Beck AF, Florin TA (co-first author), Campanella S, Shah SS. Geographic Variation in Hospitalization for Lower Respiratory Tract Infections Across One County. JAMA Pediatrics. 2015 Sep;169(9):846-54.
This study sought to determine whether lower respiratory tract infection hospitalization rates varied geographically across a single county and whether such variability can be associated with socioeconomic conditions. The in-county hospitalization rate for bronchiolitis ranged from zero to 71.4 per 1,000 across all in-county census tracts, and for pneumonia it ranged from zero to 4.3 per 1,000 across all in-county census tracts. There were significant, graded differences in socioeconomic measures by hospitalization rate quintile for both bronchiolitis and pneumonia. Hospitalization hot-spots are localized to inner-city, impoverished neighborhoods. These findings support clinical and public health interventions that target those areas at high risk of excessive hospital utilization.
Henize AW, Beck AF, Klein MD, Adams M, Kahn RS. A Roadmap to Address the Social Determinants of Health through Community Collaboration. Pediatrics. 2015 Oct;136(4):e993-1001.
Economic, environmental, and psychosocial needs are common and wide-ranging among families cared for in primary care settings. Pediatric care models, however, are not set up to systematically address these fundamental risks to health. This paper offered a roadmap for developing clinical-community partnerships to help address the social needs of at-risk children and families. Researchers used Maslow’s Hierarchy of Needs as a well-recognized conceptual model to explain how to design collaborations with community organizations by assessing and prioritizing risks, developing appropriate interventions, and operationalizing those interventions in the clinical setting.
Brinkman WB, Baum R, Kelleher KJ, Peugh J, Gardner W, Lichtenstein P, Langberg J Epstein JN. Relationship between Attention-Deficit/Hyperactivity Disorder Care and Medication Continuity. J Am Acad Child Adolesc Psychiatry. 2016 Apr;55(4):289–94.
Using a retrospective cohort from a random sample of medical records in 50 pediatric practices with 188 providers, including 1,352 children who started ADHD medication, this study describes variation in titration practices, medication supply and continuity, and the relationship between titration/monitoring practices and child medication supply/continuity. This study is the first to suggest that aspects of ADHD care delivered by physicians (e.g. early medication adjustment and early contact with parent after starting medication) relates to greater medication supply and continuity. It remains for researchers to determine whether interventions that improve the quality of titration, and monitoring practices for children with ADHD, would also improve medication continuity.
Copeland KA, Khoury, JC, Kalkwarf, HJ. Child-care center characteristics associated with preschoolers' physical activity. Amer J Prev Med. 2016 Apr;50(4):470-9.
Researchers in the Preschool Eating and Activity Study (PEAS) used accelerometers to objectively measure the physical activity levels over 24-hours of 388 children in 30 child-care centers in Hamilton County, and found that child care centers play a pivotal role in children’s physical activity levels. Children in child care centers with at least 60 minutes of outdoor time were more active over 24-hours than children that did not get this time. Yet few children get to experience outdoor recess time as scheduled; only 40 percent of children took part in the two outdoor sessions scheduled and 32% of children had no outside time, thus most children did not meet daily guidelines for activity. Given that many children may lack opportunities to be active around their home, this study showed that what happens in child-care centers can have important, and lasting, effects for children’s total daily levels of activity.
Hutton JS, Horowitz-Kraus T, Mendelsohn A, DeWitt T, Holland S. Home Reading Environment and Brain Activation in Preschool Children Listening to Stories. Pediatrics. 2015 Sep 2015;136(3):466-78.
This study was the first to use functional MRI (fMRI) to show a quantifiable effect of early home reading environment on the developing brain in preschool-age children, controlling for household income. Areas of activation described support the integration of auditory and visual stimulus (words and images), which are critical for narrative comprehension, and later, reading. The involvement of visual association areas suggested a major role of imagery during story listening, and that children from more nurturing home reading environments may be better equipped to see “in their mind’s eye” what is happening, subsequently managing the transition to books without pictures. This study has inspired a series of follow-up studies exploring various aspects of home reading environment that are modifiable via pediatric anticipatory guidance and interventions such as Reach Out and Read and hopefully will inform a major longitudinal study of reading development between birth and school-age.