Ruth E K Stein1, Amy Storfer-Isser2, Bonnie D Kerker3, Andrew Garner4, Moira Szilagyi5, Kimberly E Hoagwood6, Karen G O'Connor7, Cori M Green8, Sarah McCue Horwitz6. 1. Albert Einstein College of Medicine/Children's Hospital at Montefiore, Bronx, NY. Electronic address: ruth.stein@einstein.yu.edu. 2. Statistical Research Consultants, LLC, Schaumburg, Ill. 3. Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY; Nathan Kline Institute of Psychiatric Research, Orangeburg, NY. 4. Case Western Reserve University School of Medicine, Cleveland, Ohio. 5. University of California at Los Angeles, Los Angeles, Calif. 6. Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY. 7. American Academy of Pediatrics, Elk Grove Village, Ill. 8. New York Presbyterian, Cornell University College of Medicine, New York, NY.
Abstract
OBJECTIVE: Since 1997 pediatric residencies have been required to provide a 4-week block rotation in developmental and behavioral pediatrics (DBP), but it is not known whether this has altered the care and management of children by practicing pediatricians. The objective of this study was to compare the self-reported practice patterns of pediatricians who were trained with 4 or more weeks of DBP with the practice patterns of those who were trained for <4 weeks. METHODS: We used self-reported practices from the American Academy of Pediatrics Periodic Survey 85. Pediatricians were asked whether they never, sometimes, or usually inquired about and screened for, and whether they treated/managed/comanaged attention deficit hyperactivity disorder, depression, anxiety, behavior problems and learning problems. They were also asked about a series of barriers to care. Analyses were weighted to account for low response rates. RESULTS: Those with more DBP training were significantly more likely to treat/manage/co-manage depression, anxiety, behavior problems and learning problems, but were still doing so less than one third of the time. There were no differences in the care of patients with attention deficit hyperactivity disorder or in screening or inquiring about mental health conditions. Those with more training were more likely to perceive somewhat fewer barriers and to report more specific familiarity with some Diagnostic and Statistical Manual of Mental Disorders criteria and some treatment modalities. CONCLUSIONS: Longer length of training is associated with more treatment, but significant deficits in self-reported practice remain, leaving much room for additional improvement in the training of clinicians in DBP.
OBJECTIVE: Since 1997 pediatric residencies have been required to provide a 4-week block rotation in developmental and behavioral pediatrics (DBP), but it is not known whether this has altered the care and management of children by practicing pediatricians. The objective of this study was to compare the self-reported practice patterns of pediatricians who were trained with 4 or more weeks of DBP with the practice patterns of those who were trained for <4 weeks. METHODS: We used self-reported practices from the American Academy of Pediatrics Periodic Survey 85. Pediatricians were asked whether they never, sometimes, or usually inquired about and screened for, and whether they treated/managed/comanaged attention deficit hyperactivity disorder, depression, anxiety, behavior problems and learning problems. They were also asked about a series of barriers to care. Analyses were weighted to account for low response rates. RESULTS: Those with more DBP training were significantly more likely to treat/manage/co-manage depression, anxiety, behavior problems and learning problems, but were still doing so less than one third of the time. There were no differences in the care of patients with attention deficit hyperactivity disorder or in screening or inquiring about mental health conditions. Those with more training were more likely to perceive somewhat fewer barriers and to report more specific familiarity with some Diagnostic and Statistical Manual of Mental Disorders criteria and some treatment modalities. CONCLUSIONS: Longer length of training is associated with more treatment, but significant deficits in self-reported practice remain, leaving much room for additional improvement in the training of clinicians in DBP.
Authors: Cori Green; Amy Storfer-Isser; Ruth E K Stein; Andrew S Garner; Bonnie D Kerker; Moira Szilagyi; Karen G O'Connor; Kimberly E Hoagwood; Sarah M Horwitz Journal: Acad Pediatr Date: 2017-03-06 Impact factor: 3.107