Journal of Pediatric Health Care

INTRODUCTION: To address healthcare disparities among transgender and gender diverse (TGD) adolescents, we examined vaccination coverage in those receiving gender-affirming care. METHOD: Our study analyzed de-identified data (2013-2022) from a tertiary care clinic. Comparing vaccination rates of 203 TGD adolescent patients to age-matched peers in New York State using CDC National Immunization Survey-Teen data. RESULTS: We found TGD patients had similar vaccination coverage to the general adolescent population...

INTRODUCTION: This study examined how lifestyle risk behaviors mediate the relationship between smartphone overdependence, depressive symptoms, and suicidal behavior in adolescents. METHOD: Based on a secondary analysis of national survey data obtained in 2020 in South Korea, this study had 54,948 participating adolescents. Multiple logistic regression and mediating effect analyses were used to assess the relationships between the study variables. RESULTS: Adolescents' lifestyle risk behaviors partially mediated the link between smartphone overdependence and depression (Z = 6...

As pediatric-focused nurse practitioners continue to grapple with the impact the COVID-19 pandemic has had on youth since 2020, they are simultaneously faced with navigating what it looks like to ensure the success and health of children moving forward from the pandemic. Despite the relaxation of COVID-19 guidelines in many schools and athletic programs across the country, ensuring a safe return-to-play post-COVID-19 infection must continue to be a priority for pediatric-focused nurse practitioners. Here, we present the case of a 13-year-old female who was seen in a primary care clinic after reporting dizziness and shortness of breath with activity post-COVID-19 infection...

Nocturnal crying in toddlers has a broad spectrum of causes, including psychosocial and somatic causes, whereby the majority are self-limiting and do not need referral to specialist medical care. Although uncommon, atypical presentations of nocturnal crying-such as spondylodiscitis-require referral to specialist medical care, especially when combined with discomfort. In this case report, we present a case of a 15-month-old girl with an atypical presentation of nocturnal crying in combination with back pain.

Dermatophytoses of the skin and scalp are common disorders in the pediatric population. The resemblance of the clinical presentation to other dermatoses can make fungal infections challenging to diagnose. We present three cases of dermatophytoses in children. The presence of fungi within skin lesions was confirmed in all cases. The diagnoses were "id" reaction in response to Trichophyton tonsurans infection, Kerion celsi because of Microsporum canis infection, and hair loss during microsporosis. Based on our review and clinical experience, we suggest diagnostic paths and treatments for dermatophytoses in children...

Social and legal determinants of health have been shown to have substantial impacts on the health outcomes of individual patients and the population as a whole. This case report highlights the importance of screening for social needs as well as having appropriate interventions to address their impact. One intervention is medical-legal partnerships. The case presented describes the use of social screening tools and medical-legal partnerships to address health concerns, reduce health care spending, and promote optimal health outcomes...

Approximately 100,000 people in the United States are affected by Sickle Cell Disease (SCD). Acute pain and chronic pain are common and are experienced by everyone with SCD. Children and adolescents who had pain from SCD reported daily pain, decreased function, missed school/workdays, and limited participation in recreational and social activities. This case report aims to highlight the lack of diversity, equity, and inclusion of pain control through the lens of a patient with SCD to improve clinical practice...

The number of youths who identify with a gender different from their sex designated at birth is increasing. Youth account for about 4% of all cancer diagnoses in the United States. Some youths may want gender-affirming medical treatment, such as puberty blockers and/or hormone therapy, which may exacerbate cancer and/or increase cancer development risk. No studies assess the impact of estrogen-based treatment in gender-diverse youth with a history of Li-Fraumeni syndrome. This case report will discuss gender-affirming care and shared decision-making in a youth with a history of Li-Fraumeni syndrome and increased risk for breast cancer...

INTRODUCTION: Pediatric nursing has been a profession dominated by women, but patients benefit from representation of both men and women. We describe characteristics associated with male pediatric nurses and consider potential pathways to greater male pediatric nurse workforce participation. METHOD: We used data from the 2018 National Sample Survey of Registered Nurses, a nationally representative survey of nurses that estimates characteristics of the workforce...

Gender-affirming care (GAC) acknowledges the right of each individual to live in the gender that is most authentic to them and to receive nonjudgmental, developmentally appropriate care. For transgender and gender-diverse (TGD) individuals, this care may include transition-related care, such as puberty blockers, gender-affirming hormones, and therapies, including surgery. All youth, including TGD youth, deserve confidential, adolescent-friendly care. However, recent legislation in many states seeks to limit access and/or ban GAC for TGD youth...

