"It Can Be Confusing": Family Perspectives on Food Insecurity Screening in Urban Pediatric Primary Care Clinics.

Food insecurity, for which families are routinely screened at medical visits, has deleterious health consequences. This study sought to understand the lived experiences of families with lower incomes participating in food insecurity screening at two urban pediatric primary care clinics. Forty-three semi-structured interviews were performed in English and Spanish with families with public insurance after well visits where food insecurity screening was documented. Immersion-crystallization analysis was used to identify salient themes. Families reported discomfort with food insecurity screening, but nonetheless found screening acceptable when performed universally and privately. Families shared confusion about how their screening responses would be used and expected that resources would be available promptly for those who screen positive. Food insecurity screening may be improved for families through explanations of how responses will be used, allowing families to opt out, soliciting family preferences for resource referral, and offering promptly available resources for families with food insecurity.

Diversity, Equity, Inclusion, and Justice in Medical Education: A Faculty Development Perspective.

As many residency programs expand teaching to address the knowledge, skills, and attitudes that residents need to dismantle structural racism and other systemic inequities, many faculty are not prepared to teach these topics. However, there is limited literature on which to base faculty development in this area. The aim of this article is to review how diversity, equity, inclusion, and justice education is integrated in pediatric faculty development efforts. This review will include published and gray literature on curricula and programs in medical education for faculty learners and will address common barriers and challenges faced by faculty members. [Pediatr Ann. 2023;52(7):e266-e272.].

Leveraging E-Learning and Community Assets to "TEACH" Residents to Address Child Poverty.

OBJECTIVE: To evaluate the effectiveness of a multimodal child poverty curriculum for pediatric residents. METHODS: The Trainee Education in Advocacy and Community Health (TEACH) curriculum trains residents to recognize and address the effects of child poverty, utilizing learning objectives modified from the US Child Poverty Curriculum, new interactive web-based modules, experiential learning, and reflection. This mixed-methods evaluation of the first component, "Epidemiology of Child Poverty," includes nearly 2 years of resident participation. Pre/post knowledge and attitudes regarding child poverty were assessed. Behavior change was evaluated in a subset of participants using an Objective Structured Clinical Examination (OSCE), comparing intervention and control groups of residents. Residents' experience with the curriculum was assessed using qualitative analysis of debrief sessions with faculty. RESULTS: Fifty-two residents completed the curriculum between June 2018 and March 2020. Residents increased in knowledge (P < .001) and confidence (P < .0001) in recognizing and addressing poverty. They also self-reported greater preparedness (P < .001) and effectiveness (P < .001) in addressing social determinants of health. Early data from the OSCE have not shown a statistically significant change in skills compared with a control group. Qualitative themes included an increase in empathy for, understanding of, and responsibility to address the effects of poverty in caring for patients. CONCLUSIONS: The multimodal "Epidemiology of Child Poverty" portion of the TEACH curriculum increased resident knowledge, confidence, and empathy. Given the ubiquitous nature of poverty and the generalizability of the online modules, the TEACH curriculum can be a resource for other residency programs.

"TEACH"ing Medical Students to Address Child Poverty: A Multimodal Curriculum.

Literature on the effectiveness of child poverty education in undergraduate medical education is scant. This study adds quantitative and qualitative support for incorporation of a multimodal curriculum to improve student knowledge, confidence, and attitudes toward child poverty.

"I am affected in all the ways ": A phenomenographic analysis of Latinx adolescents' perceptions of family separations at the border.

OBJECTIVES: This phenomenographic analysis examines how news of family separations at the U.S.-Mexico border shaped variations of experience and perceptions among U.S. Latinx adolescents across parental residency status. METHOD: In 2018-2019, 340 15-18-year-old Latinx adolescents in the Washington D.C. area participated in a study on immigration actions and responded to an open-ended question detailing how news of family separations at the border affected them and their families. The sample was comprised of equivalent numbers of adolescents whose parents had U.S. citizenship, permanent residency, temporary protected status, or were undocumented. Utilizing a phenomenographic analysis, we compared data across the participants' parental residency status. RESULTS: Three categories captured the complex influences that news of family separations had on Latinx adolescents not directly affected. Perceptual Experiencing described the sympathetic and vicarious emotions produced by the news of family separations. Lived Experiencing described the tangible effects experienced by participants, including incidents of increased racism and fear. Catalyzing effects described spillover effects of the first two themes where internalized feelings induced fear and catalyzed family behaviors. All themes were noted across residency status; however, the third was most strongly supported by those whose parents had precarious statuses. CONCLUSIONS: Findings suggest Latinx families across residency statuses can be negatively affected by news of the adversities experienced by a subgroup. Service and healthcare providers, and educators must be prepared to support Latinx youth faced with fear, discrimination, and isolation arising from exposure to news on immigration actions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Advocating for Immigration Policies that Promote Children's Health.

Immigration laws and policies, as well as related media and public discourse, have a direct and significant effect on the health and well-being of children and families. The purpose of this article is to identify the impact of family immigration status and immigration laws on children's health, to understand the legal system that immigrant children face, and to describe opportunities for health care professionals to engage in advocacy at the systems level, from the local community to Capitol Hill.