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Abbas MI, Kohli R, Du N, Orsagh-Yentis DK, Dotson JL. Advocacy in pediatric gastroenterology: An academic clinician's impact and guide. J Pediatr Gastroenterol Nutr 2024. [PMID: 38773963 DOI: 10.1002/jpn3.12244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/28/2024] [Accepted: 04/11/2024] [Indexed: 05/24/2024]
Abstract
The current state of policy-making necessitates clinicians and their organizations to be more engaged. This article provides practical examples of how to engage in various levels of advocacy within pediatric gastroenterology.
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Affiliation(s)
- Mazen I Abbas
- Department of Pediatrics, Hawaii Pacific Health, Kapi'olani Medical Center for Women and Children, Honolulu, Hawaii, USA
| | - Rohit Kohli
- Division of Pediatric Gastroenterology, Children's Hospital of Los Angeles, Department of Pediatrics, University of Southern California, Los Angeles, California, USA
| | - Nan Du
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
| | | | - Jennifer L Dotson
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics, The Ohio State Wexner Medical Center, Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
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2
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Burnett JR, De Lima B, Wang ES, McGarry K, Kim DI, Kisielewski M, Manley K, Desai SS, Eckstrom E, Henry TL. How Are We Teaching Advocacy? A National Survey of Internal Medicine Residency Program Directors. J Gen Intern Med 2024:10.1007/s11606-024-08753-3. [PMID: 38710862 DOI: 10.1007/s11606-024-08753-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/29/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Although internal medicine (IM) physicians accept public advocacy as a professional responsibility, there is little evidence that IM training programs teach advocacy skills. The prevalence and characteristics of public advocacy curricula in US IM residency programs are unknown. OBJECTIVES To describe the prevalence and characteristics of curricula in US IM residencies addressing public advocacy for communities and populations; to describe barriers to the provision of such curricula. DESIGN Nationally representative, web-based, cross-sectional survey of IM residency program directors with membership in an academic professional association. PARTICIPANTS A total of 276 IM residency program directors (61%) responded between August and December 2022. MAIN MEASUREMENTS Percentage of US IM residency programs that teach advocacy curricula; characteristics of advocacy curricula; perceptions of barriers to teaching advocacy. KEY RESULTS More than half of respondents reported that their programs offer no advocacy curricula (148/276, 53.6%). Ninety-five programs (95/276, 34.4%) reported required advocacy curricula; 33 programs (33/276, 12%) provided curricula as elective only. The content, structure, and teaching methods of advocacy curricula in IM programs were heterogeneous; experiential learning in required curricula was low (23/95, 24.2%) compared to that in elective curricula (51/65, 78.5%). The most highly reported barriers to implementing or improving upon advocacy curricula (multiple responses allowed) were lack of faculty expertise in advocacy (200/276, 72%), inadequate faculty time (190/276, 69%), and limited curricular flexibility (148/276, 54%). CONCLUSION Over half of US IM residency programs offer no formal training in public advocacy skills and many reported lack of faculty expertise in public advocacy as a barrier. These findings suggest many IM residents are not taught how to advocate for communities and populations. Further, less than one-quarter of required curricula in public advocacy involves experiential learning.
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Affiliation(s)
- Joel R Burnett
- Oregon Health & Science University (OHSU) School of Medicine, Portland, OR, USA.
