Abstract
Problem:
There is a significant mismatch between the prevalence of children with respiratory diseases in the U.S. and the numbers and distribution of health care professionals with the skills to treat them. The 2017-18 National Survey of Children's Health identified nearly 6 million children nationally who have frequent/chronic difficulty with breathing or other respiratory problems, and 5.5 million children who are currently suffering from asthma. While the need for pediatric pulmonology services is great, the number of providers is relatively small. This mismatch is especially true in HRSA Region IX. The region covers a wide-spread geographic area that encompasses the states of Arizona, California, Hawaii and Nevada, and includes many rural and Pacific Ocean island communities. There are only 150 pediatric pulmonologists serving the entire region, making the ratio of specialists per child population significantly lower than the U.S. as a whole: nearly 78,000 children per physician in Region IX compared to 62,000 nationally. The clustering of these specialists in a few, mainly urban, counties creates barriers to accessing services for much of the region. The diversity of the population and the proximity to the U.S.-Mexico border adds to the region's unique character and health care delivery challenges.
Goals and objectives:
The UAPPC program is focused on developing a cadre of health care providers who will improve the care and health status of children and families with chronic respiratory conditions throughout the region. Responding to the shortage of pediatric pulmonologists, the UAPPC aims to cultivate physicians, nurse practitioners, nutritionists, social workers, family leaders, and clinical pharmacists who understand the complex issues facing children and youth with special health care needs (CSHCN) and their families, and who can provide leadership in making knowledgeable, interdisciplinary, family-centered care more readily available to children with chronic respiratory conditions.
Goal 1: To provide interdisciplinary leadership training at the graduate and postgraduate levels in pediatric pulmonary medicine, nursing, nutrition and social work plus pharmacy to prepare health professionals to effectively care for children with chronic respiratory disease.
Goal 2: To engage with families as full partners to support family-centered practice, policies, and research serving children and youth with special health care needs.
Goal 3: Increase access to health services through innovative methods such as telehealth, collaborative systems of care, and distance learning modalities.
Goal 4: To provide technical assistance, consultation, continuing education (CE), and subject matter expertise to facilitate academic-practice partnerships.
Goal 5: To support diverse and underrepresented trainees and faculty, and increase the cultural competence and skills of trainees and faculty to address health disparities in underserved communities.
Methodology:
This will be accomplished by delivering an interdisciplinary leadership training program to develop the capabilities of future health practitioners at the graduate and post graduate level, by cultivating the involvement of CSCHN family members to improve service delivery, and by making continuing education and technical assistance available throughout the region.