An Intervention to Improve Chlamydia and Gonorrhea Testing Among Adolescents in Primary Care.

Background And Objectives: Rates of chlamydia and gonorrhea among adolescents continue to rise. We aimed to evaluate if a universal testing program for chlamydia and gonorrhea improved testing rates in an urban general pediatric clinic and an urban family medicine clinic within a system of federally qualified health care centers and evaluated the feasibility, cost, and logistic challenges of expanding implementation across 28 primary care clinics within a federally qualified health care centers system.

Methods: A universal testing quality improvement program for male and female patient 14 to 18 years old was implemented in a general pediatrics and family medicine clinic in Denver, Colorado.

Parental Vaccine Hesitancy and Risk of Pediatric Influenza Under-Vaccination in a Safety-Net Health Care System.

Objective: To measure the risk of influenza under-vaccination in children of vaccine-hesitant parents, referent to children of nonhesitant parents, in a sample of disadvantaged families in one influenza season.

Study Design: A prospective observational cohort study of English- and Spanish-speaking parents of 2-year-olds presenting at random for well, sick, or specialty visit care from August 1, 2019 to February 28, 2020. Parents answered demographic questions and the Parent Attitudes about Childhood Vaccines survey.

Gonorrhea and Chlamydia Rates Among 12- to 24-Year-Old Patients in an Urban Health System.

Background: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) infection rates continue to rise. Screening guidelines have largely focused on sexually active female individuals and men who have sex with men populations. Health care system testing and infection rates, particularly among heterosexual male individuals, are poorly understood.

Screening and Referral for Low-Income Families' Social Determinants of Health by US Pediatricians.

Objective: To measure the frequency US pediatricians report screening and referring for social needs and identify pediatrician and practice-level predictors for screening and referral.

Methods: Data were from the American Academy of Pediatrics Periodic Survey for October 2014 to March 2015 with a response rate of 46.6% (732/1570).

United States Pediatricians' Attitudes Regarding Public Policies for Low-Income Children and Their Profession's Advocacy Priorities.

Objective: To examine pediatricians' attitudes toward public policies for low-income children and the advocacy efforts for the American Academy of Pediatrics (AAP).

Methods: Data from the AAP Periodic Survey in October 2014 to March 2015 were used. Respondents ranked 1) attitudes toward government programs, and 2) attitudes toward AAP policies on: income support, housing, education, job training, food, and health care.

An Essential Role for Pediatricians: Becoming Child Poverty Change Agents for a Lifetime.

Poverty has profound and enduring effects on the health and well-being of children, as well as their subsequent adult health and success. It is essential for pediatricians to work to reduce child poverty and to ameliorate its effects on children. Pediatricians have important and needed tools to do this work: authority/power as physicians, understanding of science and evidence-based approaches, and first-hand, real-life knowledge and love of children and families.

Redesigning Health Care Practices to Address Childhood Poverty.

Child poverty in the United States is widespread and has serious negative effects on the health and well-being of children throughout their life course. Child health providers are considering ways to redesign their practices in order to mitigate the negative effects of poverty on children and support the efforts of families to lift themselves out of poverty. To do so, practices need to adopt effective methods to identify poverty-related social determinants of health and provide effective interventions to address them.

Pediatric influenza immunization in an integrated safety net health care system.

Objective: In 2008 the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) recommended that all children aged 6 months to 18 years receive annual influenza vaccine. Full pediatric influenza administration has proven difficult. We compared rates of full influenza immunization between a safety net health care system and CDC sentinel sites and evaluated sociodemographic factors associated with full influenza immunization.

Addressing adolescent immunization disparities: a retrospective analysis of school-based health center immunization delivery.

Objectives: We compared completion rates for adolescent immunization series administered at school-based health centers (SBHCs) to completion rates for series administered at community health centers (CHCs) within a single integrated delivery system.

Methods: We performed a retrospective analysis of data from an immunization registry for patients aged 12-18 years. Patients were assigned to either an SBHC or a CHC during the study interval based on utilization.

Perspective: Physician advocacy: what is it and how do we do it?

Many medical authors and organizations have called for physician advocacy as a core component of medical professionalism. Despite widespread acceptance of advocacy as a professional obligation, the concept remains problematic within the profession of medicine because it remains undefined in concept, scope, and practice. If advocacy is to be a professional imperative, then medical schools and graduate education programs must deliberately train physicians as advocates.

Disruptions in insurance coverage: patterns and relationship to health care access, unmet need, and utilization before enrollment in the State Children's Health Insurance Program.

Background: The numbers and types of disruptions in insurance that children experience and the effects of these disruptions on health care measures have not been well characterized.

Objectives: Our goals were to (1) describe the number and patterns of insurance disruptions within a population of children newly enrolling into the State Children's Health Insurance Program and (2) assess the relationship among insurance disruptions and sociodemographic characteristics of these children and their families to specific measures of access to care, unmet need, and health care utilization during the year before enrollment.

Methods: We conducted telephone interviews in families with children newly enrolling in the State Children's Health Insurance Program.

A successful international child health elective: the University of Colorado Department of Pediatrics' experience.

Objectives: To describe the organizational features of an international child health elective (ICHE) and to document the diversity of diagnoses observed by residents.

Design: Faculty from the Department of Pediatrics, University of Colorado Health Sciences Center, Denver, created a steering committee in 1999 to develop and direct an ICHE, including selecting residents, selecting and organizing sites, and creating objectives and a year-long preparatory curriculum. The elective was piloted in 2000 and repeated in 2002 and 2004.