| | - Bryanna De Lima
- Oregon Health & Science University (OHSU) School of Medicine, Portland, OR, USA
| | - Emily S Wang
- UT Health San Antonio Long School of Medicine, San Antonio, TX, USA
| | - Kelly McGarry
- Alpert Medical School at Brown University, Providence, RI, USA
| | - Daniel I Kim
- University of California, Riverside School of Medicine, Riverside, CA, USA
| | | | - Kelsi Manley
- Oregon Health & Science University (OHSU) School of Medicine, Portland, OR, USA
| | - Sima S Desai
- Oregon Health & Science University (OHSU) School of Medicine, Portland, OR, USA
| | - Elizabeth Eckstrom
- Oregon Health & Science University (OHSU) School of Medicine, Portland, OR, USA
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3
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Bode SM, Anwar E, Best DL, Patel M, Beers LS, Kaczorowski JM, Solomon BS, Chamberlain LJ. Pediatric advocacy: Advancement in academic institutions. Pediatr Res 2024; 95:1476-1479. [PMID: 38195941 PMCID: PMC11126388 DOI: 10.1038/s41390-023-02997-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/16/2023] [Accepted: 12/15/2023] [Indexed: 01/11/2024]
Abstract
IMPACT Children are facing many threats to their health today that require system change at a sweeping level to have real-world impact. Pediatricians are positioned as natural leaders to advocate for these critical community and policy changes. Academic medical center (AMC) leaders recognize the importance of this advocacy and clear steps can be taken to improve the structure to support pediatricians in their advocacy careers through faculty development and promotion, including standardized scholarly measurement of the outcomes.
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Affiliation(s)
- Sara M Bode
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA.
| | - Eimaan Anwar
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Debra L Best
- Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | - Mona Patel
- Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Lee S Beers
- Department of General and Community Pediatrics, Children's National Health System, Washington, DC, USA
| | | | - Barry S Solomon
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MA, USA
| | - Lisa J Chamberlain
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
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4
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Cahill AM, Carlson JC. A Scoping Review of Physician Advocacy on Twitter. Cureus 2023; 15:e41632. [PMID: 37565125 PMCID: PMC10410681 DOI: 10.7759/cureus.41632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 08/12/2023] Open
Abstract
Twitter has been adopted by physicians across most medical specialties; it allows for the wide dissemination of information and calls to action, brings new stakeholders into collations, promotes academic engagement, and fosters collaboration between academia and private practice. In this review of the literature, we briefly outline the state of advocacy in health care and summarize current Twitter-based advocacy efforts in the major specialties of health care, identifying both successful strategies as well as gaps in Twitter advocacy research. Relevant articles were obtained via PubMed and Google Scholar searches using the phrases "Twitter advocacy healthcare," "[specialty name] Twitter" and "[specialty name] Twitter advocacy." Several overarching themes were found to be widely utilized in specialty-specific discussions of Twitter advocacy efforts: organizing under a specific hashtag, fostering dialogue between stakeholders, and tweeting using personalized, action-oriented language. Fields such as pediatrics, heme/onc, ENT, and ophthalmology have most thoroughly embraced the desire to learn how to most effectively advocate on Twitter. Other fields such as OBGYN, cardiology, and surgery have less academic focus on online advocacy. Outside of advocacy efforts, the research and academic benefits of Twitter are well described in nearly every specialty. In conclusion, while clinicians are encouraged to advocate online, only broad strategies for online engagement are currently offered. Additional research into the details of how to successfully create an online profile and Twitter presence is needed to ensure all physicians are able to maximize their advocacy efforts, with clarification of the goals and objectives of this engagement also required.
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Affiliation(s)
- Abigail M Cahill
- Pediatrics, Tulane University School of Medicine, New Orleans, USA
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5
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Abstract
Pediatricians are effective advocates to improve the health and well-being of children, yet there are limited avenues by which to pursue academic promotion based on these activities. Drawing on an expanded definition of scholarship, pediatric advocates can use the portfolio format to highlight the quantity, quality, and impact of advocacy activities. True congruence with research and education will only be achieved through recognition and value by institutions and organizations.
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Pulcini CD, Raphael JL, Lopez KN. Translating Research into Child Health Policy: Aligning Incentives and Building a New Discourse. Pediatr Clin North Am 2023; 70:151-164. [PMID: 36402465 DOI: 10.1016/j.pcl.2022.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Research has led to major achievements in public policy and child health. Despite the gains, the need for research to inform policy remains paramount against a backdrop of inadequate public health investments, health inequities, and public skepticism toward science. However, the translation of research into child health policy has often been slow due to misalignments in incentives between researchers and policy makers and a paucity of conceptual models to inform translation. This article outlines barriers to translation, provides examples of discordance between evidence and policy, summarizes models to inform translation, and offers strategies to improve translation of research to policy.
