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Community Pediatrics Training Initiative

The UF College of Medicine – Jacksonville Department of Pediatrics was one of only ten sites nation-wide to be awarded a five-year, $1.8 million Anne E. Dyson Community Pediatrics Training Initiative grant for 2002-2007. Through the grant, and since, we have partnered with numerous community-based organizations in Jacksonville to provide residents with a better view of the complex issues impacting children and the interdisciplinary knowledge, skills and cultural competence required to understand and improve the health of children and families hailing from different ethnic and cultural backgrounds.

All residents attend a comprehensive noon-conference curriculum, developed and taught by a multi-disciplinary staff, which explores issues such as community oriented primary care, child advocacy, child rights, the medical home model and global health. During the first year, residents participate in a month-long community and societal pediatrics rotation that exposes them, through practical application and hands-on experience, to community assessment, epidemiology, community resources, health promotion, disease prevention and legislative advocacy; all through the lens of a child rights, social justice and health equity framework. In addition, starting mid-way through the first year, residents who elect to do a community advocacy initiative (CAI) project will choose a population or health gap of interest and begin exploring this subject area. Residents will be supported in their work through elective rotations in the division of community & societal pediatrics (CSP) and through dedicated noon conferences throughout the year. Through direct participation, each resident will work with both faculty and community mentors to help improve the health status of children and families.

Residents are encouraged to write an opinion piece in the local newspaper on an area of interest. Below are links to some recent articles written by our PGY-1 residents:

In terms of CAI projects, past residents have developed initiatives in the areas of breastfeeding, early childhood education, trauma informed care and the use of motivational interviewing in adolescent patients. Current and ongoing CAIs include work with local refugee resettlement agencies, pediatric mental health services, health advocacy for LGBTQ youth and giving children and families a voice through narrative medicine. Residents have also been involved in advocacy initiatives globally such as participation in the ‘Helping Babies Breathe Program’ in Africa and ‘identifying resilience among gang involved youth’ in Guatemala. Some of these projects have resulted in scholarly presentations at local and national meetings.

In addition, residents will have opportunities to learn about and participate in advocacy work at the clinical, systems and legislative level through a series of bimonthly discussions. The aim of these discussions is to give residents basic knowledge and skills in advocacy. Residents will learn about local, regional and national advocacy-related meetings, which they may attend and/or present their work. In 2017, we hosted a workshop under the auspices of the Florida Chapter of the AAP (FCAAP) where residents were provided information on the basics of advocacy at the state level and offered the chance to meet with their area legislators.

Additionally, residents could visit Tallahassee, Florida’s state capitol when the government was in session during children’s week. Our residents were also given the opportunity to work with the chapter on the HPV grant awarded to the FCAAP by the national AAP.

In collaboration with our state chapter, we plan to participate in statewide advocacy initiatives. These may include looking at the appropriate use of Florida Shots, the state’s immunization registry, as well as a grass roots campaign to improve immunization rates in Florida. In January 2018 and March 2019, selected residents also participated in children’s week activities in Tallahassee.

Residents interested in advocacy have the option to further their interests through the advocacy tract offered in the program. Rotations offered through the tract are as follows:

CSP1: Community and societal pediatrics rotation where residents will be introduced to the core concepts of child rights, social justice and health equity as they relate to the health and well-being of children. Residents will experience a variety of community resources and learn how these resources impact children’s lives. The rotation will also provide an opportunity for trainees to step out of the “medical” model and view pediatrics through a community lens.

CSP2: Residents on the CSP track will have a second month during first year to further explore a specific community health, advocacy or special population topic. During this month residents will receive guidance on performing a literature search related to their topic of interest. They will also learn how to identify and communicate with key stakeholders and organizations relating to the topic. By the end of the month (or PGY-2 year), residents should have a clear introduction/aim/objectives/plan in place for their CAI.

Community pediatric development: Residents will spend a month meeting with community leaders in pediatrics and learn about the most relevant health issues facing children in our community and how to advocate for children in this context. The rotation will also include literature review of leadership in the field of pediatrics, the history behind pediatric organizations and initiatives. Residents will leave the rotation with a better understanding of how a pediatrician’s role in the community and as a leader can impact the health and well-being of the children we serve. As mentioned previously, care of the medically complex child and outpatient mental health rotations are also offered through the CSP tract.

For further information on this training initiative, please go to www.aap.org/commpeds/CPTI/.

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