Funded Projects

Eliminating Physician Bias of Incarcerated Youth

Project Year

2024

City & State

Houston, Texas

Program Name

CATCH Resident

Topic

Detained and Incarcerated Youth Health

Program Description

Consider Newton’s First Law, which states that an object will not change its state of motion unless acted upon by a net force. Now, let’s consider the School to Prison Pipeline in which policies that promote the law enforcement disciplining school aged children are put into effect. Minor infractions are criminalized, and students are expelled or suspended rather than disciplined in school. The link between substandard education, harsh punishment, poverty, racial injustice, and adverse health outcomes is no new phenomenon. The compounding effects of systemic downfalls such as the aforementioned pipeline and lack of available resources and interventions for incarcerated youth lead to significant adverse health outcomes. Revisiting Newton’s Law, we can infer that youth who encounter law enforcement will continue in a cycle of incarceration, probation, pseudo-freedom, and bondage - unless an outside force intervenes.   In addition to the problems inherent to being an incarcerated youth are the many stigma they face upon societal reentry. Unfortunately, healthcare providers are not immune from the implicit biases that cause us to stereotype and stigmatize these youth, which can lead to worsened health outcomes. Given our unique role as residents, we have the opportunity to use our knowledge and resources to affect vast change in the lives of these youth by increasing physician education and awareness. We would like to address this public health as CATCH grant recipients focusing on two major goals: 1) resident awareness and training on trauma informed care and 2) community intervention and resource connection for youth in Houston’s Juvenile Justice Center (JJC). This will take place in four phases as detailed below.   Phase 1 involves introducing the project to residents-at-large, identifying residents who are passionate about addressing health needs of incarcerated youth, providing trauma-informed care training, and engaging community partners to provide background information and increase awareness amongst the residents. We have reached out to the program director and chief residents who are on board, including incorporating lectures into Academic Half Day (AHD). Our first presentation will involve a pre-test to all residents (to assess comfort, bias, and awareness of incarcerated youth health needs), a survey for interested residents, and a lecture to introduce implicit bias, trauma informed care, and the common difficulties incarcerated youth face. In Phase 2, the subset of residents will begin a more in-depth course in trauma-informed-care, bias and discrimination amongst adolescents. We will also engage in outreach activities to build rapport with the youth. Residents will also be able to gauge what topics are of interest and of necessity to the well-being of the youth. After receiving the training and getting to know the youth and their needs, the residents assist in creating a curriculum for 1) the youth and 2) other residents to be presented at AHD. We will also have lecture #2 with pre and post testing. In phase 3, we will begin “doc talks” with the JJC youth and residents. By this time, we will have had experience with the youth and community partners that will help us create meaningful curricula to incorporate into the adolescent rotation and advocacy elective/track. We will also continue with the resident-youth mentorship experience and hold our third AHD lecture, including pre and post-test. The final phase, Phase 4, involves data collection and evaluation, a final lecture, and comprehensive post-testing. Long-term goals include developing an elective in which residents can continue to give these “doc talks” on common health concerns in this population to their co-residents. This will allow residents-at-large to receive more regular trauma-informed knowledge/training to implement in their own practices. 

Project Goal

#1 Development of resident curricula for trauma informed care and community engagement  #2 Establish a community intervention for pediatricians to coordinate with the Juvenile Justice Center to provide outreach education 

Project Objective 1

#1A- Have 40 residents attend Academic Half Day Lecture #1 and complete pre-test and post test by August 2024.  #2A- Engage with 6 clients (youth) per session at the JJC by June 2025.

Project Objective 2

#1B- See a 25% change in resident knowledge between pre and post-test scores after Academic Half Day by lecture #2 December 2024.  #2B- Identify 3 interested residents who would like to mentor at the JJC by December 2024.

Project Objective 3

#1C- Connect with 3 community partners by December 2024.  #2C- Provide mentorship and ‘Doc talks’ once a month by June 2025.

AAP District

District VII

Institutional Name

University of Texas McGovern Medical School Pediatric Residency Program  

Contact 1

Alexandria Laws, MD

Contact 2

Andrea Pinto, MD