1
|
Hess CW, Rea KE, Wruble LP, Yee ST, Bejarano CM, Williford DN, Gibler RC, Eshtehardi SS, Fisher RS, Morgan CH. Examining where to go: pediatric psychology trainees' perception of their graduate training in culture and diversity. J Pediatr Psychol 2024:jsae049. [PMID: 38872285 DOI: 10.1093/jpepsy/jsae049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 05/23/2024] [Accepted: 05/28/2024] [Indexed: 06/15/2024] Open
Abstract
OBJECTIVE Culture and diversity-related training is critical to the development of competent pediatric psychologists. Evaluation of training efforts have been conducted at the program level, yet evaluation of trainee experiences in culture and diversity-related training remains unassessed. This trainee-led study was the first formal assessment of pediatric psychology trainee experiences of culture and diversity-related training and the impact of training on their own cultural humility. METHODS Study overview and a survey link was distributed across 2 listservs associated with the American Psychological Association (Division 53, Division 54) and sent directly to directors of graduate, internship, and fellowship training programs with a request to share with trainees. Surveys assessing integration of cultural training and trainee cultural humility were completed. Trainees also provided qualitative feedback regarding their multicultural training and development. RESULTS Pediatric psychology trainees (N = 90) reported inconsistent integration of culture and diversity topics into their training. Of the 34 training areas assessed, 10 were perceived as thoroughly integrated into formal training by at least half of the respondents. Trainees often sought independent cultural training outside of their programs, and no relationship was detected between perceived integration of cultural training and trainee cultural competence. DISCUSSION Results indicate room for improvement regarding integration of cultural training and a need to better understand driving forces behind trainees independently seeking training outside of their formal training programs. Moreover, understanding the aspects of training that are most contributory to trainee development is needed given that no relationship between training and development emerged in the current study.
Collapse
Affiliation(s)
- Courtney W Hess
- Department of Anesthesiology, Perioperative, & Pain Medicine, Stanford University School of Medicine, Palo Alto, United States
| | - Kelly E Rea
- Division of Pediatric Psychology, Department of Pediatrics, C. S. Mott Children's Hospital, University of Michigan Health, Ann Arbor, United States
| | - Lauren P Wruble
- Division of Pediatric Psychology, Department of Pediatrics, C. S. Mott Children's Hospital, University of Michigan Health, Ann Arbor, United States
| | - Shanique T Yee
- Division of Pediatrics, Department of Behavioral Health, Nemours Children's Health, Orlando, United States
| | - Carolina M Bejarano
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, United States
| | - Desireé N Williford
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, United States
| | - Robert C Gibler
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, United States
| | - Sahar S Eshtehardi
- Department of Pediatrics, Psychology Division, Texas Children's Hospital/Baylor College of Medicine, Houston, United States
| | - Rachel S Fisher
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, United States
| | - Casie H Morgan
- Department of Psychology, University of Alabama at Birmingham, Birmingham, United States
| |
Collapse
|
2
|
Feldman MA, Agoston AM, Burnside AN, Emerson ND, Mudd E, Koehn KZ, Gallanis LE. Management of High Acuity Patients in Pediatric Medical Settings: The Role of Consultation/Liaison Psychologists During the Growing Mental Health Crisis. J Clin Psychol Med Settings 2024:10.1007/s10880-024-10010-y. [PMID: 38615279 DOI: 10.1007/s10880-024-10010-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2024] [Indexed: 04/15/2024]
Abstract
Since the onset of the COVID-19 pandemic, consultation/liaison (C/L) psychologists had to drastically shift their practices to care for psychiatrically acute pediatric patients admitted to medical settings. The aim of the current study was to provide an updated state of the field surrounding these changes and their implications for clinical practice. Psychologists and psychology post-doctoral fellows completed an anonymous, 51-item survey distributed via a national professional organization listserv. The results review responses, by percentages, about C/L team composition and practice patterns, as they relate to suicide risk assessments, transfers to inpatient psychiatric and other levels of care, intervention for boarding patients, and disposition and safety planning. Thematically coded qualitative responses regarding impact and management of high acuity patients are also summarized. The state of the field outlined by this survey suggests an increase in C/L assessments and interventions delivered to pediatric patients with acute psychiatric needs, as well as a reverberating effects on provider wellness. Ensuring providers establish competency for this subset of patients is vital to the continued provision of optimal patient care and to sustained provider wellness. Considerations for the field are explored.
