Voices of Fathers During Pregnancy: The MGH Prenatal Care Obstetrics Fatherhood Study Methods and Results.

Introduction: Despite the growing recognition of father's importance for early family health and well-being, there has been very limited attention to men's own experiences and developmental needs antenatally, and specifically during their partner's prenatal care (PNC) visits. This study explores the feasibility of capturing men's own voices; documents their antenatal experiences and needs; assesses their treatment by Obstetric staff; and enquires about additional paternal information and skills desired and how best to provide them.

Methods: All fathers accompanying their partners to PNC services during two weeks at Massachusetts General Hospital were invited to fill out an anonymous, 15-min, two-part, iPad survey.

Maternal Substance Use Disorders and Infant Outcomes in the First Year of Life among Massachusetts Singletons, 2003-2010.

Objective: To determine the association of maternal substance use disorders (SUDs) during pregnancy with adverse neonatal outcomes and infant hospital re-admissions, observational stays, and emergency department utilization in the first year of life.

Study Design: We analyzed 2 linked statewide datasets from 2002 to 2010: the Massachusetts Pregnancy to Early Life Longitudinal data system and the Massachusetts Bureau of Substance Abuse Services Management Information System. Generalized estimating equations were used to assess the association of maternal SUDs and neonatal outcomes and infant hospital-based care in the first year of life, controlling for maternal and infant characteristics.

Geography matters: state-level variation in children's oral health care access and oral health status.

Objectives: To ascertain differences across states in children's oral health care access and oral health status and the factors that contribute to those differences.

Study Design: Observational study using cross-sectional surveys.

Methods: Using the 2007 National Survey of Children's Health, we examined state variation in parents' report of children's oral health care access (absence of a preventive dental visit) and oral health status.

Trends in Electronic Cigarette Use Among U.S. Adults: Use is Increasing in Both Smokers and Nonsmokers.

Objectives: We assessed trends in use of electronic cigarettes among U.S. adults, demographic predictors of use, and smoking status of current electronic cigarette users.

Quality of life outcomes in proton and photon treated pediatric brain tumor survivors.

Background: Radiotherapy can impair Health Related Quality of Life (HRQoL) in survivors of childhood brain tumors, but proton radiotherapy (PRT) may mitigate this effect. This study compares HRQoL in PRT and photon (XRT) pediatric brain tumor survivors.

Methods: HRQoL data were prospectively collected on PRT-treated patients aged 2-18 treated at Massachusetts General Hospital (MGH).

A dual-frame sampling methodology to address landline replacement in tobacco control research.

Objectives: We assessed the comparability of self-reported smoking prevalence estimates from a dual-frame survey with those from two large-scale, national surveys.

Methods: The Social Climate Survey of Tobacco Control (SCS-TC) obtained self-reported current smoking status via a dual-frame methodology in the fall of 2010. One frame used random digit dialling procedures and consisted of households with a landline telephone; the other frame consisted of a population-based probability-based online panel.

Health care transition for youth with special health care needs.

Purpose: Youth with special health care needs (YSHCN) increasingly live into adulthood, and approximately 500,000 U.S. youth transition from pediatric to adult health care systems annually.

The medical home: relationships with family functioning for children with and without special health care needs.

Objective: In this study we tested the association of the medical home with family functioning for children without and with special health care needs (CSHCN).

Methods: We used data from the 2007 National Survey of Children's Health to run multivariate logistic regressions to test the association between having a medical home and family functioning (difficulty with parental coping, parental aggravation, childcare/work issues, and missed school days). We further assessed interactions of CSHCN status with having a medical home.

Understanding pediatricians' views toward school-based BMI screening in Massachusetts: a pilot study.

Background: Massachusetts (MA) mandated body mass index (BMI) screening in schools in 2010. However, little is known about pediatricians' views on school-based screening or how the pediatricians' perspectives might affect the school-based screening process. We assessed MA pediatricians' knowledge, attitudes, beliefs, and practices concerning BMI screening.

Impact of type 1 diabetes mellitus on the family is reduced with the medical home, care coordination, and family-centered care.

Objectives: To examine whether the medical home, care coordination, or family-centered care was associated with less impact of type 1 diabetes mellitus (T1D) on families' work, finances, time, and school attendance.

Study Design: With the 2005 to 2006 National Survey of Children with Special Health Care Needs, we compared impact in children with T1D (n = 583) with that in children with other special health care needs (n = 39 944) and children without special health care needs (n = 4945). We modeled the associations of the medical home, care coordination, and family-centered care with family impact in T1D.

