First name
Ramzi
Middle name
G
Last name
Salloum

Title

Pediatric Resident Training in Tobacco Control and the Electronic Health Record.

Year of Publication

2020

Number of Pages

Date Published

2020 Oct 29

ISSN Number

1873-2607

Abstract

<p>Given the dangers posed by tobacco use and tobacco smoke exposure, pediatricians should address tobacco use and exposure with patients and parents at every opportunity, but this is not consistently done in practice. One reason may be that many medical residents do not receive education on how to address tobacco use and tobacco smoke exposure with patients and their parents. In a 2012 survey of U.S. pediatric program directors, 65% of programs reported covering tobacco control in their curricula, but most training programs focused on tobacco's health effects and not intervention strategies for clinical practice. Since that survey, electronic health records have been implemented broadly nationwide and utilized to address tobacco smoke exposure. Investigators surveyed U.S. program directors in 2018 and residents in 2019 to explore the ways in which the residents learn about tobacco use and tobacco smoke exposure, components and use of the electronic record specific to tobacco use and tobacco smoke exposure, and perceived resident effectiveness in this area. All the program directors and 85% of the residents valued training, but 21% of the residents reported receiving none. Moreover, a minority of the residents assessed themselves as effective at counseling parents (19%) or adolescents (23%), and their perceived effectiveness was related to small group learning and active learning workshops, modalities that were infrequently implemented in training. Respondents also reported infrequent use of electronic health record prompts regarding tobacco and the absence of prompts about critical issues (e.g., addressing tobacco smoke exposure in vehicles or other settings or offering treatment or referrals to parents who smoke). This paper provides recommendations about augmenting pediatric resident training in simple ways.</p>

DOI

10.1016/j.amepre.2020.07.016

Alternate Title

Am J Prev Med

PMID

33131991
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Title

New Strategies to Tackle the Combined Biological and Social Context of Preterm Birth.

Year of Publication

2019

Number of Pages

Date Published

2019 Sep 03

ISSN Number

1098-8785

Abstract

<p><strong>OBJECTIVE: </strong> Preterm birth rates in the population and associated racial inequities have remained relatively unchanged in the United States despite research aimed at prevention. This is potentially the result of the multifactorial pathophysiologic pathways that result in preterm birth, where biological and social drivers intersect in unique ways for different women. The field of dissemination and implementation (D&amp;I) science may address this issue by promoting the contextually-aware uptake of science into health and health care delivery.</p>

<p><strong>STUDY DESIGN: </strong> In this paper, we describe how the field of D&amp;I science may afford new perspectives on preterm birth prevention to researchers and tools to design studies that translate clinical trial data into measurable changes at the level of the population. We discuss key examples where the perspectives and tools of D&amp;I science have been used in conjunction with quality improvement methodology to change preterm birth rates in large population studies. We build on these case studies and suggest future D&amp;I science-informed studies that could be explored.</p>

<p><strong>CONCLUSION: </strong> Incorporating D&amp;I scientific principles into the design of studies to prevent preterm birth may allow future research to better address the varied ways in which social forces comingle with biological risk factors to result in preterm birth.</p>

DOI

10.1055/s-0039-1695774

Alternate Title

Am J Perinatol

PMID

31480082
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