Abstract
Problem:
The high prevalence of children with disabilities requires increased efforts to train Developmental- Behavioral Pediatricians (DBPs) to diagnose and treat these conditions. Primary care clinicians and others, e.g, psychologists, nurses, and educators, also must contribute to service delivery. Children with disabilities are more likely than others to experience unfavorable social determinants of health and adverse childhood events, particularly important in California, the largest and most diverse state. DBP needs leaders to contribute to research, community service, and public policy to achieve equity and improve systems integration.
Goals and objectives:
Goal 1 is to increase the number of DBPs. The objectives are to enroll 5 DBP fellows over 5 years and provide a comprehensive curriculum. Goal 2 is to increase the capacity of primary care clinicians to address DBP issues in their practices. One objective is to enroll 5 mini-fellows from federally qualified health centers in a multi-faceted program with supervised DBP care in their own clinical settings. A second objective is to deliver Continuing Medical Education on DBP to practicing clinicians. Goal 3 is to provide a range of training in DBP clinical care, research, and community projects. The objectives are to enroll >150 trainees/year in innovative education, supervised clinical practice, and research projects. Goal 4 is to contribute to systems improvements and equity through program development, research, and technical assistance to organizations that serve children with disabilities and their families. HEALTHY PEOPLE 2030 OBJECTIVES: HP 2030 emphasizes 2 salient goals for this project: To improve the health and well-being of people with disabilities and to improve mental health. HP 2030 also emphasizes measurement of functional and quality of life outcomes.
Methodology:
Fellowship training includes didactics, in-person and telehealth clinical rotations, research and medical education training, and leadership education and opportunities. Mini-fellowship training integrates intensive in-person didactics, an ongoing ECHO course, and supervised clinical work within the clinician's own practice, using tele-supervision. Other long-, medium- and short-term trainees participate in didactics, clinics, and research as appropriate to their educational interests and needs. Family-centered care, cultural competence, interdisciplinary teams, MCH principles, diversity and inclusion, and a lifespan framework are woven through all curricula. Community opportunities enhance interdisciplinary collaboration and systems integration. Research opportunities include health services and quality improvement studies of primary care provision of DBP. Each year, faculty and fellows participate in at least one project to improve equity and systems integration.
Evaluation:
Process evaluation addresses leadership of faculty, implementation of program components, and training effectiveness. Outcomes evaluations focus on the degree to which fellows demonstrate leadership after training and documentation of positive changes in the health care and outcomes of children with disabilities.