Funded Projects

Problem:

Early experiences, gene-environment interactions and relationships determine a child's lifecourse. Leaders are needed who realize the impact of biologic, psychosocial and cultural factors on children and families and are skilled in family-centered practices that enhance care and must inform policy.

Goals and Objectives:

Goal 1: Recruit and prepare DBPs from diverse backgrounds to become skilled in family-centered, culturally and linguistically competent care for children with biobehavioral concerns and to teach these skills Objective 1: Increase from 3 to 5 DBP fellows trained yearly to demonstrate expertise in evaluation, management and provision of DBP care to vulnerable populations, including those who are minorities, low income, or non-English speaking, and those with special needs Objective 2: DBP fellows will demonstrate skill in teaching the concepts of DBP to trainees through 1:1 mentorship, small group discussion, and formal presentations and in teaching families through clinical encounters and formal presentations to parent groups Objective 3: DBP fellows will participate in a range of interdisciplinary experiences with mentorship of expert faculty. These will be family centered, culturally competent and will promote the development of a puclic health perspective and an appreciation of resources available to meet the needs of families. Goal 2: Prepare academicians in DBP to evaluate, design, conduct and disseminate research and the energy and passion to provide service and inform public policy in collaboration with families and communities Objective 1: Each fellow will complete a research project, present it nationally and publish it Objective 2: DBP fellows and faculty will provide consultation and technical assistance to at least 5 community based programs and/or Title V programs each year Objective 3: During each year of the project period, DBP fellows and key faculty will produce and disseminate 12 peer-reviewed journal articles, books, book chapters or sets of educational materials on current topics in DBP and related research and/or advocacy efforts. Goal 3: Increase knowledge, attitudes and skills of medical students, residents, faculty, community practitioners, and allied health professionals to promote prevention, optimize resiliency and inform policy Objective 1: Pediatric residents will complete a rotation in Developmental-Behavioral Pediatrics that emphasizes a family-centered biopsychosocial approach to child behavior, development and health and identifies community based resources Objective 2: Core faculty will provide 20 Collaborative Office Rounds (COR) and/or Grand Rounds sessions yearly for community pediatricians, allied health professionals, residents, medical students and families to enhance their skills in Developmental and Behavioral aspects of Pediatric care Objective 3: DBP faculty and fellows will provide technical assistance to faculty and residents in our busy primary care clinics serving vulnerable populations, to assist in integration of formal developmental & behavioral screening and assist them in triage of children who screen positive. Goal 4: Increase collaboration in research and adovocacy for faculty and fellows in MCHB sponsored DBP Programs Objective 1: Core faculty and DBP fellows will actively participate in DBPNet research network committees and collaborate on project development, implementation and dissemination. Objective 2: DBP faculty and fellows will host the MCHB DBP Fellowship Conference in Providence, RI in March of 2012. The theme of the program will be Cultural Competence and Advocacy Supporting Healthy Lifecourse Trajectories.

Methodology:

The training program includes lectures, seminars, clinical experiences, research training and mentorship, and community placements. Interdisciplinary faculty represent Developmental-Behavioral Pediatrics, Pediatrics, Child Protection, Pediatric Psychology, Anthropology, Child Psychiatry, Child Neurology, Genetics, Metabolism, Social Work, Nursing, Physical Therapy, Occupational Therapy and Speech Therapy. In 2012, we will host the annual DBP fellowship collaborative meeting in Providence, RI.

Coordination:

Brown affiliated programs at Hasbro Children's Hospital, Women and Infants' Hospital, Bradley Hospital, Memorial Hospital of RI and Brown's Program in Public Health provide sites for clinical care and research mentorship with community based advocacy and education in partnership with the RI Dept. of Health Title V and KIDSNET programs, RI's EI and Comprehensive Evaluation Diagnosis Assessment Referral and Reevaluation programs and the RI and SE Massachusetts parent and pediatric community.

Evaluation:

Ongoing faculty, staff, peer, patient evaluations, scholarship oversight and self evaluation of fellows, an Individual Learning Plan and portfolio, completion of research and a manuscript with evaluation of medical charts, clinical conferences and management plans are used to evaluate fellows. The program is evaluated in writing yearly by all stakeholders with tracking of career development and productivity of faculty and current and former trainees.

Experience to Date:

This year we were able to recruit two new DBP fellows, both ethnic minorities, to join our program. We increased the total number of fellows trained yearly from 4 to 5, with additional funding for stipend support from CAA/MCHB. We also graduated two capable fellows and they both joined our faculty at our affiliated training site at MHRI, so they are well on their way to becoming leaders in DBP. One was selected to become RI's Act Early Ambassador. Faculty and fellows published 42 articles in scholarly journals, 7 chapters and a book this year and made 33 presentations locally, nationally and for international audiences. They provided technical assistance to RI's MCH programs, DOH, Early Learning Council, Autism Commission, EI and advocacy groups, as well as to the AAP and SDBP. They provided continuing education in local, national and international forums that reached more than 3,000 participants. They collaborated with HRSA/MCHB, the 10 MCHB funded DBP Programs, the SDBP, AIR-P and AIR-B and research faculty from UC Davis and Cincinnati Children's Hospital to form the first DBP Research Network this year. To date, projects underway include 1) Delphi process aimed at identifying the most important research questions in the field, 2) study of practice variation in the identification and care of children with autism and ADHD, 3) survey of how research training is funded in DBP education and 4) study of the scope of practice in DBP across sites.