Prevention counseling among pediatric patients presenting with unintentional injuries to physicians' offices' in the United States

Hammig, Bart

doi:10.1016/j.ypmed.2015.02.001

Cited by 10 publications

(8 citation statements)

References 27 publications

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“…We also found overall low levels of documented preventive care delivery, especially screening and counseling for injury prevention, oral health, and lead, emphasizing gaps in pediatric preventive care that have been similarly noted in prior studies. [23][24][25] Although we found a significant 4-fold increase in oral health counseling among patients prompting the EHR clinical alert system for immunizations compared to controls, this is likely not attributable to positive spillover effects of the EHR alerts but rather due to practice changes in oral health screening between the historical control (2007)(2008)(2009) and intervention (2010-2011) time periods. In late 2009, the clinic began fluoride varnish applications, with full adoption in 2010 during the ImmProve trial period.…”

Section: Discussionmentioning

confidence: 96%

Electronic Immunization Alerts and Spillover Effects on Other Preventive Care

Kim

Rivera

Persing

et al. 2017

Clin Pediatr (Phila)

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The impact of electronic health record (EHR) immunization clinical alert systems on the delivery of other preventive services remains unknown. We assessed for spillover effects of an EHR immunization alert on delivery of 6 other preventive services, in children 18 to 30 months of age needing immunizations. We conducted a secondary data analysis, with additional primary data collection, of a randomized, historically controlled trial to improve immunization rates with EHR alerts, in an urban, primary care clinic. No significant differences were found in screening for anemia, lead, development, nutrition, and injury prevention counseling in children prompting EHR immunization alerts (n = 129), compared with controls (n = 135). Significant increases in oral health screening in patients prompting EHR alerts (odds ratio = 4.8, 95% CI = 1.8-13.0) were likely due to practice changes over time. An EHR clinical alert system targeting immunizations did not have a spillover effect on the delivery of other preventive services.

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Section: Discussionmentioning

confidence: 96%

Electronic Immunization Alerts and Spillover Effects on Other Preventive Care

Kim

Rivera

Persing

et al. 2017

Clin Pediatr (Phila)

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“…37,38 Strikingly, providers consistently reported low levels of comfort, knowledge, and frequency of counseling for pedestrian safety and adolescent driving, which is incongruent with CDC statistics that identify motor vehicle crashes as the leading cause of death for children and adolescents greater than age 5. 2 Differences in clinician knowledge and counseling for injury topics are known to be highly variable 9,11,[14][15][16] and may be attributable to provider biases. [32][33][34] Additional education of providers and public health efforts toward teenage driving and pedestrian safety are warranted.…”

Section: Discussionmentioning

confidence: 99%

“…3-5 Anticipatory guidance has been demonstrated in meta-analyses to improve patient and family knowledge, as well as the adoption of injury prevention behaviors, 6,7 in settings ranging from primary care offices to EDs. 8 Education, however, is inconsistently provided by health care providers 9-16 due to multiple barriers, including increasing administrative responsibilities, decreased time allotted for patient encounters, and increasing numbers of recommended topics to address. 7,17-19…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5] Anticipatory guidance has been demonstrated in meta-analyses to improve patient and family knowledge, as well as the adoption of injury prevention behaviors, 6,7 in settings ranging from primary care offices to EDs. 8 Education, however, is inconsistently provided by health care providers [9][10][11][12][13][14][15][16] due to multiple barriers, including increasing administrative responsibilities, decreased time allotted for patient encounters, and increasing numbers of recommended topics to address. 7,[17][18][19] Faced with these challenges, health care providers have started to explore and study new technologies and workflows for counseling, such as smartphones, [20][21][22][23] computer kiosks, [24][25][26] and screening tools.…”

Section: Introductionmentioning

confidence: 99%

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Pediatric Health Care Provider Perspectives on Injury Prevention Counseling in Acute and Primary Care Settings

Gaw

Berthet

Curry

et al. 2020

Clin Pediatr (Phila)

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The objective of this study was to characterize how pediatric primary care and emergency medicine health care providers and trainees engage in injury prevention counseling and assess perceptions toward injury prevention resources. We surveyed physicians, advanced practice providers, and trainees in the Emergency Department, Primary Care Network, and Pediatric Residency Program at Children’s Hospital of Philadelphia from September to November 2019. Of the 578 eligible participants, 208 (36.0%) completed the survey. When asked to rank the suitability of alternative personnel for providing counseling, 63.0% of the participants selected an injury prevention specialist as best suited. Seventy-six percent of the providers considered a tablet or mobile device used before a patient encounter to be a helpful resource. Variability existed in provider comfort, knowledge, and frequency of counseling by injury topic. Free-text responses cited time as a barrier to counseling. Opportunities exist to improve the provision of injury education through the utilization of novel resources and personnel.

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“…This study demonstrates several important findings regarding the ability to screen and discuss IP risks in the pediatric office setting and the effectiveness of this counseling. Unfortunately, PCPs are still infrequently discussing IP at primary care visits (Hammig & Jozkowski, 2015 ). Previous studies have shown that practitioners can easily implement an IP screening tool into routine WCVs to increase the number of IP topics covered (Gittelman et al, 2015 ).…”

Section: Discussionmentioning

confidence: 99%

A quality improvement program in pediatric practices to increase tailored injury prevention counseling and assess self-reported changes made by families

et al. 2018

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BackgroundMany pediatric providers struggle to screen families for the majority of age-appropriate injury risks and educate them when appropriate. Standardized tools have helped physicians provide effective, more purposeful counseling. In this study, pediatricians utilized a standardized, injury prevention screening tool to increase targeted discussions and families were re-screened at subsequent visits to determine changes in their behavior.MethodsPediatric practices, recruited from the Ohio Chapter, American Academy of Pediatrics database, self-selected to participate in a quality improvement program. Two screening tools, for children birth-4 month and 6–12 month, with corresponding talking points, were to be implemented into every well child visit. During the 7-month collaborative, screening results and pediatrician counseling for reported unsafe behaviors were calculated. Patients who completed a screening tool at subsequent visits were followed up at a later visit to determine self-reported behavior changes. We examined statistically significant differences in frequencies using the X2 test. Providers received maintenance of certification IV credit for participation.ResultsSeven practices (39 providers) participated. By the second month, participating providers discussed 75% of all inappropriate responses for birth-4 month screenings and 87% for 6–12 months. Of the 386 families who received specific counseling and had a follow-up visit, 65% (n = 94/144) of birth-4 month and 65% (n = 59/91) of 6–12 month families made at least one behavior change. The X2 test showed that families who received counseling versus those that did not were significantly more likely to change inappropriate behaviors (p < 0.05). Overall, of all the risks identified, 45% (136) of birth-4 month and 42% (91) of 6–12 month behaviors reportedly changed after a practitioner addressed the topic area.ConclusionsParticipation in a quality improvement program within pediatric offices can increase screening for injury risks and encourage tailored injury prevention discussions during an office encounter. As a result, significantly more families reported to practice safer behaviors at later visits.

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Prevention counseling among pediatric patients presenting with unintentional injuries to physicians' offices' in the United States

Cited by 10 publications

References 27 publications

Electronic Immunization Alerts and Spillover Effects on Other Preventive Care

Electronic Immunization Alerts and Spillover Effects on Other Preventive Care

Pediatric Health Care Provider Perspectives on Injury Prevention Counseling in Acute and Primary Care Settings

A quality improvement program in pediatric practices to increase tailored injury prevention counseling and assess self-reported changes made by families

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