Abstract
Problem:
Houston is the fourth largest and one of the most diverse cities in the US. In the Houston Metropolitan area, there are 2,150,000 children and adolescents with disorders of development and learning, 44% of residents speak a language other than English, and 51% reside in immigrant families. The Developmental-Behavioral Pediatrics Clinic at Texas Children's Hospital, the primary teaching site of Baylor College of Medicine, is one of only about 4 in the entire state accepting Medicaid for developmental evaluations. Post-diagnosis, families regularly wait between 14-16 years for state-funded waiver programs that provide additional support. Additionally, individuals with autism and IDD are more likely to have poor health outcomes as adults, and there are multiple barriers to healthcare transition and adequate lifespan care.
Goals and objectives:
The goals and objectives of the Baylor College of Medicine DBP Training Program are to 1) To train leaders in DBP by increasing the size of our DBP fellowship program and continuing our interdisciplinary curriculum focused on clinical care, research, leadership, education, and advocacy; 2) To train providers to manage DBP diagnoses across the lifespan by training physician mini fellows as experts in healthcare transition and lifespan care; 3) To train local and rural primary care pediatricians via DBP mini-fellowships, DBP Extension for Community Healthcare Outcomes (ECHO) rounds, and technical assistance activities and 4) To expand access to care for our bilingual families and to support Title V community agencies through needs assessments that inform the delivery of technical assistance activities.
Coordination:
The BCM DBP Training Program collaborates locally with the BCM Transition Medicine Clinic, the UT Lonestar LEND, Baylor's Intellectual and Developmental Disabilities Research Center, local UCEDDs, the Texas Council for Developmental Disabilities, the Harris Health System and other MCH/Title V Programs, community agencies and schools. The program collaborates nationally with the AUCD, the National Fragile X Foundation, the Spina Bifida Association and as a member of DBPNet.
Evaluation:
Data on DBP fellows' progress in clinical care, research, education/leadership, advocacy and other MCH leadership competencies are formally evaluated biannually with data collected at multiple time points. We evaluate all mini-fellows, faculty, and the program components at multiple points using discrete measures to capture productivity, change in important outcome measures, and to determine if program activities have increased access to care. The program holds a program leadership and stakeholder meeting annually, including family members, self-advocates, and community agency representatives, to review all data and determine aims for quality improvement in the coming year.