Collapse
Affiliation(s)
- Marissa A Feldman
- Department of Psychology, Johns Hopkins All Children's Hospital, 880 Sixth Street South, Suite 460, Saint Petersburg, FL, 33713, USA.
| | | | - Amanda N Burnside
- Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Natacha D Emerson
- Department of Psychiatry & Biobehavioral Sciences, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Emily Mudd
- Center for Pediatric Behavioral Health, Cleveland Clinic Children's, Cleveland, OH, USA
| | - Kate Z Koehn
- Mental Health Services, Children's Minnesota, Minneapolis, MN, USA
| | - Lauren E Gallanis
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| |
Collapse
|
3
|
Stiles-Shields C, Reyes KM, Lennan N, Zhang J, Archer J, Julion WA, Shalowitz MU. Community Teens' COVID-19 Experience: Implications for Engagement Moving Forward. J Clin Psychol Med Settings 2024; 31:143-152. [PMID: 37803094 PMCID: PMC11174976 DOI: 10.1007/s10880-023-09975-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/08/2023]
Abstract
Data collected from pediatric primary care settings during the pandemic suggest an increase in internalizing symptoms and disparities in care based upon minoritized identity status(es). To inform care moving forward, the current study characterized the pandemic and related technology usage experiences of teenaged pediatric patients from communities with high hardship indexes. As part of a larger mixed-methods study, 17 teens (Mean age = 15.99 ± .99) and 10 caregivers independently voiced experiences related to the pandemic during remote focus group and interview sessions. Thematic analyses were used to assess qualitative data; descriptive analyses were used to characterize qualitative data. Despite no direct queries about the pandemic, 41% of teens and 40% of caregivers described their lived experiences during the pandemic. Two subthemes emerged within the primary theme of COVID-19: (1) Wellness/Mental Health and (2) Smartphone Use and Utility. Although distress and negative effects were voiced, questionnaire data indicated normative psychosocial functioning for both teen self-report and caregiver proxy report. Informed by the voiced experiences of teens and their caregivers from communities with high hardship indexes, methods for better assessing and managing internalizing symptoms in teen patients are presented. A multi-modal and multi-informant approach that leverages technology to garner information about teens' experiences and deliver care may help improve the well-being of teens in communities systemically burdened with disparities.
Collapse
Affiliation(s)
- Colleen Stiles-Shields
- Institute for Juvenile Research, Department of Psychiatry, The University of Illinois at Chicago, 1747 West Roosevelt Road, Chicago, IL, 60608, USA.
- Section of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, USA.
| | - Karen M Reyes
- Section of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, USA
| | - Nia Lennan
- Section of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, USA
| | - Jim Zhang
- Rosalind Franklin University of Medicine and Science, North Chicago, USA
| | - Joseph Archer
- School of Medicine and Public Health, University of Wisconsin, Madison, USA
| | - Wrenetha A Julion
- Department of Women, Children and Family Nursing, Rush University College of Nursing, Chicago, USA
| | - Madeleine U Shalowitz
- Section of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, USA
- Department of Pediatrics, Rush University Medical Center, Chicago, USA
| |
Collapse
|
4
|
Valentino K, Zhen-Duan J, Padilla J, Bernard D. Intergenerational Continuity of Child Maltreatment, Parenting, and Racism: Commentary on Valentino et al., (2012). CHILD MALTREATMENT 2023; 28:556-562. [PMID: 37491779 PMCID: PMC10543487 DOI: 10.1177/10775595231191395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Recent editorials published in Child Maltreatment bring much needed attention to racism in child maltreatment reporting and investigation. In this commentary, we extend these efforts by responding to Valentino et al., (2012) and addressing prior omissions in our race-related work by explicitly discussing the role of racism in our explanation of key study findings. Together with scholars with expertise in the impact of racism on children and families, this commentary (a) discusses theoretical models of child maltreatment and of the influence of racism on parenting and child development; (b) discusses parental responses to racism in relation to the Valentino et al., (2012) findings; and (c) highlights future research directions.
Collapse
Affiliation(s)
- Kristin Valentino
- Department of Psychology, University of Notre Dame, Notre
Dame, IN, USA
| | - Jenny Zhen-Duan
- Disparities Research Unit, Massachusetts General Hospital,
Boston, MA, USA
| | - Jenny Padilla
- Department of Psychology, University of Notre Dame, Notre
Dame, IN, USA
| | - Donte Bernard
- Department of Psychological Sciences, University of
Missouri, Columbia, MO, USA
| |
Collapse
|
5
|
Bates CR, Pallotto IK, Moore RM, Covitz LM, Dreyer Gillette ML. Barriers and facilitators of family rules and routines during pediatric cancer treatment. J Pediatr Nurs 2023; 72:e33-e39. [PMID: 37308340 DOI: 10.1016/j.pedn.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Pediatric nurses work closely with families of children with new cancer diagnoses and can provide essential supports to promote coping and adjustment. This cross-sectional qualitative study aimed to gather caregiver perspectives on barriers and facilitators to adaptive family functioning during the early phases of cancer treatment, with a focus on family rules and routines. METHODS Caregivers (N = 44) of a child diagnosed with cancer and receiving active treatment completed a semi-structured interview about their engagement in family rules and routines. Time since diagnosis was abstracted from the medical record. A multi-pass inductive coding strategy was utilized to extract themes identifying caregiver-reported facilitators and barriers to maintaining consistent family rules and routines during the first year of pediatric treatment. RESULTS Caregivers identified three primary contexts that presented barriers and facilitators to engagement in family rules and routines: the hospital setting (n = 40), the family system (n = 36), and the broader social and community setting (n = 26). Caregivers reported barriers primarily related to the demands of their child's treatment, additional caregiving needs, and needing to prioritize basic daily tasks (e.g., food, rest, household needs). Caregivers reported that different networks of support across contexts facilitated family rules and routines by expanding caregiver capacity in distinctive ways. CONCLUSIONS Findings provided insight into the importance of having multiple networks of support to extend caregiving capacity in the context of cancer treatment demands. PRACTICE IMPLICATIONS Providing nurses with training to facilitate problem-solving skills in the context of competing demands may provide a new avenue of clinical intervention at the bedside.