The association between adverse childhood experiences and negative health outcomes is a public health concern, particularly affecting disadvantaged groups and contributing to health disparities. Pediatric nurse practitioners are well-positioned to address this issue, emphasizing the importance of incorporating social justice concepts into nursing education to develop a pediatric workforce with the necessary skills to curb health disparities. However, evidence-based approaches to incorporating these concepts into pediatric nursing education are limited...

Poor health outcomes for children are directly tied to poor social determinants of health and systemic, embedded health care inequities. To prepare the next generation of pediatric advanced practice registered nurses (APRNs), nursing schools must educate students to address inequities through innovative curricular models and teaching modalities. The purpose of this manuscript is to describe the application of an antiracism framework to a graduate APRN program. This article describes the application of this framework, which led to significant administrative, curricular, and course changes to prepare pediatric-focused APRN students to address the health inequities and poor social determinants of health facing children today...

School connectedness is the degree to which students experience acceptance, inclusion, and care by school personnel and peers. A sense of belonging incorporates an emotional connection to the community. School connectedness and belonging are protective factors that promote student engagement, accomplishment, and community performance. Despite the rise in students from immigrant families in the United States, belonging and connectedness for youth from diverse cultural and linguistic experiences are understudied...

In response to growing health disparities, social inequities, structural racism, and discrimination, the National Association of Pediatric Nurse Practitioners established a Diversity, Equity, and Inclusion Taskforce. In 2020, this group transitioned into a national committee to infuse equity across the organization and empower pediatric-focused advanced practice registered nurses as agents of change to address health disparities. Emphasizing the critical need for understanding health disparities in the context of racism and discrimination, this committee champions a paradigm shift, transcending educational initiatives, advisory roles, advocacy efforts, leadership strategies, and community services to illuminate an equitable future for all children and families...

The Centers for Disease Control and Prevention affirm that health equity is only achieved when everyone has opportunities to attain full health potential without disadvantages related to social position or socially determined circumstances. To reduce health inequities in nursing research, researchers must increase diversity in study samples and ensure that study participants are representative of all populations in the United States. Identifying effective methods for recruiting underrepresented populations must be a thoughtful and reflective component of every research methodology...

A scoping review was conducted to systematically map the research on children with medical complexity and children and youth with special health care needs (CYSHCN) surrounding health equity. Fifteen articles were reviewed with focus on: access to care, quality of life and well-being, and insurance challenges/financing. Findings suggest CYSHCN require more and different types of services than those for typically developing children and youth, yet the current system is not ensuring access to these services. It is important to understand the unique perspectives, challenges, and opportunities of and for this population to better inform policy, research, and practice...

INTRODUCTION: Podcasts are effective tools for disseminating health education. This study aimed to disseminate a health equity curriculum on best practices. METHOD: A cross-sectional descriptive study was conducted as part of the Health Equity in Pediatrics podcast series between May and June 2023. Listeners were surveyed following each episode, and both quantitative and qualitative responses of voluntary respondents were analyzed. RESULTS: Episodes were downloaded 4,095 times...

INTRODUCTION: This qualitative research study explored practices that support and advance diverse membership in Patient and Family Advisory Councils (PFACs) in children's hospitals and the involvement of PFACs in organization-level diversity, equity, and inclusion work. METHOD: This study consisted of a focused literature review and 17 key informant interviews. The study sought to identify important learnings about (1) recruiting and supporting patient and family advisors (PFAs) from historically marginalized populations and (2) ways to develop and sustain meaningful partnerships with PFAs and PFACs in diversity, equity, and inclusion work...

INTRODUCTION: This analysis sought to identify disparities in social determinants of health (SDOH) outcomes at a Texas pediatric hospital. METHODS: This retrospective study used electronic health records of pediatric patients families surveyed August -December 2022. Outcomes for health literacy, social support, food, transportation, energy, digital, and housing insecurity, and tobacco exposure were analyzed across demographic categories. RESULTS: Among 15,294 respondents to the survey (mean child age, 8...

INTRODUCTION: This study describes mothers' knowledge, attitudes, beliefs, and practices about their toddler's sleep health among an underresourced sample of mothers with diverse racial and ethnic identities. METHOD: This was a descriptive qualitative study with 16 mothers and their 12- to 36-month-old child. Mothers completed a semistructured, audio-recorded interview about their toddler's sleep health. Data were analyzed using inductive content analysis on the basis of established methods...