Faculty Bibliography

OBJECTIVE: To improve academic general pediatrics (AGP) fellowship programs by 1) developing curriculum guidelines and program standards and 2) creating a process for program review and consultation that might later be used for accreditation of AGP fellowship programs. METHODS: This project of the Ambulatory Pediatric Association (APA) created 4 documents: AGP fellowship program requirements, core curriculum, educational goals and objectives, and a standardized form to describe required program characteristics. Site visits were conducted at 7 volunteer AGP fellowship programs, selected for diversity of content, structure, and location. Evaluations were conducted using a uniform checklist of requirements that combined numerical ratings with a written evaluation summary. Feedback from programs on the review process enabled refinement of the documents. RESULTS: The site visits revealed great variety in emphasis among the 7 programs. In general, faculty were dedicated and capable, and programs showed considerable educational strengths. Typical problems were lack of integration of the program within departmental structures, overburdened faculty, and uncertain funding. Many programs demonstrated suboptimal curriculum planning and weak evaluation methods. Most program leaders felt that the project materials helped to improve the quality of their programs, and 5 of 7 programs expressed willingness to be involved in formal accreditation review in the future. CONCLUSIONS: AGP fellowship programs that volunteered for piloting of an accreditation process were diverse and vital, with rich educational offerings despite a lack of optimal curriculum structure, minimal evaluation, limited faculty resources, and tenuous funding. An APA accreditation process appears to be feasible and may enhance AGP fellowship programs

Academic generalists are unique and important members of the pediatric landscape.(1) Academic general pediatrics (AGP) is not considered a subspecialty, because it adheres to generalist values and embraces a wide range of clinical activities. Nonetheless, academic generalists engage in important scholarly efforts, contribute extensively to the education of new pediatricians, and must be prepared to survive in academia. Academic general pediatric faculty positions are subject to the same appointment and promotion requirements as those of subspecialist faculty

OBJECTIVE: To describe the interrelationships between books and toys in the home, parent-child interaction, and child development at 21 months among low-income Latino children. METHODS: Latino mother-infant dyads enrolled in a level 1 nursery and infants were followed to 21 months. The subjects consisted of the control group of a larger intervention study. At 6 and 18 months, the number of books and toys in the home and the frequency of reading aloud were measured by the StimQ. At 21 months, child cognitive and language development and parent-child interaction were assessed by the Bayley Mental Development Index (MDI), the Preschool Language Scale-3 (PLS-3), and the Caregiver-Child Interaction Rating Scale, respectively. Eligibility for early intervention (EI) services was determined on the basis of the MDI and PLS-3. RESULTS: Data were obtained for 46 (63.0%) of 73 at 21 months. In multiple regression analysis, books provided at 18 months predicted both cognition (semipartial correlation [sr] = .49, P= .001) and receptive language (sr = .37, P= .02), whereas toys provided at both 6 and 18 months predicted 21-month receptive language (sr = .40, P= .01; sr = .32, P= .047, respectively). Reading aloud by parents > or =4 days a week was associated with decreased EI eligibility (adjusted odds ratio = 0.16, 95% confidence interval 0.03-0.99). CONCLUSIONS: Reading aloud and provision of toys are associated with better child cognitive and language development as well as with decreased likelihood of EI eligibility

ABSTRACT.: The authors performed a randomized, controlled trial to assess the impact of the Video Interaction Project (VIP), a program based in pediatric primary care in which videotaped interactions are used by child development specialists to promote early child development. Ninety-three Latino children (51 VIP, 42 control) at risk of developmental delay on the basis of poverty and low maternal education (none had completed high school) were assessed for cognitive and language development at age 21 months. Results differed depending on the level of maternal education; the VIP was found to have a moderate impact on children whose mothers had between seventh and 11th grade education (approximately 0.75 SD for cognitive development, 0.5 SD for expressive language) but little impact on children whose mothers had sixth grade or lower education

OBJECTIVE: Failure to read at grade level predicts life-long economic and social disability. Early exposure to reading aloud may prevent reading problems. This study seeks to determine whether institution of Reach Out and Read (ROR) programs is associated with increased reading aloud in a national sample. DESIGN: Before-after intervention study: separate convenience samples were studied before and after institution of ROR programs at multiple sites. PARTICIPANTS AND SETTING: A convenience sample of parents of children age 6-72 months seeking routine health care at 19 clinical sites in 10 states. INTERVENTIONS: The ROR model incorporates anticipatory guidance about reading aloud and distribution of free picture books at health supervision visits from 6 months through 5 years as well as reading aloud in the waiting room. MAIN OUTCOME MEASURES: Parents were interviewed about their attitudes and practices related to reading aloud, using questions drawn from validated instruments. RESULTS: The sample included 1647 subjects (730 intervention, 917 comparison). After controlling for multiple potential confounding factors, significant associations were found between exposure to ROR and reading aloud as a favorite parenting activity (Adjusted Odds Ratio [AOR] 1.6, P < .001); reading aloud at bedtime (Adjusted Odds Ratio [AOR*rsqb; 1.5, P < .001); reading aloud 3 or more days per week (AOR 1.8, P < .001); and ownership of > or = 10 picture books (AOR 1.6, P < .001). CONCLUSIONS: In a national sample, implementation of ROR programs was associated with increased parental support for reading aloud. This study provides evidence of the effectiveness of a primary care intervention strategy to promote reading aloud to young children