Incorporating Climate Change Education Into Residency: A Focus on Community Risks and Resources.

Background: Graduate medical education (GME) focused on climate change (CC) health effects is essential. However, few CC education evaluations exist to guide residency programs looking to implement CC content.

Objective: To evaluate the effect of an education session on residents' self-reported knowledge of CC health effects and confidence utilizing local CC anticipatory guidance and community resources with patients.

Implementing Inpatient Social Needs Screening in an Urban Tertiary Care Children's Hospital.

Background And Objectives: The American Academy of Pediatrics recommends screening for unmet social needs, and the literature on inpatient screening implementation is growing. Our aim was to use quality improvement methods to implement standardized social needs screening in hospitalized pediatric patients.

Methods: We implemented inpatient social needs screening using the Model for Improvement.

Consensus on Social Determinants of Health Knowledge Topics and Behavior Learning Goals Across Primary Care Residencies: Results of a Delphi Study.

Purpose: Social determinants of health (SDH) are a substantial contributor to health outcomes and health inequities across populations. The Accreditation Council for Graduate Medical Education has called for the incorporation of SDH into graduate medical education (GME), yet there is no consensus on what SDH knowledge or skills residents in primary care specialties should have on completion of training. The aim of this study was to develop expert consensus on the most important SDH knowledge topics and behavior learning goals for residents in 4 primary care fields.

Pediatric primary care and subspecialist providers' comfort, attitudes and practices screening and referring for social determinants of health.

Background: Early detection and management of poverty-related disorders is a recommended pediatric practice; however, little is known about variations of practice between pediatric primary care physicians and subspecialists. The objectives of this study were to assess (1) provider perceptions and attitudes toward caring for low-income children in an urban academic medical center, and (2) variations between primary care physicians and subspecialists in social and financial needs screening and referral practices for low-income children.

Design/methods: Primary care providers (pediatric and family medicine) and subspecialists providing direct patient care in an urban academic medical center (response rate = 24 %, n = 85/356) completed a 24-item survey (adapted with permission from the AAP Periodic Survey of Fellows No.

"Increasing Warm Handoffs: Optimizing Community Based Referrals in Primary Care Using QI Methodology".

Social and environmental factors have an outsized effect on one's health. Children are particularly impacted by the adverse effects of poverty. While social determinants of health (SDH) screening in healthcare settings has proliferated there remain gaps in best practices for screening processes.

Unmet Social Needs and No-Show Visits in Primary Care in a US Northeastern Urban Health System, 2018-2019.

To characterize the association between social needs prevalence and no-show proportion and variation in these associations among specific social needs. In this study, we used results from a 10-item social needs screener conducted across 19 primary care practices in a large urban health system in Bronx County, New York, between April 2018 and July 2019. We estimated the association between unmet needs and 2-year history of missed appointments from 41 637 patients by using negative binomial regression models.

Integrating Social Needs Screening and Community Health Workers in Primary Care: The Community Linkage to Care Program.

Clinic-based social needs screening has been associated with increased access to social services and improved health outcomes. Using a pragmatic study design in an urban pediatric practice, we used logistic regression to identify factors associated with successful social service uptake. From December 2017 to November 2018, 4948 households were screened for social needs, and 20% self-reported at least one.

From Policy Statement to Practice: Integrating Social Needs Screening and Referral Assistance With Community Health Workers in an Urban Academic Health Center.

Social and economic factors have been shown to affect health outcomes. In particular, social determinants of health (SDH) are linked to poor health outcomes in children. Research and some professional academies support routine social needs screening during primary care visits.

CORNET Card Study #1: Do You See What I See? Provider Confidence in Caring for Children With Special Health Care Needs.

Objective: Understanding differences between trainee and faculty experience with and confidence caring for children with special health care needs (CSHCN) can inform pediatric resident education.

Methods: Residents and faculty across the continuity research network (CORNET) reported on a consecutive series of 5 primary care encounters. Respondents answered questions about visit characteristics, patient demographics, and applied the CSHCN Screener.

