Maternal and Child Health Training Program

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Funded Projects

Grant Status: Completed

Grant Title: Behavioral Pediatrics Fellowship Training

Grantee Product(s):

Project Director(s):

Nancy Roizen, MD
Assistant Professor
Case Western Reserve University
Rainbow Babies and Childrens Hospital
Division of Behavioral Pediatrics and Psychology - RBC 6038
Walker BLDG Suite 3151, 1110 Euclid Avenue
Cleveland, OH  44106-6038
Phone: (216) 983-1224
Email: Nancy.Roizen@uhhospitals.org

Problem:

Develop D-B pediatricians to provide leadership in patient care, teaching, research, advocacy. Need based on large numbers of children with d-b problems who should be treated by clinically experienced professionals, informed of/involved in current research, and actively teaching these skills.

Goals and Objectives:

Goal 1: To prepare fellows to provide evidence-based, culturally-competent, family-centered patient care through effective assessment, diagnosis, management, consultation for developmental/behavioral problems Objective 1: Learn to assess, diagnose, manage, treat culturally diverse population with D-B problems. Objective 2: Learning will be through an integrated curriculum covering core knowledge areas specified by ACGME DBP subspecialty training. Objective 3: Learn interviewing skills through structured clinical observation, including a family-centered block, in multiple clinics with varied populations. Goal 2: To prepare fellows to assume leadership positions as teachers of developmental-behavioral pediatrics Objective 1: Learn teaching techniques by participating in university seminar program Objective 2: Develop own presentation skills by developing various presentations, including CME and through evaluation of others' presentations Objective 3: Participate in providing technical assistance and teaching through COR program; practice written teaching of parents by developing handouts Goal 3: To train fellows to perform independent as well as collaborative research and participate in the elements of academic enterprise Objective 1: Complete and pass courses in Clinical Research Seminar series Objective 2: Choose research topic, review, synthesize current literature, formulate research hypothesis, develop research project, gather and analyze data Objective 3: Write up and submit for presentation and publication and present results in > 2 forums; learn process of manuscript review. Goal 4: To train fellows about medical practice and health care delivery systems in order to become effective advocates for children with D-B problems and special healthcare needs Objective 1: Learn from local role models/examples through review and writing-up these activities Objective 2: Participate in advocacy project; keep portfolio of advocacy activities, follow-up on regular basis to determine effectiveness Objective 3: Learn about role of communication through observing testimony, writing letters to legislature, OP Ed pieces Goal 5: To enable the fellows to develop the knowledge, skill sets, and professionalism needed to assume leadership roles in their states and communities Objective 1: Develop planning/focus skills through formulation of goals and assessment of progress Objective 2: Develop new program, including space/budget/time; develop seminars, including needs assessment/topic/speaker selection/advertising/evaluation; learn constructive peer review

Methodology:

Fellows learn professionalism, communication, cultural competency, provision of family-centered care, interdisciplinary team building, working with systems in variety of clinical experiences (Continuity, Multi-Ethnic, Adoption Health Services). Critical thinking/communication skills for teaching developed through involvement in pediatric resident rotation program, participating in evaluation/development of strategies for improvement. Presentations for different audiences will encourage critical thinking on issues relevant to MCH concerns: ethical issues, communities and systems, advocacy. Fellows learn elements of research process through review/synthesis of current literature, formulation of hypothesis, data gathering, writing, presentation/publication thus learning academic skills: written/oral presentations, review of papers, writing/reviewing grants, budgets, and the IRB process. In advocacy activities, fellows observe and practice tools of advocacy through observing and practicing oral and written testimony, writing an OP ED piece on MCH issue, developing issue paper for BCMH (Title V) or the Center for Health Policy. Working with advocacy mentors, they will learn about the spectrum of the activities of advocacy, and will also see in action the power of well chosen words and a well crafted letter. These clinical, teaching, research, and advocacy experiences will provide fellows the materials and skills to assume leadership roles in their professional lives

Coordination:

Working knowledge of Title V of Social Security Act, Title X (Family Planning), XIX (Medicaid/EPSDT), XXI (State Children's Health Insurance Program) provided by seminars led by Dr. James Bryant, Chief of (BCMH), which funds services for children in need of services. Dr. Bryant will work with fellows to provide technical assistance to BCMH and develop issue papers on important D-B topics. He has also agreed to provide an opportunity to sit in a pre-review session for Title V grant proposals

Evaluation:

Comprehensive evaluation includes documentation of engagement in stated goals/objectives through: twice monthly meetings of fellows with program director; semi-annual performance review to review data that demonstrates progress toward stated goals/objectives/competencies; 360 peer, administrative, self evaluations; Fellows' Review Committee (program director, co-director, clinic attendings, research director, program coordinator) will meet at 3 months, and then every 6 months to review progress

Experience to Date:

The 2010-11 academic year has been a productive one for both the fellows and for building services for children with autism spectrum disorder (ASD). One fellow presented an abstract on her work on preemie twins at PAS, has a paper on Down syndrome (DS) grown-up in press, and is an active member of the DBPediatrics in Review question writing committee. The other fellow has a chapter in press and is working on research on hearing loss in DS. The faculty has lost one and gained two psychologists and recruiting a replacement Developmental-Behavioral Pediatrician. The faculty has continued to work on clinical and research projects and to provide educational experiences locally, nationally, and internationally. One DBP faculty has been collaborating as an ACT ambassador with the Columbus LEND/and with the CDC ACT autism project. We have established the multidisciplinary Rainbow Autism Diagnostic Clinic to provide quick, comprehensive evaluations for young children with a question of ASD. We have added a fall/spring Quick Start seminar series for parents of young children with ASD and professionals who work with them, while also continuing to provide the annual (8th) Autism Seminar Series. We have established quarterly networking and collaboration meetings with those who provide medical, educational, and support services in our community for children with ASD and their families. We are also collaborating with community partners to establish a research center for ASD.

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