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Affiliation(s)
- Christian D Pulcini
- Department of Emergency Medicine and Pediatrics, University of Vermont Larner College of Medicine, Fletcher House 301, 111 Colchester Avenue, Burlington, VT 05401, USA.
| | - Jean L Raphael
- Department of Pediatrics, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Keila N Lopez
- Department of Pediatrics, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
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7
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Beers LS, Williams-Willingham MA, Chamberlain LJ. Making Advocacy Part of Your Job: Working for Children in Any Practice Setting. Pediatr Clin North Am 2023; 70:25-34. [PMID: 36402468 DOI: 10.1016/j.pcl.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Effective child health advocacy is an essential strategy to improve child health, and can improve access to equitable care. It can also be professionally rewarding and improve career satisfaction. However, while advocacy has been a part of pediatrics since its origins as a specialty, many barriers to engaging in health advocacy exist which can be challenging to navigate. There are a wide range of organizational practice settings, which are each accompanied by unique strengths and limitations. No matter the practice setting, pediatricians can be effective advocates for child health through leveraging organizational, professional, and community resources and partnerships.
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Affiliation(s)
- Lee Savio Beers
- Child Health Advocacy Institute, Children's National Hospital, 111 Michigan Avenue Northwest, Washington, DC 20010, USA.
| | | | - Lisa J Chamberlain
- Department of Pediatrics, Stanford, School of Medicine, 453 Quarry Road, Mail Code 5459, Stanford, CA 94305, USA
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8
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Luo OD, Razvi Y, Kaur G, Lim M, Smith K, Carson JJK, Petrin-Desrosiers C, Haldane V, Simms N, Miller FA. A qualitative study of what motivates and enables climate-engaged physicians in Canada to engage in health-care sustainability, advocacy, and action. Lancet Planet Health 2023; 7:e164-e171. [PMID: 36754472 DOI: 10.1016/s2542-5196(22)00311-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 11/09/2022] [Accepted: 11/14/2022] [Indexed: 06/18/2023]
Abstract
Increasing numbers of health-care professionals are aware of the need to deliver low-carbon sustainable health systems. We aimed to explore how physicians can be motivated and supported to pursue this ambition by conducting an exploratory qualitative descriptive study that involved individual in-depth interviews with climate-engaged Canadian physicians participating in health-care sustainability advocacy and action. Interview transcripts were analysed to identify themes related to the actions that physicians can take to promote sustainable health care, and the motivators and enablers of physician engagement in sustainable health care. Participants (n=19) engaged in a spectrum of health-care sustainability initiatives ranging from reducing health-care waste to lobbying and political action. They were motivated to advance health-care sustainability by their concern about the health implications of climate change, frustration with health-care waste, and recognition of their locus of influence as physicians. Participants articulated that policy and system, organisational and team, and knowledge generation and translation supports are required to strengthen their capacity to advance health-care sustainability. These findings can provide inspiration for engagement opportunities in health-care sustainability, guide service delivery and educational innovations to promote health-care professionals' interest in becoming sustainability champions, and extend the capacity of health-care professionals to reduce the climate impact of health care.
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Affiliation(s)
- Owen Dan Luo
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, QC, Canada
| | - Yasmeen Razvi
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Gurleen Kaur
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Michelle Lim
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kelti Smith
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jacob Joel Kirsh Carson
- Department of Pediatrics, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Claudel Petrin-Desrosiers
- Département de Médecine Familiale et de Médecine d'Urgence, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
| | - Victoria Haldane
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Nicole Simms
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Centre for Sustainable Health Systems, University of Toronto, Toronto, ON, Canada
| | - Fiona A Miller
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Centre for Sustainable Health Systems, University of Toronto, Toronto, ON, Canada.