Collapse
Affiliation(s)
- Carolyn R Bates
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA; Center for Children's Healthy Lifestyles and Nutrition, Kansas City, MO, USA; University of Kansas Cancer Center, Kansas City, KS, USA.
| | | | - Rachel M Moore
- Division of Developmental and Behavioral Health, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA; University of Missouri - Kansas City School of Medicine, Kansas City, MO, USA
| | - Lynne M Covitz
- Division of Developmental and Behavioral Health, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA; University of Missouri - Kansas City School of Medicine, Kansas City, MO, USA
| | - Meredith L Dreyer Gillette
- Center for Children's Healthy Lifestyles and Nutrition, Kansas City, MO, USA; Division of Developmental and Behavioral Health, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA; University of Missouri - Kansas City School of Medicine, Kansas City, MO, USA
| |
Collapse
|
6
|
Gilbert R, Bates CR, Khetawat D, Dreyer Gillette ML, Moore R. Risk and Resilient Functioning of Families of Children with Cancer during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5208. [PMID: 36982118 PMCID: PMC10048924 DOI: 10.3390/ijerph20065208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/11/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
Previous literature highlights the impact of COVID-19 on family functioning. Less is known about the impact of the pandemic on families of pediatric cancer patients. In order to determine universal and unique risk and resilience factors of these families during the pandemic, a qualitative analysis was conducted on families currently receiving cancer treatment at a Midwestern hospital. Results of the data analysis depict ways in which these families have been impacted by and have adapted to COVID-19. These findings suggest that families of pediatric cancer patients have unique experiences in the context of COVID-19, in addition to universal experiences outlined in previous literature.
Collapse
Affiliation(s)
- Renee Gilbert
- Clinical Child Psychology Program, Dole Human Development Center, University of Kansas, Lawrence, KS 66044, USA
| | - Carolyn R. Bates
- Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 64114, USA
- University of Kansas Cancer Center, 4001 Rainbow Blvd, Kansas City, KS 64114, USA
| | - Devanshi Khetawat
- Clinical Child Psychology Program, Dole Human Development Center, University of Kansas, Lawrence, KS 66044, USA
| | | | - Rachel Moore
- Department of Pediatrics, Children’s Mercy Kansas City, 2401 Gillham Rd, Kansas City, MO 64108, USA
| |
Collapse
|
7
|
Rea KE, West KB, Dorste A, Christofferson ES, Lefkowitz D, Mudd E, Schneider L, Smith C, Triplett KN, McKenna K. A systematic review of social determinants of health in pediatric organ transplant outcomes. Pediatr Transplant 2023; 27:e14418. [PMID: 36321186 DOI: 10.1111/petr.14418] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/27/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Equitable access to pediatric organ transplantation is critical, although risk factors negatively impacting pre- and post-transplant outcomes remain. No synthesis of the literature on SDoH within the pediatric organ transplant population has been conducted; thus, the current systematic review summarizes findings to date assessing SDoH in the evaluation, listing, and post-transplant periods. METHODS Literature searches were conducted in Web of Science, Embase, PubMed, and Cumulative Index to Nursing and Allied Health Literature databases. RESULTS Ninety-three studies were included based on pre-established criteria and were reviewed for main findings and study quality. Findings consistently demonstrated disparities in key transplant outcomes based on racial or ethnic identity, including timing and likelihood of transplant, and rates of rejection, graft failure, and mortality. Although less frequently assessed, variations in outcomes based on geography were also noted, while findings related to insurance or SES were inconsistent. CONCLUSION This review underscores the persistence of SDoH and disparity in equitable transplant outcomes and discusses the importance of individual and systems-level change to reduce such disparities.
