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Janet R Serwint - One of the best experts on this subject based on the ideXlab platform.
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pediatric residents knowledge and comfort with oral health Bright Futures concepts a cornet study
Academic Pediatrics, 2015Co-Authors: Rani S Gereige, Niramol Dhepyasuwan, Janet R Serwint, Karla L Garcia, Rukmani Vasan, Henry H BernsteinAbstract:Abstract Objective Training residents in oral health helps eliminate disparities and improves access. The American Academy of Pediatrics Bright Futures Guidelines curriculum is used as a training guide. We assessed knowledge, confidence, and perceived barriers to incorporating Bright Futures oral health concepts into well-child care for children below 3 years in a national sample of pediatric residents. Methods A sample of postgraduate year 1 and 2 residents from CORNET sites completed demographic, Bright Futures oral health concepts confidence and knowledge cross-sectional surveys before any intervention. Measures were tested for reliability using Cronbach's alpha coefficient. Results One hundred sixty-three residents from 28 CORNET sites completed the surveys. One third reported no prior training in oral health. Time (42%) and knowledge (33%) led the perceived barriers to addressing these concepts in well visits. Although 63% rated their confidence as excellent in identifying tooth decay risk factors, a significant percentage rated their oral health risk assessment skills as poor or neutral (64%) and identifying caries at examination (53%). Only 49% conveyed oral health messages during encounters and 80% correctly scored 75% or higher on knowledge questions. Conclusions This cross-sectional study shows that residents from a wide geographic range have high self-reported oral health knowledge but low perceived skills and competency in clinical implementation. Lack of time and knowledge in identifying caries led the perceived barriers. Barriers are addressed by implementing oral health curricula that promote competence and skill-development. This study helps programs effectively implement Bright Futures concepts to train graduates to incorporate oral health in well visits.
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evaluation of a national Bright Futures oral health curriculum for pediatric residents
Academic Pediatrics, 2013Co-Authors: Henry H Bernstein, Niramol Dhepyasuwan, Kara Connors, Kevin Volkan, Janet R SerwintAbstract:Abstract Objective Training in Bright Futures and oral health concepts is critical for delivery of high-quality primary care and preventive health services by residents, our future pediatric workforce. The goal of this study was to evaluate the effectiveness of an online health promotion curriculum on pediatric residents' confidence, knowledge, and clinical performance in Bright Futures and oral health practice. Methods Residents from sites that had been stratified by size and randomized were assigned to the Bright Futures Oral Health curriculum (intervention group) or an active control group. Confidence and knowledge were measured by self-report and multiple-choice questions, respectively. Clinical performance was measured with structured clinical observations, performed by trained faculty, of Bright Futures and oral health performance before and after intervention. Mean scores between intervention and control groups were compared using a 2-tailed, repeated-measures F test. Results A total of 143 pediatric residents from 27 Continuity Research Network (CORNET) sites participated in the study. At a median of 3 months after intervention, the intervention group demonstrated significant improvement in general Bright Futures confidence (n = 128, F = 6.564, P = .012) and knowledge (n = 102, F = 5.296, P = .023), oral health confidence (n = 123, F = 15.220, P F = 11.315, P = .001) compared with the control group. Conclusions The Bright Futures Oral Health curriculum promoted an increase in confidence and knowledge in Bright Futures concepts and in confidence and clinical performance in oral health concepts among pediatric residents. This online curriculum demonstrated a positive impact on documented resident behavior, maintained for 3 months after intervention, and provides a replicable national training model to advance important elements of primary care pediatrics.
Henry H Bernstein - One of the best experts on this subject based on the ideXlab platform.
