Abstract
Problem:
The number of developmental-behavioral pediatricians (DBPs) in the US is woefully inadequate to meet current needs, and the prevalence of some conditions, such as autism, is on the rise. Besides training more DBPs, novel and creative ways to expand the DBP workforce are needed, including engaging and supporting primary care providers in DBP care. Given the particularly challenging structural and social determinants of health at play in Arkansas, efforts to improve equity in and access to DBP care are of paramount importance in our proposed program.
Goals and objectives:
Goal 1: Train DBP fellows and other long-term trainees (LTTs), residents, medical students, and other learners in the essential knowledge and skills of DBP clinical care and in the psychosocial contributors to DBP health. Goal 2: Train a diverse group of LTTs to be competent DBP clinicians, in order to build workforce capacity to diagnose and clinically care for persons with developmental disabilities, including autism. Goal 3: Prepare DBP fellows to assume leadership roles and to teach others to provide evidence-based DBP care. Goal 4: Train LTTs in the foundations of research and in the critical analysis of the published literature. Goal 5: Strengthen systems of care and improve access for children with autism and developmental disabilities and their families, particularly underserved families, through education and training in DBP, extension of DBP care, and technical assistance to community systems of care.
Methodology:
We will recruit diverse trainees to significantly expand the DBP workforce, including at least 10 LTTs (DBP fellows, nurse practitioner students, and other learners) over 5 years. Trainees will receive didactic, clinical, and community-based interdisciplinary DBP training, as well as training in teaching, research, and leadership skills. Trainees will also learn from individuals and families with lived experiences in coping with developmental and behavioral disabilities. Timely, evidence-based continuing education will be provided annually to practicing pediatric primary care providers (PCPs). PCPs will be trained to provide reliable, advanced autism screening and diagnostic evaluations in the community and will have access to novel DBP mini-fellowship training opportunities. Faculty and trainees will collaborate with Title V and community agencies to provide at least 10 technical assistance activities per year. Quarterly outreach clinics and other collaborations in the community will address equity and improve access to DBP services in Arkansas.
Coordination:
Through this project, we will develop new collegial relationships and expand existing ones among UAMS Sections of DBP and Community Pediatrics, nurse practitioner leadership at UAMS, AR LEND and AR UCEDD, and Title V and other community partners. This investment will provide synergistic opportunities to expand DBP care in our state and region in novel and impactful ways.
Evaluation:
The program will be evaluated annually in a comprehensive, multifaceted, systematic, and longitudinal fashion. Our program will be evaluated by ACGME DBP requirements, our project's goals and objectives, and HRSA program performance measures.