Collapse
Affiliation(s)
- Kelly E Rea
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Kara B West
- Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Anna Dorste
- Boston Children's Hospital, Boston, Massachusetts, USA
| | | | - Debra Lefkowitz
- Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Emily Mudd
- Cleveland Clinic Children's, Center for Pediatric Behavioral Health, Wilmington, North Carolina, USA
| | - Lauren Schneider
- Stanford University School of Medicine, Palo Alto, California, USA
| | - Courtney Smith
- Norton Children's, University of Louisville, Louisville, Kentucky, USA
| | - Kelli N Triplett
- Children's Health, Children's Medical Center Dallas, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | |
Collapse
|
8
|
Bounds DT, Stiles-Shields C, Schueller SM, Odgers CL, Karnik NS. Ethical considerations for developing pediatric mhealth interventions for teens with socially complex needs. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2023; 36:7-16. [PMID: 36134754 PMCID: PMC9898213 DOI: 10.1111/jcap.12396] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/03/2022] [Accepted: 09/11/2022] [Indexed: 02/06/2023]
Abstract
TOPIC Mobile Health (mHealth) stands as a potential means to better reach, assess, and intervene with teens with socially complex needs. These youth often face overlapping adversities including medical illness and a history of experiencing adverse childhood experiences (ACEs). Clinicians are faced with navigating ethical decisions when developing mHealth tools for teens who have socially complex needs. Many tools have been developed for adults from the general population. However, despite the development of thousands of mHealth interventions, developers tend to focus on designing for usability, engagement, and efficacy, with less attention on the ethical considerations of making such tools. PURPOSE To safely move mHealth interventions from research into clinical practice, ethical standards must be met during the design phase. In this paper we adapt the Four Box Model (i.e., medical indications, preferences of patients, quality of life, and contextual features) to guide mHealth developers through ethical considerations when designing mHealth interventions for teens who present with a medical diagnosis and a history of ACEs. SOURCES A review of language, inclusive features, data sharing, and usability is presented using both the Four Box Model and potential scenarios to guide each consideration. CONCLUSIONS To better support designers of mHealth tools we present a framework for evaluating applications to determine overlap with ethical design and are well suited for use in clinical practice with underserved pediatric patients.
Collapse
Affiliation(s)
- Dawn T Bounds
- Irvine, Sue & Bill Gross School of Nursing, University of California, Irvine, California, USA
- Department of Psychiatry and Behavioral Sciences, Section of Community Behavioral Health, Rush University, Chicago, Illinois, USA
| | - Colleen Stiles-Shields
- Department of Psychiatry and Behavioral Sciences, Section of Community Behavioral Health, Rush University, Chicago, Illinois, USA
- Institute for Juvenile Research, University of Illinois at Chicago, Illinois, USA
| | - Stephen M Schueller
- Department of Psychological Science, University of California-Irvine, Irvine, California, USA
| | - Candice L Odgers
- Department of Psychological Science, University of California-Irvine, Irvine, California, USA
- Social Science Research Institute, Duke University, Durham, North Carolina, USA
| | - Niranjan S Karnik
- Department of Psychiatry and Behavioral Sciences, Section of Community Behavioral Health, Rush University, Chicago, Illinois, USA
- Institute for Juvenile Research, University of Illinois at Chicago, Illinois, USA
| |
Collapse
|
9
|
Fisher RS, Mullins LL. JPP Student Journal Club Commentary: Exploring Medication Adherence in Hematopoietic Stem Cell Transplant. J Pediatr Psychol 2022; 48:425-427. [DOI: 10.1093/jpepsy/jsac091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/05/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
- Rachel S Fisher
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Larry L Mullins
- Department of Psychology, Center for Pediatric Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| |
Collapse
|
10
|
Sweenie R, Keyser HHD, Gutiérrez-Colina AM, Brammer C, Ramsey RR. Adherence and Self-management Interventions among Systemically Marginalized and Underserved Youth with Asthma. CLINICAL PRACTICE IN PEDIATRIC PSYCHOLOGY 2022; 10:394-408. [PMID: 37275278 PMCID: PMC10237045 DOI: 10.1037/cpp0000462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Objective Asthma disproportionately impacts youth who have been systemically marginalized and underserved, henceforth termed underserved for brevity. Disparities are driven by systemic and structural racism and social determinants of health. We aimed to synthesize findings from interventions delivered among youth who have been underserved, highlight effective intervention strategies, and provide recommendations to promote health equity. To demonstrate, we also present a case example of clinical application. Methods We conducted a systematic literature search of randomized trials among youth (≤18 years old) who are often underserved, delivered in clinical, community, or home-based settings with medication adherence and/or self-management behaviors as an intervention outcome. We used descriptive statistics to synthesize study characteristics and outcomes. Results Twenty four articles, representing 21 unique interventions, met inclusion criteria. Forty-six percent reported significant improvements in adherence or self-management for the intervention group. Self-management interventions focused on symptom recognition and monitoring demonstrated the greatest percentage of significant intervention findings (71.4%); controller medication adherence interventions demonstrated the fewest (33.3%). Conclusions Interventions are not consistently effective for youth who have been underserved. Findings suggest that pediatric psychologists can help patients from underserved backgrounds by bolstering symptom recognition and monitoring skills, providing self-management skill education, and problem-solving ways to reduce triggers through individually tailored, multicomponent approaches. Pediatric psychologists should simultaneously strive to consider and address systemic, structural, and social determinants of asthma disparities in their work.