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9
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Earnest M, Wong SL, Federico S, Cervantes L. A Model of Advocacy to Inform Action. J Gen Intern Med 2023; 38:208-212. [PMID: 36323827 PMCID: PMC9629756 DOI: 10.1007/s11606-022-07866-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
The need for effective advocacy on the part of health professionals has never been greater. The recent COVID-19 pandemic has made the connection between human health and social conditions clear, while highlighting the limitations of biomedical interventions to address those conditions. Efforts to increase the frequency and effectiveness of advocacy activities by health professionals have been hampered by the lack of a practical framework to define and develop advocacy competencies among trainees as well as to plan and execute advocacy activities. The authors of this article propose a framework which defines advocacy as occurring across three domains of influence (practice, community, and government) using three categories of advocacy skills (policy, communication, and relationships). When these skills are successfully applied in the appropriate domains of influence, the resulting change falls into three levels: individual, adjacent, and structural. The authors assert that this framework is immediately applicable to a broad variety of health professionals, educators, researchers, organizations, and professional societies as they individually and collectively seek to improve the health and well-being of those they care for.
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Affiliation(s)
- Mark Earnest
- Division of General Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Shale L Wong
- Department of Pediatrics, Eugene S. Farley, Jr. Health Policy Center, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Steve Federico
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, USA.,Denver Health and Hospital Authority, Denver, USA
| | - Lilia Cervantes
- Division of Hospital Medicine, University of Colorado Anschutz Medical, Aurora, USA
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10
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Clark SG, Cohen A, Heard-Garris N. Moving Beyond Words: Leveraging Financial Resources to Improve Diversity, Equity, and Inclusion in Academic Medical Centers. J Clin Psychol Med Settings 2022:10.1007/s10880-022-09914-4. [PMID: 36495346 PMCID: PMC9739343 DOI: 10.1007/s10880-022-09914-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2022] [Indexed: 12/14/2022]
Abstract
Diversity, equity, and inclusion (DEI) efforts at academic medical centers (AMCs) began prior to 2020, but have been accelerated after the death of George Floyd, leading many AMCs to recommit their support for DEI. Institutions crafted statements to decry racism, but we assert that institutions must make a transparent, continuous, and robust financial investment to truly show their commitment to DEI. This financial investment should focus on (1) advocacy efforts for programs that will contribute to DEI in health, (2) pipeline programs to support and guide minoritized students to enter health professions, and (3) the recruitment and retention of minoritized faculty. While financial investments will not eliminate all DEI concerns within AMCs, investing significant financial resources consistently and intentionally will better position AMCs to truly advance diversity, equity, and inclusion within healthcare, the community, and beyond.
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Affiliation(s)
- Shawnese Gilpin Clark
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL USA ,Mary Ann & J. Milburn Smith Child Health Outcomes, Research and Evaluation Center, Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E Chicago Avenue, Box 162, Chicago, IL 60611 USA
| | - Alyssa Cohen
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL USA ,Division of Advanced General Pediatrics and Primary Care, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL USA
| | - Nia Heard-Garris
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL USA ,Mary Ann & J. Milburn Smith Child Health Outcomes, Research and Evaluation Center, Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E Chicago Avenue, Box 162, Chicago, IL 60611 USA ,Division of Advanced General Pediatrics and Primary Care, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL USA
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11
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Chung RJ, Ramirez MR, Best DL, Cohen MB, Chamberlain LJ. Advocacy and Community Engagement: Perspectives from Pediatric Department Chairs. J Pediatr 2022; 248:6-10.e3. [PMID: 35032554 DOI: 10.1016/j.jpeds.2021.12.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/17/2021] [Accepted: 12/05/2021] [Indexed: 01/17/2023]
Affiliation(s)
- Richard J Chung
- Department of Pediatrics, Duke University School of Medicine, Durham, NC
| | - Melanie R Ramirez
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
| | - Debra L Best
- Department of Pediatrics, Duke University School of Medicine, Durham, NC
| | - Mitchell B Cohen
- Department of Pediatrics, The University of Alabama at Birmingham School of Medicine, Birmingham, AL
| | - Lisa J Chamberlain
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA.
