Abstract
Goals and objectives:
The purpose of the "Training Leaders in Developmental Behavioral Pediatrics" program at the University of Michigan (UM-DBP) is to utilize tiered training and technical assistance to expand the Developmental Behavioral Pediatrics (DBP) workforce capacity in Michigan (MI) to evaluate, diagnose or rule out developmental disabilities, autism, and other developmental-behavioral conditions (DD/A/DB); increase equitable access to evaluation and services; and provide culturally-inclusive, family-centered care through tiered training, technical assistance and scholarship. NEED: The prevalence of DD/A/DB conditions is significant and increasing. The pediatric workforce is underprepared, with pediatric providers (PCPs) reporting a lack of knowledge regarding screening and diagnosis of DD/A/DB conditions, and is understaffed, with a national shortage of trained providers to manage these issues. Michigan has important challenges regarding DBP care. Racial, geographic, and socioeconomic disparities result in significantly underserved populations. Recent events (COVID-19) amplified the behavioral health needs of MI children and families and illuminated structural and social determinants of health contributing to disparate outcomes. PROPOSED SERVICES: UM-DBP aims to expand the MI DBP workforce capacity through tiered training, increase equitable access to DBP care for the underserved, and facilitate timely diagnosis and care to optimize outcomes for individuals with DD/A/DB conditions through the lifespan. Using C.L.E.A.R. goals and C.A.R.E.-focused objectives, we will: (C) Build CAPACITY of a tiered DBP workforce to screen/evaluate/manage DD/A/DB conditions; (L) Create LEADERS in DBP C.A.R.E. (Clinical care; Advocacy, Research and Education); (E) EDUCATE trainees at all levels in DD/A/DB care and needs of underserved populations; increase access to DBP care via training in evidence-based screening and assessment tools (A) Provide Technical ASSISTANCE (TA) to strengthen DD/A/DB systems of care AND (R) Provide RESEARCH and quality improvement (QI) training and disseminate findings to advance DBP knowledge POPULATION TO BE SERVED: The primary population served is the multilevel trainees served via tiered training (= 1000 short-term and medium-term trainees; = 10 long-term trainees, = 750 PCPs over the 5-year funding period). Additional beneficiaries include MI children and families, especially those with SSDOH, and living in underserved areas.
Methodology:
The UM-DBP program curriculum includes Interdisciplinary, Didactic, Clinical and Educational experiences to promote culturally inclusive, equitable care focused on DD/A/DB. Curriculum includes input from advocates (family/self), Structural Racism Advisor, and Rural/Community partners to advise on SSDOH, equity oriented care, and the lived experiences of DD/A/DB. Training in cultural inclusivity provided by Reflective Supervision, Trauma-Informed Care and MCH Leadership Competencies. MI-Leadership Education in Neurodevelopmental and other Related Disabilities educates LT-DBP fellows in leadership/diversity. Regional partnerships with other programs and community agencies provide outreach and TA for DD/A/DB conditions. Continuing education will be implemented through trainings to reach MI PCPs statewide. TA will occur through state/regional partnerships with Title V and other MCH stakeholders. Research and QI projects will be guided by interdisciplinary investigators and informed by diversity, equity and inclusion principles.
Evaluation:
Outcomes will be measured at least annually to iteratively inform the project. Number of trainees, number and type of collaborations/activities/scholarly products and modes of dissemination will be measured. Trainee, faculty/staff, family and self-advocates and PCP feedback about the efficacy of training will be assessed as metrics of program success in expanding the workforce in a comprehensive and equitable manner.