Collapse
Affiliation(s)
- Rachel Sweenie
- Division of Behavioral Medicine and Clinical Psychology,
Cincinnati Children's Hospital Medical Center
| | - Heather Hoch De Keyser
- Department of Pediatrics, Section of Pediatric Pulmonary
and Sleep Medicine, School of Medicine, University of Colorado Anschutz and the
Breathing Institute at Children's Hospital Colorado
| | | | - Caitlin Brammer
- Division of Behavioral Medicine and Clinical Psychology,
Cincinnati Children's Hospital Medical Center
| | - Rachelle R. Ramsey
- Division of Behavioral Medicine and Clinical Psychology,
Cincinnati Children's Hospital Medical Center
- Department of Pediatrics, University of Cincinnati College
of Medicine
| |
Collapse
|
11
|
Brinkman AH, Rea-Sandin G, Lund EM, Fitzpatrick OM, Gusman MS, Boness CL. Shifting the discourse on disability: Moving to an inclusive, intersectional focus. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2022; 93:50-62. [PMID: 36265035 PMCID: PMC9951269 DOI: 10.1037/ort0000653] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Individuals with disabilities comprise one of the largest marginalized groups in the United States and experience systemic barriers in health care. In Westernized communities, disability has historically been conceptualized via the medical model, which considers disability an individual-level deficit in need of correction. Although other models of disability (e.g., social model) have been developed to address the medical model's ableist shortcomings, these fail to consistently acknowledge intersectionality. Specifically, these models fail to consider that (a) a disabled individual may hold other marginalized or oppressed identities and (b) these intersecting oppressions may exacerbate health inequities. Intersectionality, which originates from Black feminist literature, describes the ways that systems of power and oppression (e.g., racism, sexism) interact to form an individual's unique experience. To date, the intersection of disability and other marginalized identities has been neglected in psychology and related fields, leaving little guidance for how scholars, clinicians, and other stakeholders can address disability via an intersectional lens. The present article discusses how a disability-affirmative, intersectional approach can serve as a strategy for challenging and reforming oppressive systems across the field of psychology. We assert that, ultimately, this approach has the potential to optimize and expand access to equitable, inclusive mental health care, and we propose actionable steps psychologists can take in research, practice, training, and policy in pursuit of this aim. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
Affiliation(s)
| | | | - Emily M. Lund
- Department of Educational Studies in Psychology, Research Methodology, and Counseling, University of Alabama
| | | | | | | | | |
Collapse
|
12
|
Janevic MR, Mathur VA, Booker SQ, Morais C, Meints SM, Yeager KA, Meghani SH. Making Pain Research More Inclusive: Why and How. THE JOURNAL OF PAIN 2022; 23:707-728. [PMID: 34678471 PMCID: PMC9018873 DOI: 10.1016/j.jpain.2021.10.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/28/2021] [Accepted: 10/05/2021] [Indexed: 02/09/2023]
Abstract
Current knowledge about mechanisms and interventions for pain has largely been derived from samples that are healthier, wealthier, younger, and more likely to be White than the general population. Failure to conduct inclusive pain research not only restricts generalizability and application of findings, but also hampers the discovery of mechanisms and the development of measures and interventions that are valid across population subgroups. Most of all, inclusive practices are critical to ensure that underrepresented groups derive equitable benefit from pain research. Here, we provide guidance for the pain research community on how to adopt inclusive research practices. We define "inclusion" to encompass a range of identities and characteristics, including racialized group/ethnicity, disability status, gender identity, sexual orientation, and age. We first describe principles relevant to promoting inclusion in pain research, including attention to: 1) stakeholder engagement; 2) structural factors underlying inequities; 3) the limitations of "disparity" research; 4) intersectionality; and 5) universal design. Next, we provide checklists with practical strategies for making studies more inclusive at each stage of the research process. We conclude by calling for system-level changes to ensure that the future of pain research is socially just, scientifically productive, and responsive to the needs of all people. PERSPECTIVE: This paper offers guidance on promoting inclusion of underrepresented groups in pain research. We describe principles relevant to conducting more inclusive research; eg, attention to stakeholder engagement, structural factors, and universal design. We provide checklists with practical strategies for inclusion at each stage of the research process.