Strategies for addressing barriers to publishing pediatric quality improvement research.

Background: Advancing the science of quality improvement (QI) requires dissemination of the results of QI. However, the results of few QI interventions reach publication.

Objective: To identify barriers to publishing results of pediatric QI research and provide practical strategies that QI researchers can use to enhance publishability of their work.

Global teens and tobacco: a review of the globalization of the tobacco epidemic.

Worldwide, the burden of suffering to children caused by tobacco does not just originate from exposure to tobacco smoke or smoking, but includes exposure to tobacco-friendly media, poverty associated with money spent on tobacco, increased incidence of tobacco-related fires, and the harms related to child labor in tobacco cultivation. Despite global efforts through human rights acts, the Framework Convention on Tobacco Control, and the MPOWER report, tobacco use continues to accelerate in most countries. While the efforts that have been taken, such as smoking bans in public, are worthy actions, not enough is being done to protect children and teens.

Provision of fluoride varnish to Medicaid-enrolled children by physicians: the Massachusetts experience.

Objectives: To evaluate the impact of a 2008 Medicaid policy in Massachusetts (MA), regarding reimbursing physicians for providing fluoride varnish (FV) to eligible children in medical settings.

Data Source: Survey of a sample of primary care physicians in MA.

Study Design: Cross-sectional survey of a sample of physicians who provide care to MassHealth (MA Medicaid) enrolled-children.

Depressive symptoms in severely obese compared with normal weight adolescents: results from a community-based longitudinal study.

Purpose: Little is known about the relationship between severe obesity and depressive symptoms, particularly in community as opposed to clinic-based samples. This study determined the relationship of severe obesity and depressive symptoms over 3 years in a community-based sample of non-Hispanic black and white adolescents in grades 7-12 at baseline.

Methods: The nested matched cohort study using data from a longitudinal school-based study of youth followed up for 3 years.

Measuring patient and family experiences of health care for children.

Background: The Institute of Medicine considers patient centeredness a core dimension of quality. Several patient/family surveys exist to assess pediatric health care. The Children's Health Insurance Program Reauthorization Act mandates strengthening quality measurement for children, including for patient/family experience of care.

Measures of availability of health care services for children.

Objective: The Children's Health Insurance Program Reauthorization Act (CHIPRA) mandates that measures of availability of child health services be included in the recommended core measurement set. The objective of this work was to review and evaluate measures of availability of child health services for potential inclusion in the initial core set of health care quality measures as mandated by CHIPRA.

Methods: To find measures, I searched the published literature, measurement sets, and recommended articles to identify existing measures of availability.

US attitudes about banning menthol in cigarettes: results from a nationally representative survey.

Menthol is a cigarette flavoring that makes smoking more appealing to smokers. The US Food and Drug Administration (FDA) has regulatory authority to ban mentholated cigarettes to reduce youth uptake and encourage adult cessation. Survey findings indicate that more than half of all Americans (56.

Acceptability of testing children for tobacco-smoke exposure: a national parent survey.

Background: Tests are available to measure children's exposure to tobacco smoke. One potential barrier to testing children for tobacco-smoke exposure is the belief that parents who smoke would not want their child tested. No previous surveys have assessed whether testing children for exposure to tobacco smoke in the context of their child's primary care visit is acceptable to parents.

Increases in behavioral health screening in pediatric care for Massachusetts Medicaid patients.

Objective: To explore rates of screening and identification and treatment for behavioral problems using billing data from Massachusetts Medicaid immediately following the start of the state's new court-ordered screening and intervention program.

Design: Retrospective review of the number of pediatric well-child visits, number of screens, and number of screens that identify risk for psychosocial problems from January 2008 (the month pediatric screening started) to March 2009. During the surrounding 1-year period, we also examined the number of claims with a behavioral health evaluation code.

Electronic health record decision support and quality of care for children with ADHD.

Objectives: The objective of this study was to assess the effect of electronic health record (EHR) decision support on physician management and documentation of care for children with attention-deficit/hyperactivity disorder (ADHD).

Methods: This study involved 79 general pediatricians in 12 pediatric primary care practices that use the same EHR who were caring for 412 children who were aged 5 to 18 years and had a previous diagnosis of ADHD. We conducted a cluster randomized trial of EHR-based decision support that included (1) clinician reminders to assess ADHD symptoms every 3 to 6 months and (2) an ADHD note template with structured fields for symptoms, treatment effectiveness, and adverse effects.