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12
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Child health advocacy in Saudi Arabia: Traditional medicine as a model. J Taibah Univ Med Sci 2022; 18:1-8. [DOI: 10.1016/j.jtumed.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/01/2022] [Accepted: 07/03/2022] [Indexed: 11/19/2022] Open
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Bode SM, Hoffman BD, Chapman SH, Kaczorowski JM, Best DL, Shah AN, Nerlinger AL, Barnard JA, Loud KJ, Brophy P, Reed AM, Braner D. Academic Careers in Advocacy: Aligning Institutional Values Through Use of an Advocacy Portfolio. Pediatrics 2022; 150:188322. [PMID: 35734955 DOI: 10.1542/peds.2021-055014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/20/2022] [Indexed: 11/24/2022] Open
Abstract
Academic children's hospitals must embrace advocacy as a central component of their missions to discover new knowledge and improve the health of the communities and patients they serve. To do so, they must ensure faculty have both the tools and the opportunities to develop and articulate the work of advocacy as an academic endeavor. This can be accomplished by integrating the work of advocacy at the community and policy-change levels into the traditional value systems of academic medicine, especially the promotions process, to establish its legitimacy. Academic pediatric institutions can support this transformation through robust training and professional development programs and establishing opportunities, resources, and leadership positions in advocacy. The adoption of an advocacy portfolio can be used to align these activities and accomplishments to institutional values and promotion. This alignment is crucial to supporting the advocacy work of pediatricians at a time in which community engagement and systems and policy change must be added to professional activities to ensure optimal outcomes for all children.
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Affiliation(s)
- Sara M Bode
- Nationwide Children's Hospital, Columbus, Ohio
| | | | - Steven H Chapman
- Children's Hospital at Dartmouth-Hitchcock, Lebanon, New Hampshire
| | | | - Debra L Best
- Duke Children's Hospital and Health Center, Durham, North Carolina
| | - Anita N Shah
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | | | | | - Keith J Loud
- Children's Hospital at Dartmouth-Hitchcock, Lebanon, New Hampshire
| | | | - Ann M Reed
- Duke Children's Hospital and Health Center, Durham, North Carolina
| | - Dana Braner
- Doernbecher Children's Hospital, Portland, Oregon
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Nerlinger A, Shah A. Faculty Support for Advocacy Is Key to Training the Next Generation of Pediatrician-Advocates. Hosp Pediatr 2022; 12:e223-e224. [PMID: 35543032 DOI: 10.1542/hpeds.2022-006630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Abby Nerlinger
- Department of Pediatrics, Nemours Children's Hospital, Wilmington, Delaware
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Anita Shah
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
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15
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A Qualitative Study of Caregiver Perspectives on Health Policy Discussions Initiated by Pediatricians. Acad Pediatr 2022; 22:454-460. [PMID: 34482016 PMCID: PMC8888768 DOI: 10.1016/j.acap.2021.08.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 08/12/2021] [Accepted: 08/23/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Prior studies suggest that pediatricians believe discussing health policy issues with families is important. Caregiver preferences on these discussions, however, have not been examined. We explored circumstances in which caregivers may be receptive to discussing health policy issues with pediatricians. METHODS We conducted 26 semistructured interviews with mostly Black female caregivers at 3 urban academic pediatric primary care practices. Using both structured and open response questions, we explored 4 primary content areas: 1) caregivers' perspectives on discussing health policy issues in pediatricians' offices; 2) which health policy topics caregivers may prefer to discuss; 3) factors that render policy discussions in the clinic inappropriate to caregivers; and 4) which communication modalities caregivers prefer. Interview transcripts were coded and analyzed using content analysis. RESULTS Themes that emerged from interviews included: 1) pediatricians are perceived as trusted information sources on health policy; 2) caregivers want to talk with pediatricians about children's health insurance policy changes; 3) time constraints are a barrier to health policy discussions; 4) caregivers prefer to discuss health policy topics during well-child visits; 5) caregivers want the option to opt-out of these conversations; 6) preferred modalities for communicating about health policy issues, including printed materials and health fairs or educational events. CONCLUSIONS Caregivers expressed a satisfactory view of pediatricians discussing directly relevant health policy issues, including congressional debates on health insurance, in the primary care setting. Our findings highlight other caregiver preferences for engaging families in health policy discussions, including the timing of these conversations.