Collapse
Affiliation(s)
| | - Vani A. Mathur
- Department of Psychological & Brain Sciences, Texas A&M University
| | - Staja Q. Booker
- College of Nursing, Department of Biobehavioral Nursing Science University of Florida
| | - Calia Morais
- Department of Community Dentistry and Behavioral Science, University of Florida
| | - Samantha M. Meints
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School
| | | | - Salimah H. Meghani
- Department of Biobehavioral Health Sciences; New Courtland Center for Transitions and Health; Leonard Davis Institute of Health Economics, University of Pennsylvania
| |
Collapse
|
13
|
Traino KA, Hawkins MA, Chaney JM, Mullins LL. The role of health anxiety in healthcare management transition and health-related quality of life in young adults with medical conditions. CHILDRENS HEALTH CARE 2021. [DOI: 10.1080/02739615.2021.1983434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Katherine A. Traino
- Center for Pediatric Psychology, Psychology Department, Oklahoma State University, Stillwater, OK, USA
| | - Misty A.W. Hawkins
- Center for Pediatric Psychology, Psychology Department, Oklahoma State University, Stillwater, OK, USA
| | - John M. Chaney
- Center for Pediatric Psychology, Psychology Department, Oklahoma State University, Stillwater, OK, USA
| | - Larry L. Mullins
- Center for Pediatric Psychology, Psychology Department, Oklahoma State University, Stillwater, OK, USA
| |
Collapse
|
14
|
Matthew AJ, Clark MA, McDavid LM. Combating racism: the role of the pediatrician. Pediatr Res 2021; 90:708-710. [PMID: 33469175 PMCID: PMC7814523 DOI: 10.1038/s41390-020-01345-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 01/30/2023]
Affiliation(s)
- Andrea J Matthew
- Pediatric Residency Program, University Hospitals Cleveland Medical Center, Rainbow Babies and Children's Hospital, Cleveland, OH, USA.
- Department of Developmental-Behavioral Pediatrics and Psychology, University Hospitals Cleveland Medical Center, Rainbow Babies and Children's Hospital, Cleveland, OH, USA.
- Department of Child Advocacy and Protection, University Hospitals Cleveland Medical Center, Rainbow Babies and Children's Hospital, Cleveland, OH, USA.
| | - Marie A Clark
- Pediatric Residency Program, University Hospitals Cleveland Medical Center, Rainbow Babies and Children's Hospital, Cleveland, OH, USA
- Department of Developmental-Behavioral Pediatrics and Psychology, University Hospitals Cleveland Medical Center, Rainbow Babies and Children's Hospital, Cleveland, OH, USA
- Department of Child Advocacy and Protection, University Hospitals Cleveland Medical Center, Rainbow Babies and Children's Hospital, Cleveland, OH, USA
| | - Lolita M McDavid
- Pediatric Residency Program, University Hospitals Cleveland Medical Center, Rainbow Babies and Children's Hospital, Cleveland, OH, USA
- Department of Developmental-Behavioral Pediatrics and Psychology, University Hospitals Cleveland Medical Center, Rainbow Babies and Children's Hospital, Cleveland, OH, USA
- Department of Child Advocacy and Protection, University Hospitals Cleveland Medical Center, Rainbow Babies and Children's Hospital, Cleveland, OH, USA
| |
Collapse
|
15
|
Aylward BS, Gal-Szabo DE, Taraman S. Racial, Ethnic, and Sociodemographic Disparities in Diagnosis of Children with Autism Spectrum Disorder. J Dev Behav Pediatr 2021; 42:682-689. [PMID: 34510108 PMCID: PMC8500365 DOI: 10.1097/dbp.0000000000000996] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 06/28/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT This special article uses a biosocial-ecological framework to discuss findings in the literature on racial, ethnic, and sociodemographic diagnostic disparities in autism spectrum disorder. We draw explanations from this framework on the complex and cumulative influences of social injustices across interpersonal and systemic levels.
Collapse
Affiliation(s)
| | | | - Sharief Taraman
- Cognoa, Inc, Palo Alto, CA; and
- Department of Neurology, CHOC Children's, Orange, CA
| |
Collapse
|
16
|
Engel ML, Pike MR, Cohen MF, Dunlop AL, Corwin EJ, Pearce BD, Brennan PA. Intergenerational Impacts of Maternal Stress on Early Childhood Atopy in Black Americans. J Pediatr Psychol 2021; 46:891-901. [PMID: 34100948 PMCID: PMC8357225 DOI: 10.1093/jpepsy/jsab038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 03/15/2021] [Accepted: 03/19/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Black children are disproportionately affected by atopic diseases (i.e., atopic dermatitis, allergic rhinitis, asthma, and food allergies), with health disparities present in early life. Studies in White samples suggest that maternal stress confers risk for offspring atopy, yet little is known about these relationships in Black populations. This study seeks to (a) examine the relationship between self-reported and physiological indicators of maternal stress and offspring atopy and (b) explore warm and responsive caregiving as a potential protective factor in Black Americans. METHODS A sample of 179 Black mother-child dyads of varying socioeconomic status participated in a prospective longitudinal study. Mothers completed self-reports of childhood trauma, prenatal stress, postnatal stress, and physician diagnosis of offspring atopy; provided blood samples to assess physiological responses to chronic stress exposure; and participated in a behavioral task with their infant. RESULTS Maternal self-reports of childhood trauma, prenatal stress, and postnatal stress were not associated with offspring diagnosis of atopy by 2-3 years of age. Mothers who produced a smaller inflammatory response during pregnancy were more likely to have an offspring with atopy by 2-3 years of age. Warm and responsive parenting demonstrated a protective effect; the positive association between maternal stress and offspring atopy was less apparent in cases of mother-child interactions characterized by high levels warm and responsive parenting. CONCLUSION Failure to replicate previous findings suggests that the maternal stress-offspring atopy relationship is complex. Future studies must examine the unique stressors in Black Americans, as well as caregiving as a potential protective factor.
