Pediatricians? Perspectives Regarding Community Child Health: Training, Involvement, and Expectations By Age

Cynthia Minkovitz, MD, MPP ¹, Anita Chandra, MPH ¹, Michael Kogan, PhD ², Karen O'Connor ³, Holly Grason, MA ¹ and Tom Tonniges, MD ³. ¹ Population and Family Health Sciences, Bloomberg School of Public Health, Baltimore, MD, 21205; ² Maternal and Child Health Bureau, HRSA, Rockville, MD, 20857 and ³ American Academy of Pediatrics, Elk Grove Village, IL, 60007.

 

Background: There are increasing opportunities for pediatricians to promote children?s health through community involvement and growing emphasis on related training during residency. Little is known about whether younger pediatricians (emerging workforce) relative to established pediatricians have different training experiences, perspectives, or involvement in community activities.

 

Objective: To examine pediatricians? training, perspectives, and involvement in community activities and examine variation by age among those who completed residency.

 

Design/Methods: National, random sample, mailed Periodic Survey of American Academy of Pediatrics US members, 2004; response rate = 58%. Chi square statistics were used to measure associations of age [<34, 35-39, 40-50, >51 years] with training, perspectives, and involvement.

 

Results: Younger pediatricians reported more training in community child health during and before residency but were less likely to currently be involved in community activities to promote children?s health (37.9% for <34, 44.4% for 35-39, 46.2% for 40-50, and 48.3% for >51 years). They also were more likely to report that their current level of involvement was too little rather than just right or too much (81.3%, 73.5%, 60.7%, 47.1%; p<.01). Also, younger pediatricians were more willing to spend > 1 hour/ month devoted to community child health activities over the next year (95.0%, 91.2%, 89.7%, 85.4%; p<.01). Younger vs. older pediatricians were more likely to sense moderate or greater responsibility for improving the health children in their community (83.6%, 77.2%, 76.7%, 70.2%; p<.05) and expected their community work to increase over the next 5 years (80.0%, 67.5%, 59.7%, 40.1%; p<.01). Age findings persisted when adjusted for gender.

 

Conclusions: Although practice constraints for the youngest portion of the pediatric workforce may constrain community involvement, younger pediatricians anticipate growing involvement in community activities. Longitudinal studies are needed to determine whether such expectations are realized.