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Houtrow AJ, Akamagwuna UO, Holman L, Bosques G. Advancing our field by academically advancing pediatric rehabilitation medicine physicians. J Pediatr Rehabil Med 2022; 15:237-247. [PMID: 35311732 DOI: 10.3233/prm-220033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Academic promotion is desired by many faculty practicing at academic medical institutions, but the criteria for promotion often appear opaque to many physician faculty. In nearly all cases, evidence of scholarship is required regardless of academic track. Academic advancement can be stymied by unclear expectations, lack of protected time to engage in scholarly projects, insufficient evidence of dissemination, and limited guidance, mentorship and sponsorship. In addition to being important for promotion, scholarship is an essential aspect of academic medicine because it helps inform and advance the science. Pursuing academic excellence is an important goal for pediatric rehabilitation medicine faculty members because it helps advance the care of children with disabilities and the field itself. Pediatric rehabilitation medicine faculty in the clinician educator or clinician leader tracks are encouraged to understand the criteria for advancement, seek out mentorship, scholarize their career ikigai and identify opportunities to demonstrate academic excellence.
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Affiliation(s)
- Amy J Houtrow
- University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
| | | | - Lainie Holman
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
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Pediatricians Contributing to Poverty Reduction Through Clinical-Community Partnership and Collective Action: A Narrative Review. Acad Pediatr 2021; 21:S200-S206. [PMID: 34740429 DOI: 10.1016/j.acap.2021.04.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 04/01/2021] [Accepted: 04/10/2021] [Indexed: 12/13/2022]
Abstract
Poverty affects child health and well-being in short- and long-term ways, directly and indirectly influencing a range of health outcomes through linked social and environmental challenges. Given these links, pediatricians have long advocated for poverty reduction in both clinical settings and society. Pediatricians and others who work in pediatric settings are well-suited to address poverty given frequent touchpoints with children and families and the trust that develops over repeated encounters. Many pediatricians also recognize the need for cross-sector engagement, mobilization, and innovation in building larger collaborative efforts to combat the harmful effects of poverty. A range of methods, like co-design, community organizing, and community-engaged quality improvement, are necessary to achieve measurable progress. Moreover, advancing meaningful representation and inclusion of those from underrepresented racial and ethnic minority groups will augment efforts to address poverty within and equity across communities. Such methods promote and strengthen key clinical-community partnerships poised to address poverty's upstream root causes and its harmful consequences downstream. This article focuses on those clinical-community intersections and cross-sector, multi-disciplinary programs like Medical-Legal Partnerships, Medical-Financial Partnerships, clinic-based food pantries, and embedded behavioral health services. Such programs and partnerships increase access to services difficult for children living in poverty to obtain. Partnerships can also broaden to include community-wide learning networks and asset-building coalitions, poised to accelerate meaningful change. Pediatricians and allied professionals can play an active role; they can convene, catalyze, partner, and mobilize to create solutions designed to mitigate the harmful effects of poverty on child health.
