Maternal and Child Health Training Program

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Funded Projects

Grant Title: Collaborative Office Rounds

Project Director(s):

Barbara True Felt, MD
University of Michigan
Center for Human Growth and Development
300 N. Ingalls FL 10th
Ann Arbor, MI  48109
Phone: (734) 764-2443
FAX: (734) 936-9288
Email: truefelt@umich.edu

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Problem:

Economic struggles have increased psychosocial and mental health problem risks in children, yet such problems remain under-identified or addressed. This project seeks to improve the ability of primary care providers to identify, treat and refer children and families for appropriate care.

Goals and Objectives:

Goal 1: To improve COR member skills in screening, identification, and management of developmental and behavioral disturbances and disorders. Objective 1: Objective 1.1 Members will increase the use and documentation of standardized screening tools at health supervision visits; the 15- and 48-month visits will be the focus in year 1. Objective 2: Objective 1.2 Members will increase the number of appropriate referrals to developmental and mental health providers. Goal 2: To improve COR member knowledge of community programs and resources. Objective 1: Objective 2.1 Members will appropriately refer cases to community-based programs and resources. Objective 2: Objective 2.2 Members (and non-members) will use the COR website resource links, and this use will increase over time. Goal 3: To enhance member knowledge of, and sensitivity to, the many cultural backgrounds of Michigan families. Objective 1: Objective 3.1 Members will highlight cultural differences and related practice change in presentations. Objective 2: Objective 3.2 Members will increase the proportion presentations and practice notes in which ethnicity/cultural beliefs/preferences and the effect on plan of management are stated. Goal 4: To reach out to primary care providers in underserved Michigan regions. Objective 1: Objective 4.1 COR value will be similar for in-person and remote members. Objective 2: Objective 4.2 Group participation of in-person and remote members will be comparable. Objective 3: Objective 4.3 The number of COR website "hits" will increase over the project period.

Methodology:

The COR group at the University of Michigan will be primarily moderated by Dr. Barbara Felt, MD, Developmental Behavioral Pediatrician (DBP) and Dr. Charles Krasnow, MD, Child Psychiatrist (CP). The backup moderators are Dr. Betsy Lozoff, MD (DBP) and Dr. Kate Fitzgerald, MD (CP). The moderators have significant experience in education and practice; both DBPs and Krasnow have been fellowship program directors, and both CPs and Felt have very active clinical practices. The COR group consists of primary care providers from pediatrics and family medicine, other DBPs, and pediatric psychologists. Recently, through the first step of our outreach to community resources, an early infant-child therapist has joined our group, representing the Guidance Center for Wayne County. Our COR meets the 1st, 3rd, and 5th Wednesday morning of each month from September through June for 1.5 hrs and the activities include topic discussions, case presentations, practice note review. Cases involving challenging families, patients and medical/mental health problems are regularly presented and often followed overtime. Outreach will expand across years to include website development to share education and through invitation to other out-of-area rural and urban providers.

Coordination:

COR member links to State and local agencies include: Solomon - closely with the Michigan Children with Special Health Care Needs; Swindell - State and National AAP task forces for lead screening, immunizations and gun control; Walden - educates local and State primary care providers on gun control; Felt - the State maternal-perinatal depression network; Sims - closely with state agencies for early child personnel training, supervision and the coordination of care across agencies.

Evaluation:

Our evaluations will focus on translation of knowledge to practice and outreach. Methods will include: biannual review of visit records for documentation of screening methods and referrals; COR website usage; discussion and documentation of ethnicity/cultural preferences; attendance and CME ratings.

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