Collapse
Affiliation(s)
| | - Madeline R Pike
- Department of Psychiatry and Behavioral Sciences, Emory University, USA
| | | | - Anne L Dunlop
- Nell Hodgson Woodruff School of Nursing, Emory University, USA
| | | | - Brad D Pearce
- Department of Epidemiology, Rollins School of Public Health, Emory University, USA
| | | |
Collapse
|
17
|
Kamody RC, Kamody ES, Rosenthal A, Olezeski CL. Optimizing Medical-Legal Partnerships in Pediatric Psychology to Reduce Health Disparities. J Pediatr Psychol 2021; 47:69-74. [PMID: 34313766 DOI: 10.1093/jpepsy/jsab076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 06/19/2021] [Accepted: 06/23/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To provide a topical review of the literature on the use of medical-legal partnerships (MLPs) to address social determinants of health (SDH) needs as a means to reduce health disparities, and to make recommendations for the implementation of MLPs within pediatric psychologists' clinical work, research, and training. METHODS We conducted a topical review of the research on the intersection of MLPs, SDH needs, and health disparities among pediatric populations. Given the scarcity of literature available, both empirical and theoretical articles were included in the review. RESULTS Though limited, the extant literature suggests that use of MLPs may help address the SDH needs that perpetuate disparities among pediatric populations. To date, MLPs are not as frequently incorporated in the training and work of pediatric psychologists as they may be in other related fields (e.g., medicine). CONCLUSIONS MLPs provide an opportunity for psychologists to broaden their interdisciplinary collaborations, to more aptly meet the social and legal needs of their patients to assist in reducing inequities among underserved pediatric populations. The systematic incorporation of MLPs into pediatric psychology training may help to increase the utilization of these services moving forward.
Collapse
Affiliation(s)
- Rebecca C Kamody
- Child Study Center, Yale School of Medicine, New Haven, CT, USA.,Yale Gender Program, Yale School of Medicine, New Haven, CT, USA
| | | | - Alice Rosenthal
- Yale Gender Program, Yale School of Medicine, New Haven, CT, USA.,Center for Children's Advocacy at Yale New Haven Hospital, New Haven, CT, USA
| | - Christy L Olezeski
- Child Study Center, Yale School of Medicine, New Haven, CT, USA.,Yale Gender Program, Yale School of Medicine, New Haven, CT, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| |
Collapse
|
18
|
Fix RL, Testa EG, Thurston IB, Gray WN, Russell MT. Anti-Racism Strategies in Pediatric Psychology: Using STYLE Can Help Children Overcome Adverse Experiences With Police. J Clin Psychol Med Settings 2021; 29:262-273. [PMID: 34302580 PMCID: PMC8302965 DOI: 10.1007/s10880-021-09804-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2021] [Indexed: 12/04/2022]
Abstract
Black children are exposed to police violence at alarming rates. Such stress impacts development and treatment of physical health problems. In the current discourse, we introduce STYLE (Self-examination, Talk about community-police relations and racism, Yield space and time to anti-racism work, Learn about how structural racism impacts child health, Evaluate policies and practices through an anti-racism lens). STYLE offers a framework through which professionals in pediatric psychology can engage in anti-racist work across contexts from clinical care to academic and advocacy settings. Pediatric psychologists have a responsibility to be on the frontline as interventionists, educators, researchers, organizers, and advocates for racial justice through anti-racism practices. The current paper introduces STYLE in clinical care, community service, training/supervision, and academic and advocacy contexts. Case examples are provided. Professionals in pediatric psychology must first focus on changing their STYLE to promote individual and infrastructural change consistent with anti-racism work.
Collapse
Affiliation(s)
- Rebecca L Fix
- Bloomberg School of Public Health, Johns Hopkins University, 415 N. Washington Street, Baltimore, MD, 21231, USA.
