You are being asked to participate in this study (COMIRB Protocol 18-2248) because you are a medical provider who manages children with acute asthma exacerbations in the outpatient setting. The purpose of this study is to examine outpatient treatment decisions regarding oral corticosteroids in children with acute asthma. Participation will only require that you answer a short series of questions regarding oral corticosteroid management of children with acute asthma exacerbations in your practice, followed by a few general questions about your background and work setting.

Integrated perinatal behavioral healthcare provides opportunities to support women and their babies as part of their primary care medical home. The COVID-19 pandemic required significant changes to be made to medical practices to enhance safety and reduce risk, particularly for vulnerable populations, including pregnant women. Previously established modes of mental health service delivery in the HEART program, an integrated behavioral health program embedded in a primary care clinic for adolescent mothers and their babies, and the PROMISE Clinic, an integrated obstetric behavioral health program that serves pregnant women, quickly pivoted to telehealth services because of the pandemic. HEART serves a racially and ethnically diverse patient population, with over 85% of patients publicly insured. The PROMISE Clinic serves a socioeconomically, racially, and ethnically diverse patient population. Behavioral health clinicians implemented a variety of technology-based services including telephone interventions and support, virtual visits using iPads during medical visits, and video visits that patients accessed from their homes. In HEART, behavioral health visits continued at pre-COVID rates during telehealth adaptations.In the PROMISE clinic, the number of perinatal women seen doubled, the total number of patient contacts tripled, and the missed appointment rate significantly decreased during COVID. In the PROMISE clinic, significantly more White and Hispanic perinatal women were seen during COVID and telehealth adaptations, while significantly fewer Black perinatal women were seen during this period.Further research is indicated to examine patient attitudes towards telehealth services, barriers to treatment for Black women, and outcome data.

Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) variants and re‐emergence of other respiratory viruses highlight the need to understand the presentation of and factors associated with SARS‐CoV‐2 in pediatric populations over time. The objective of this study was to evaluate the sociodemographic characteristics, symptoms, and epidemiological risk factors associated with ambulatory SARS‐CoV‐2 infection in children and determine if factors differ by variant type. We conducted a retrospective cohort study of outpatient children undergoing SARS‐CoV‐2 polymerase chain reaction testing between November 2020 and January 2022. Test‐positive were compared with test‐negative children to evaluate symptoms, exposure risk, demographics, and comparisons between Omicron, Delta, and pre‐Delta time periods. Among 2264 encounters, 361 (15.9%) were positive for SARS‐CoV‐2. The cohort was predominantly Hispanic (51%), 5–11 years (44%), and 53% male; 5% had received two coronavirus disease 2019 (COVID‐19) vaccine doses. Factors associated with a positive test include loss of taste/smell (adjusted odds ratio [aOR]: 6.71, [95% confidence interval, CI: 2.99–15.08]), new cough (aOR: 2.38, [95% CI: 1.69–3.36]), headache (aOR: 1.90, [95% CI: 1.28–2.81), fever (aOR: 1.83, [95% CI: 1.29–2.60]), contact with a positive case (aOR: 5.12, [95% CI: 3.75–6.97]), or household contact (aOR: 2.66, [95% CI: 1.96–3.62]). Among positive children, loss of taste/smell was more predominant during the Delta versus Omicron and pre‐Delta periods (12% vs. 2% and 3%, respectively, p = 0.0017), cough predominated during Delta/Omicron periods more than the pre‐Delta period (69% and 65% vs. 41%, p = 0.0002), and there were more asymptomatic children in the pre‐Delta period (30% vs. 18% and 10%, p = 0.0023). These findings demonstrate that the presentation of COVID‐19 in children and most susceptible age groups has changed over time.

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