Three-Tiered Advocacy: Using a Longitudinal Curriculum to Teach Pediatric Residents Advocacy on an Individual, Community, and Legislative Level.

Background: Pediatricians play a critical role as health advocates. Teaching residents to advocate for their patients on an individual, community, and legislative level is a priority for residency training programs. This study examined the effects of a longitudinal curriculum teaching 3-tiered advocacy on pediatric residents' attitudes, knowledge, and practice.

Social Networks and Sugar-Sweetened Beverage Consumption in a Pediatric Urban Academic Practice.

Increased sugar-sweetened beverage (SSB) consumption is linked to childhood obesity. The risk of increased SSB consumption is multifactorial. Limited studies have examined children's SSB consumption and social networks.

Closing the delivery gap.

Purpose The purpose of this paper is to describe the authors' experience operationalizing the care delivery value chain (CDVC) as a management and continuous quality improvement (QI) approach to strengthen HIV/AIDS services provided in Northern Togo through addressing gaps across a care continuum. Design/methodology/approach The authors led a series of discussions to develop a CDVC specific to existing HIV/AIDS services in Northern Togo. Using the CDVC framework, 28 specific gaps in service delivery were identified and integrated into a strategic QI plan.

Resident Documentation of Social Determinants of Health: Effects of a Teaching Tool in the Outpatient Setting.

Social determinants of health (SDH) significantly affect the health of children and thus, screening is important in pediatric primary care. We assessed the use of a formal social history taking tool after a 2-phase intervention. The first phase (P1) was a teaching module describing SDH and community resources and the second phase (P2) consisted of visual reminders to use the tool.

Identifying inequities in maternal and child health through risk stratification to inform health systems strengthening in Northern Togo.

Objective: In Togo, substantial progress in maternal and child health is needed to reach global development goals. To better inform clinic and community-based health services, this study identifies factors associated with maternal and child health care utilization in the Kara region of Northern Togo.

Methods: We conducted a population-representative household survey of four health clinic catchment areas of 1,075 women of reproductive age in 2015.

Closing the delivery gaps in pediatric HIV care in Togo, West Africa: using the care delivery value chain framework to direct quality improvement.

Providing quality care for all children living with HIV/AIDS remains a global challenge and requires the development of new healthcare delivery strategies. The care delivery value chain (CDVC) is a framework that maps activities required to provide effective and responsive care for a patient with a particular disease across the continuum of care. By mapping activities along a value chain, the CDVC enables managers to better allocate resources, improve communication, and coordinate activities.

Smartphones and pediatric apps to mobilize the medical home.

Objectives: To assess digital access and mobile health in urban pediatric clinics by measuring demographics of smartphone ownership, primary uses of mobile devices by teens vs parents/caregivers, and interest levels in using smartphone health apps.

Study Design: This cross-sectional survey studied teenagers and caregivers from 2 urban pediatric practices in Bronx, New York; 148 surveys were administered verbally in waiting rooms using a 24-item "iHealthNYC" questionnaire. A demonstration of smartphone health apps was then conducted and data analyzed using bivariate analysis and χ(2) statistics.

The use of complementary therapies in inner-city asthmatic children.

Use of complementary/alternative medicine (CAM) has been increasing, especially among patients with a chronic illness. Although asthma is the most common chronic illness affecting children in the United States, very little is known about the use of CAM in children with asthma. Our objective was to determine the prevalence and correlates of CAM use among inner-city children with asthma.

Documenting asthma severity: do we get it right?

Background: The 1997 National Asthma Education and Prevention Program (NAEPP) recommends a severity classification scheme to optimize the use of anti-inflammatory therapy for persistent asthma. Physician documentation of asthma severity is often used as a quality assurance measure.

Objective: To test the hypothesis that physician documentation of asthma severity is associated with appropriate use of anti-inflammatory therapy.