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Klein M, Hanson E, Lichtenstein C, Mogilner L, Falusi O, Tolliver DG, Lungelow L, Chamberlain L. Poverty Related Education in Pediatrics: Current State, Gaps and Call to Action. Acad Pediatr 2021; 21:S177-S183. [PMID: 34740426 DOI: 10.1016/j.acap.2021.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/27/2021] [Accepted: 02/03/2021] [Indexed: 11/29/2022]
Abstract
Children are the poorest age group in our country, with 1 in 6, or 12 million, living in poverty. This sobering statistic became even more appalling in spring 2020 when COVID-19 magnified existing inequities. These inequities are particularly important to pediatricians, because poverty, along with racism and other interrelated social factors, significantly impact overall child health and well-being. It is imperative that pediatric educators redouble their efforts to train learners to recognize and address health inequities related to poverty and all of its counterparts. In this paper, we describe the current state of poverty-related training in pediatric undergraduate, graduate, and continuing medical education as well as opportunities for growth. We highlight gaps in the current curricula, particularly around the intersectionality between poverty and racism, as well as the need for robust evaluation. Using a logic model framework, we outline content, learning strategies, and outcomes for poverty-related education. We include opportunities for the deployment of best practice learning strategies and the incorporation of newer technologies to deliver the content. We assert that collaboration with community partners is critical to shape the depth and breadth of education. Finally, we emphasize the paramount need for high-quality faculty development and accessible career paths to create the cadre of role models and mentors necessary to lead this work. We conclude with a call for collaboration between institutions, accrediting bodies, and policymakers to promote meaningful, outcome-oriented, poverty-related education, and training throughout the medical education continuum.
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Affiliation(s)
- Melissa Klein
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine (M Klein), Cincinnati, Ohio.
| | - Elizabeth Hanson
- Joe R. and Teresa Lozano Long School of Medicine, UT Health San Antonio (E Hanson), San Antonio, Tex
| | - Cara Lichtenstein
- The George Washington University School of Medicine and Health Sciences, Children's National Hospital (C Lichtenstein), Washington, DC
| | - Leora Mogilner
- Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital (L Mogilner), New York, NY
| | - Olanrewaju Falusi
- The George Washington University School of Medicine and Health Sciences, Children's National Hospital (O Falusi), Washington, DC
| | - Destiny G Tolliver
- Yale National Clinician Scholars Program, Yale School of Medicine (DG Tolliver), New Haven, Conn
| | - Lisha Lungelow
- Cincinnati Children's Hospital Medical Center (L Lungelow), Cincinnati, Ohio
| | - Lisa Chamberlain
- Stanford University School of Medicine (L Chamberlain), Stanford, Calif
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Affiliation(s)
- Jonathan E Fried
- Harvard Medical School, Boston, MA, USA.,John F. Kennedy School of Government at Harvard University, Cambridge, MA, USA
| | - Scott A Shipman
- Association of American Medical Colleges, Washington, DC, USA.,The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, NH, USA
| | - Laura L Sessums
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
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Shah S, Brumberg HL, Kuo A, Balasubramaniam V, Wong S, Opipari V. Academic Advocacy and Promotion: How to Climb a Ladder Not Yet Built. J Pediatr 2019; 213:4-7.e1. [PMID: 31561780 DOI: 10.1016/j.jpeds.2019.07.051] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 07/22/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Shetal Shah
- Division of Neonatal Medicine, Department of Pediatrics, New York Medical College, Maria Fareri Children's Hospital, Valhalla, NY.
| | - Heather L Brumberg
- Division of Neonatal Medicine, Department of Pediatrics, New York Medical College, Maria Fareri Children's Hospital, Valhalla, NY
| | - Alice Kuo
- Department of Internal Medicine, Pediatrics, and Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, and Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA
| | - Vivek Balasubramaniam
- Division of Pediatric Pulmonology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Shale Wong
- Department of Pediatrics, Eugene S. Farley, Jr Health Policy Center, University of Colorado School of Medicine, Denver, CO
| | - Valerie Opipari
- Division of Pediatric Hematology/Oncology, C.S. Mott Children's Hospital, University of Michigan School of Medicine, Ann Arbor, MI
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