Published online November 1, 2007
PEDIATRICS Vol. 120 No. 5 November 2007, pp. 1036-1043 (doi:10.1542/peds.2007-0842)
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ARTICLE

Pediatricians’ Perspectives Regarding Community Child Health: Training, Involvement, and Expectations According to Age

Cynthia S. Minkovitz, MD, MPPa, Karen G. O'Connor, BSb, Holly Grason, MAa, Judith S. Palfrey, MDc, Anita Chandra, DrPHa,d and Thomas F. Tonniges, MDe

a Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
b Division of Health Services Research, American Academy of Pediatrics, Elk Grove Village, Illinois
c Department of General Pediatrics, Children's Hospital Boston, Boston, Massachusetts
d Rand Corporation, Arlington, Virginia
e Boys Town National Research Hospital, Omaha, Nebraska

OBJECTIVE. There are increasing opportunities for pediatricians to promote children's health through community involvement during and after residency training. Little is known about whether younger relative to established pediatricians have different experiences regarding community activities. In this study we examined whether pediatricians’ training, perspectives, and involvement in community activities vary by age.

METHODS. Eight hundred seventy-six pediatricians participated in a national, random-sample, mailed periodic survey of US members of the American Academy of Pediatrics in 2004 (response rate: 58%). {chi}2 statistics and median tests were used to measure associations of age (≤34, 35–39, 40–50, and ≥51 years) with training, perspectives, and involvement.

RESULTS. Younger pediatricians reported more training in community child health during and before residency but were less likely to be involved currently (37.9% for ≤34 years, 44.4% for 35–39 years, 46.2% for 40–50 years, 48.3% for ≥51 years). They were more likely to report that their current involvement was too little versus just right or too much (81.3%, 73.5%, 60.7%, and 47.1%, respectively). Younger pediatricians were more willing to spend ≥1 hour/month on community child health activities (95.0%, 91.2%, 89.7%, and 85.4%, respectively). Younger versus older pediatricians were more likely to sense moderate or greater responsibility for improving children's health in their community (83.6%, 77.2%, 76.7%, and 70.2%, respectively) and expected their community work to increase during the next 5 years (80.0%, 67.5%, 59.7%, and 40.1%, respectively). Age findings persisted when adjusted for gender.

CONCLUSIONS. Although practice constraints may limit community involvement, younger pediatricians anticipated growing participation in community activities. Longitudinal studies are needed to determine whether such expectations are realized.

Key Words: community pediatrics • workforce • age

Abbreviations: AAP—American Academy of Pediatrics • PS—periodic survey

Accepted May 22, 2007.