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Study Assesses Pediatricians' Involvement in Community Child Health Activities

July 24, 2008

"Although pediatricians have a strong sense of responsibility for promoting children's health, they report declining current involvement in community activities, particularly with regard to paid opportunities," state the authors of an article published in the July
2008 issue of Archives of Pediatric and Adolescent Medicine. To promote children's well-being, pediatricians increasingly are encouraged to engage in community partnerships to address social and environmental factors that contribute to children's health. As such, residency training places a growing emphasis on acquiring skills in community pediatrics, regardless of specialization. Despite this emphasis, little is known about the ongoing involvement of pediatricians in community activities. The article presents findings from a study to

  1. describe pediatricians' current involvement in community child health activities,
  2. examine trends in community involvement from 1989 to 2004, and
  3. compare perspectives and skills related to community involvement among those who currently do and do not participate in community activities.

Data for the study were drawn from the American Academy of Pediatrics' Periodic Surveys of Fellows conducted in 1989, 1993, and 2004, each of which included questions on involvement in community child health activities. The study sample included 637 pediatricians in 1989 (88.5% of respondents), 865 pediatricians in 1993 (81.6% of respondents), and 881 pediatricians in 2004 (83.7% of respondents). The analyses assessed differences in responses between surveys. Additional analyses of the
2004 respondents included a comparison of demographic and practice characteristics, community child health perspectives, and skill level by participation in community child health activities in the past year.

The authors found that

  • During the past 15 years, the percentage of pediatricians involved in community child health activities in the preceding year rose from 56.6% in 1989 to 59.4% in 1993 but declined to 45.1% in 2004.
  • Among those who participate in community activities, more pediatricians in 2004 compared with preceding years reported that their community participation was voluntary (79.6% in 2004 vs. 57.8% in 1993 vs. 48.6% in 1989); however, the percentage of all pediatricians engaged in volunteer activities from 1993 to 2004 was consistent (34.3% in 1993 vs. 35.9% in 2004).
  • In 2004, more participants than nonparticipants reported that their level of involvement was "just right" (52.5% vs. 24.9%), felt moderately or very responsible for improving child health in their community at a population level (84.2% vs. 69.4%), expected that their community work in the next 5 years would increase (63.5% vs. 54.1%), and reported higher levels of community pediatrics skills.

"Whether acquisition of new skills during residency translates to increased participation in community activities may depend on whether activities are structured to meet the realities of the busy lives of pediatricians and whether opportunities are sufficiently valued by employers to encourage involvement as part of professional responsibilities," conclude the authors.

Minkovitz CS, O'Connor KG, Grason H, et al. 2008. Pediatricians' involvement in community child health from 1989 to 2004. Archives of Pediatric and Adolescent Medicine 162(7):658-664. Abstract available at http://archpedi.ama-assn.org/cgi/content/abstract/162/7/658.