24 months seen at three pediatric academic primary care clinics for any visit during October 1-31, 2021 were included.

Causal Mediation of Neighborhood-Level Pediatric Hospitalization Inequities.

Background And Objectives: Population-wide racial inequities in child health outcomes are well documented. Less is known about causal pathways linking inequities and social, economic, and environmental exposures. Here, we sought to estimate the total inequities in population-level hospitalization rates and determine how much is mediated by place-based exposures and community characteristics.

Racial Inequities in Palliative Referral for Children with High-Intensity Neurologic Impairment.

Objective: To evaluate whether racial and socioeconomic inequities in pediatric palliative care utilization extend to children with high-intensity neurologic impairment (HI-NI), which is a chronic neurological diagnosis resulting in substantial functional morbidity and mortality.

Study Design: We conducted a retrospective study of patients with HI-NI who received primary care services at a tertiary care center from 2014 through 2019. HI-NI diagnoses that warranted a palliative care referral were identified by consensus of a multidisciplinary team.

Voter Participation is Associated with Child Health Outcomes at the Population Level.

Civic engagement, including voting, has been linked to health outcomes for adults. Here, we found that census tract-level voter participation rates are significantly associated with pediatric inpatient bed-day rates even after adjustment for socioeconomic deprivation. Such links suggest that promotion of voting participation could be warranted in healthcare settings.

Area-Level Socioeconomic Factors Are Associated With Noncompletion of Pediatric Preventive Services.

We examined 4872 infants born consecutively, 2011-2012, and seen at 3 primary care centers to determine whether area-based socioeconomic measures were associated with noncompletion of common preventive services within the first 15 months. Addresses were geocoded and linked to census tract poverty, adult educational attainment, and household vehicle ownership rates. The quartile of patients in the highest poverty (adjusted odds ratio [aOR] 1.

Increased frequency of dietitian visits is associated with improved body mass index outcomes in obese youth participating in a comprehensive pediatric weight management program.

Background: Comprehensive weight management (CWM) interventions are most effective for obese youth when they include multiple components, such as nutrition, physical activity, and behavioral strategies. However, effectiveness of different approaches to delivering the nutrition component is unknown. Our aim was to evaluate two dietary approaches and extent of registered dietitian (RD) involvement on outcomes of obese youth participating in a CWM program.