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pediatric residents knowledge and comfort with oral health Bright Futures concepts a cornet study
Academic Pediatrics, 2015Co-Authors: Rani S Gereige, Niramol Dhepyasuwan, Janet R Serwint, Karla L Garcia, Rukmani Vasan, Henry H BernsteinAbstract:Abstract Objective Training residents in oral health helps eliminate disparities and improves access. The American Academy of Pediatrics Bright Futures Guidelines curriculum is used as a training guide. We assessed knowledge, confidence, and perceived barriers to incorporating Bright Futures oral health concepts into well-child care for children below 3 years in a national sample of pediatric residents. Methods A sample of postgraduate year 1 and 2 residents from CORNET sites completed demographic, Bright Futures oral health concepts confidence and knowledge cross-sectional surveys before any intervention. Measures were tested for reliability using Cronbach's alpha coefficient. Results One hundred sixty-three residents from 28 CORNET sites completed the surveys. One third reported no prior training in oral health. Time (42%) and knowledge (33%) led the perceived barriers to addressing these concepts in well visits. Although 63% rated their confidence as excellent in identifying tooth decay risk factors, a significant percentage rated their oral health risk assessment skills as poor or neutral (64%) and identifying caries at examination (53%). Only 49% conveyed oral health messages during encounters and 80% correctly scored 75% or higher on knowledge questions. Conclusions This cross-sectional study shows that residents from a wide geographic range have high self-reported oral health knowledge but low perceived skills and competency in clinical implementation. Lack of time and knowledge in identifying caries led the perceived barriers. Barriers are addressed by implementing oral health curricula that promote competence and skill-development. This study helps programs effectively implement Bright Futures concepts to train graduates to incorporate oral health in well visits.
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evaluation of a national Bright Futures oral health curriculum for pediatric residents
Academic Pediatrics, 2013Co-Authors: Henry H Bernstein, Niramol Dhepyasuwan, Kara Connors, Kevin Volkan, Janet R SerwintAbstract:Abstract Objective Training in Bright Futures and oral health concepts is critical for delivery of high-quality primary care and preventive health services by residents, our future pediatric workforce. The goal of this study was to evaluate the effectiveness of an online health promotion curriculum on pediatric residents' confidence, knowledge, and clinical performance in Bright Futures and oral health practice. Methods Residents from sites that had been stratified by size and randomized were assigned to the Bright Futures Oral Health curriculum (intervention group) or an active control group. Confidence and knowledge were measured by self-report and multiple-choice questions, respectively. Clinical performance was measured with structured clinical observations, performed by trained faculty, of Bright Futures and oral health performance before and after intervention. Mean scores between intervention and control groups were compared using a 2-tailed, repeated-measures F test. Results A total of 143 pediatric residents from 27 Continuity Research Network (CORNET) sites participated in the study. At a median of 3 months after intervention, the intervention group demonstrated significant improvement in general Bright Futures confidence (n = 128, F = 6.564, P = .012) and knowledge (n = 102, F = 5.296, P = .023), oral health confidence (n = 123, F = 15.220, P F = 11.315, P = .001) compared with the control group. Conclusions The Bright Futures Oral Health curriculum promoted an increase in confidence and knowledge in Bright Futures concepts and in confidence and clinical performance in oral health concepts among pediatric residents. This online curriculum demonstrated a positive impact on documented resident behavior, maintained for 3 months after intervention, and provides a replicable national training model to advance important elements of primary care pediatrics.
S J Emans - One of the best experts on this subject based on the ideXlab platform.
