ABSTRACT
Presented at the Pediatric Academic Societies annual meeting, May 2005
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.