| | | | | | - Wendy N Gray
- Children's Hospital of Orange County, Orange, USA
| | | |
Collapse
|
19
|
Bates CR, Pallotto IK, Moore RM, Fornander MJ, Covitz LM, Dreyer Gillette ML. Family rules, routines, and caregiver distress during the first year of pediatric cancer treatment. Psychooncology 2021; 30:1590-1599. [PMID: 34019721 DOI: 10.1002/pon.5736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/07/2021] [Accepted: 05/17/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE A new diagnosis of pediatric cancer may disrupt family functioning. The current study aimed to describe changes in family rules and routines during the first year of pediatric cancer treatment, and to explore associations with demographics, illness factors, and caregiver distress. METHODS This exploratory mixed-methods, cross-sectional study examined 44 primary caregivers of youth in treatment for a new cancer diagnosis in 2019 and 2020, before the onset of the COVID-19 pandemic. Caregivers completed validated questionnaires assessing demographic and child illness characteristics, psychosocial distress, and cancer-related stressors, and participated in a semi-structured interview about family rules and routines. RESULTS Caregivers reported changes in bedtime, mealtime, and school routines, relaxed behavioral expectations and rules around screen time, and new rules and routines around treatment, medications, and infection control. Caregivers with elevated levels of psychosocial distress reported more changed routines than caregivers with low levels of psychosocial distress. Caregivers who endorsed more cancer-related stressors reported more new rules and routines than those who reported fewer cancer-related stressors. Demographic and illness factors were not significantly associated with the number of changed, new, or stable family rules and routines. CONCLUSIONS Families may relax rules and routines during the first several months of diagnosis, and this may be related to side effects of treatment and limited caregiver capacity. The long-term impact of changes in family rules and routines during cancer treatment warrants further study given that accommodating parenting strategies have been associated with adverse short- and long-term child health and behavior outcomes.
Collapse
Affiliation(s)
- Carolyn R Bates
- Division of Developmental and Behavioral Health, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA
| | - Isabella K Pallotto
- Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Rachel M Moore
- Division of Developmental and Behavioral Health, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA.,University of Missouri Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Mirae J Fornander
- Division of Developmental and Behavioral Health, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA.,University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Lynne M Covitz
- Division of Developmental and Behavioral Health, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA.,University of Missouri Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Meredith L Dreyer Gillette
- Division of Developmental and Behavioral Health, Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA.,University of Missouri Kansas City School of Medicine, Kansas City, Missouri, USA.,Center for Children's Healthy Lifestyles and Nutrition, Kansas City, Missouri, USA
| |
Collapse
|
20
|
Keenan ME, Berlin KS, Cook JL, Ankney RL, Klages KL, Semenkovich KA, Rybak TM, Banks GG, Choquette AE, Alemzadeh R, Eddington AR. Predictors of HbA1c Trajectories in Predominantly Black Adolescents With Type 1 Diabetes. J Pediatr Psychol 2021; 46:241-250. [PMID: 33398334 DOI: 10.1093/jpepsy/jsaa124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 12/04/2020] [Accepted: 12/04/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Following the Journal of Pediatric Psychology's special edition on health disparities, calling for Phase 2 research exploring mechanisms of racial groups in health disparities, this study aims to explore social information processing predictors of longitudinal hemoglobin A1c (HbA1c) trajectories in a racially diverse group of adolescents. The social information processing model of glycemic control in type 1 diabetes (T1D) posits that adolescents who make negative attributions about reactions of friends are likely to find adherence difficult in social situations, have increased stress, and have suboptimal glycemic control. METHODS One hundred eighty-four youth with T1D completed self-report measures and HbA1c at three time points within 1 year was extracted from medical records. Growth mixture modeling empirically derived classes of HbA1c trajectories and explored predictive relationships of social information processing variables, demographics, and diabetes characteristics. RESULTS Three classes emerged: High Decelerating, Mid-High Accelerating, and Near-Optimal Accelerating. Black/African American participants were highly likely to be in the High and Mid-High groups. Higher anticipated adherence difficulties in social situations predicted increased odds of being in the Mid-High versus Near-Optimal HbA1c group. Increased diabetes stress predicted increased odds of being in the High versus Near-Optimal and Mid-High groups. CONCLUSIONS Continuing research on mechanisms behind this health disparity is necessary with more representation from varied racial and ethnic groups. Equal access to diabetes technology and psychosocial treatments are recommended and implications for clinical intervention development are discussed.
Collapse
Affiliation(s)
| | - Kristoffer S Berlin
- Department of Psychology, The University of Memphis.,Division of Pediatric Endocrinology & Diabetes, University of Tennessee Health Science Center
| | | | | | | | | | - Tiffany M Rybak
- Department of Psychology, Cincinnati Children's Hospital Medical Center
| | | | | | - Ramin Alemzadeh
- Division of Pediatric Endocrinology & Diabetes, University of Tennessee Health Science Center
| | - Angelica R Eddington
- Department of Psychology, The University of Memphis.,Division of Pediatric Endocrinology & Diabetes, University of Tennessee Health Science Center
| |
Collapse
|
21
|
Dimentstein K, Valenzuela JM. JPP Student Journal Club Commentary: Predictors of HbA1c Trajectories in Predominantly Black Adolescents With Type 1 Diabetes. J Pediatr Psychol 2021; 46:251-253. [PMID: 33706366 DOI: 10.1093/jpepsy/jsab024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 02/23/2021] [Accepted: 02/23/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Karen Dimentstein
- Department of Clinical and School Psychology, Nova Southeastern University
| | | |
Collapse
|