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adolescent medicine training in pediatric residency programs are we doing a good job
Pediatrics, 1998Co-Authors: S J Emans, Terrill Bravender, John R Knight, Carolyn Frazer, Maria Luoni, Carol D Berkowitz, Ehrin J Armstrong, Elizabeth GoodmanAbstract:Objectives To determine how pediatric residency programs are responding to the new challenges of teaching adolescent medicine (AM) to residents by assessing whether manpower is adequate for training, whether AM curricula and skills are adequately covered by training programs, what types of teaching methodologies are used to train residents in AM, and the needs for new curricular materials to teach AM. Design A 3-part 92-item survey mailed to all US pediatric residency training programs. Setting Pediatric residency programs. Participants Residency program directors and directors of AM training. Main outcome measures AM divisional structure, clinical sites of training, presence of a block rotation, and faculty of pediatric training programs; training materials used and desired in AM; perceived adequacy of coverage of various AM topics; competency of residents in performing pelvic examinations in sexually active teens; and manpower needs. Results A total of 155/211 (73.5%) of programs completed the program director and the AM parts of the survey. Ninety-six percent of programs (size range, 5-120 residents) had an AM block rotation and 90% required the AM block; those without a block rotation were more likely to be larger programs. Only 39% of programs felt that the number of AM faculty was adequate for teaching residents. Almost half of the programs reported lack of time, faculty, and curricula to teach content in substance abuse. Besides physicians, AM teachers included nurse practitioners (28%), psychologists (25%), and social workers (19%). Topics most often cited as adequately covered included sexually transmitted diseases (81.9%), confidentiality (79.4%), puberty (77.0%), contraception (76.1%), and menstrual problems (73.5%). Topics least often cited as adequately covered included psychological testing (16.1%), violence in relationships (20.0%), violence and weapon-carrying (29.7%), and sports medicine (29.7%). Fifty-eight percent of 137 respondents thought that all or nearly all of their residents were competent in performing pelvic examinations by the end of training; there was no difference between perceived competence and the residents' use of procedure books. Seventy-four percent used a specific curriculum for teaching AM; materials included chapters/articles (85%), lecture outlines (76.1%), slides (41.9%), videos (35.5%), written case studies (24.5%), computerized cases (6.5%), and CD-ROMs (3.2%). Fifty-two percent used Bright Futures, 48% used the Guidelines for Adolescent Preventive Services, and 14% used the Guide to Clinical Preventive Services for teaching clinical preventive services. Programs that used Bright Futures were more likely to feel that preventive services were adequately covered in their programs than those who did not (78% vs 57%). A majority of programs desired more learner-centered materials. Conclusions Although almost all pediatric programs are now providing AM rotations, there is significant variability in adequacy of training across multiple topics important for resident education. Programs desire more learner-centered materials and more faculty to provide comprehensive resident education in AM.
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should pelvic examinations and papanicolaou cervical screening be part of preventive health care for sexually active adolescent girls
Journal of Adolescent Health, 1998Co-Authors: S J Emans, Sally E Perlman, Jessica A KahnAbstract:Over the past 10 years preventive health care of adolescents has received increased attention with the publication of the American Medical Association (AMA) Guidelines for Preventive Services (GAPS) Bright Futures Health Supervision Guidelines and American Academy of Pediatrics (AAP) and American College of Obstetricians and Gynecologists (ACOG) recommendations. Screening of sexually active girls for risk behaviors and for sexually transmitted diseases (STDs) and with Papanicoloau (Pap) smears as well as the provision of human immunodeficiency virus (HIV) counseling and testing have assumed increased importance. The 1995 Youth Risk Behavior Survey found that over 50% of ninth- to 12th-grade high school girls reported ever having had sexual intercourse. Higher percentages are reported by out-of-school youth. In addition girls who do not report consensual intercourse but have been victims of sexual abuse or assault may add to the number of adolescents who have been exposed to STDs including human papillomavirus (HPV) a risk factor for abnormal Pap smears. (excerpt)
Paula M Duncan - One of the best experts on this subject based on the ideXlab platform.
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Bright Futures guidelines 3 e
2017Co-Authors: Joseph F Hagan, Judith S Shaw, Paula M DuncanAbstract:The authoritative AAP Guidelines for Health Supervision III you've relied on for years is combined with the practical approach Bright Futures delivers. Now the authoritative AAP Guidelines for Health Supervision III you've relied on for years is combined with the practical approach Bright Futures delivers. The result: an updated, highly efficient system to help you provide better health care, save time, and keep up with changes in family, communities, and society that impact child's health. The most current recommendations for the top 10 areas of child development Part I is organized into 10 themes common to all stages of child development, with special emphasis on 2 new significant challenges: mental health and healthy weight. One volume with the most up-to-date well-child supervision standards Part II focuses on specific guidance for each of 31 age-based health care visits. Each visit enumerates 5 priorities for that visit, including sample questions and discussion points for both parent and child.
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Bright Futures pocket guide 4th ed
2017Co-Authors: Joseph F Hagan, Judith S Shaw, Paula M DuncanAbstract:All the essentials of the Bright Futures health supervision visits in an easy-to-access format. It's the quick reference tool and training resource for busy health professionals. Includes every visit from birth through age 21. Also included in the appendices are Developmental Milestones at a Glance chart, Recommended Medical Screenings chart for infancy through adolescence, Sexual Maturity Ratings scale, and much more!
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Bright Futures guidelines for health supervision of infants children and adolescents 4th ed
2017Co-Authors: Joseph F Hagan, Judith S Shaw, Paula M DuncanAbstract:This essential resource provides key background information and recommendations for themes critical to healthy child development along with well-child supervision standards for 31 age-based visits--from Newborn through 21 Years. The result: better health care, more efficient visits, stronger partnerships with children and families, and better ability to keep up with changes in family, communities, and society that affect a child's health.
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improving delivery of Bright Futures preventive services at the 9 and 24 month well child visit
Pediatrics, 2015Co-Authors: Paula M Duncan, Judith S Shaw, Marian F Earls, William Stratbucker, Amy Pirretti, Jill A Healy, Steven KairysAbstract:OBJECTIVES: To determine if clinicians and staff from 21 diverse primary care practice settings could implement the 2008 Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd edition recommendations, at the 9- and 24-month preventive services visits. METHODS: Twenty-two practice settings from 15 states were selected from 51 applicants to participate in the Preventive Services Improvement Project (PreSIP). Practices participated in a 9-month modified Breakthrough Series Collaborative from January to November 2011. Outcome measures reflect whether the 17 components of Bright Futures recommendations were performed at the 9- and 24-month visits for at least 85% of visits. Additional measures identified which office systems were in place before and after the collaborative. RESULTS: There was a statistically significant increase for all 17 measures. Overall participating practices achieved an 85% completion rate for the preventive services measures except for discussion of parental strengths, which was reported in 70% of the charts. The preventive services score, a summary score for all the chart audit measures, increased significantly for both the 9-month (7 measures) and 24-month visits (8 measures). CONCLUSIONS: Clinicians and staff from various practice settings were able to implement the majority of the Bright Futures recommended preventive services at the 9- and 24-month visits at a high level after participation in a 9-month modified Breakthrough Series collaborative.
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busy practices successfully implement Bright Futures guidelines
AAP News, 2012Co-Authors: Paula M Duncan, Marian F Earls, William StratbuckerAbstract:Pediatricians have expressed concern about whether the new Bright Futures preventive services guidelines can actually be implemented in a busy practice. The answer was a resounding “yes” for 21 U.S. practices that participated in the Preventive Services Improvement Project (PreSIP). ![Figure][
Jane Bassewitz - One of the best experts on this subject based on the ideXlab platform.
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the Bright Futures training intervention project implementing systems to support preventive and developmental services in practice
Pediatrics, 2008Co-Authors: Carole Lannon, Kori B Flower, Paula Duncan, Karen Strazza Moore, Jayne Stuart, Jane BassewitzAbstract:OBJECTIVES. The objectives of this study were to assess the feasibility of implementing a bundle of strategies to facilitate the use of Bright Futures recommendations and to evaluate the effectiveness of a modified learning collaborative in improving preventive and developmental care. METHODS. Fifteen pediatric primary care practices from 9 states participated in a 9-month learning collaborative. Support to practices included a toolkit, 2 workshops, training in quality-improvement methods, monthly conference calls and data feedback, and a listserv moderated by faculty. Aggregated medical chart reviews and practice self-assessments on 6 key office system components were compared before and after the intervention. RESULTS. Office system changes most frequently adopted were use of recall/reminder systems (87%), a checklist to link to community resources (80%), and systematic identification of children with special health care needs (80%). From baseline to follow-up, increases were observed in the use of recall/reminder systems, the proportion of children9s charts that had a preventive services prompting system, and the families who were asked about special health care needs. Of 21 possible office system components, the median number used increased from 10 to 15. Comparing scores between baseline and follow-up for each practice site, the change was significant. Teams reported that the implementation of office systems was facilitated by the perception that a component could be applied quickly and/or easily. Barriers to implementation included costs, the time required, and lack of agreement with the recommendations. CONCLUSIONS. This project demonstrated the feasibility of implementing specific strategies for improving preventive and developmental care for young children in a wide variety of practices. It also confirmed the usefulness of a modified learning collaborative in achieving these results. This model may be useful for disseminating office system improvements to other settings that provide care for young children.