TY - JOUR
T1 - Extending the medical home into the community
T2 - A newborn home visitation program for pediatric residents
AU - Tschudy, Megan M.
AU - Platt, Rheanna E.
AU - Serwint, Janet R.
N1 - Funding Information:
We thank the Johns Hopkins Pediatric residents and families that they serve for enthusiastically participating in this program and honestly sharing their experiences. Supported in part by the Thomas M. Wilson Sanitarium for the Sick Children of Baltimore and the Johns Hopkins Children’s Center Special Projects Fund . Dr Tschudy is supported by a HRSA NRSA Fellowship Training Grant ( T32 HP10004-16-00 ).
PY - 2013
Y1 - 2013
N2 - OBJECTIVE: To describe the Health Begins at Home (HBH) intervention and examine pediatric resident change in knowledge, attitudes, and self-reported behaviors after the HBH intervention. METHODS: A prospective mixed-methods cohort study was conducted in 2 outpatient clinics at an urban academic pediatric residency program. Residents serving as primary care providers (n=50) of newborn infants participated in HBH, an educational home visit intervention. Study outcomes included resident pre- and post-home visit surveys and an end-of-residency survey assessing knowledge of community, attitudes, and self-reported practice behaviors. Qualitative comments from surveys and small group post-home visit debriefing sessions were coded and themes identified. RESULTS: After intervention, residents demonstrated a significant positive change (all P <.05) in the following: Adequacy of medical knowledge, understanding of home and community, excitement about home visits, and less concern about personal safety in the community. These changes were sustained in an end-of-residency survey administered 14 to 22 months after the intervention. Sixty-two percent reported a change in how they treated patients, and 94% indicated home visits should be part of the permanent curriculum. CONCLUSIONS: Conducting home visits was associated with residents' improved understanding of the community and home environment of their patients, which was sustained throughout the remainder of training. Residents reported that home visits provide an important educational experience and should be part of the permanent curriculum. Training programs should consider incorporating home visiting programs into curricula to improve resident knowledge of family home, community, and social determinants of health.
AB - OBJECTIVE: To describe the Health Begins at Home (HBH) intervention and examine pediatric resident change in knowledge, attitudes, and self-reported behaviors after the HBH intervention. METHODS: A prospective mixed-methods cohort study was conducted in 2 outpatient clinics at an urban academic pediatric residency program. Residents serving as primary care providers (n=50) of newborn infants participated in HBH, an educational home visit intervention. Study outcomes included resident pre- and post-home visit surveys and an end-of-residency survey assessing knowledge of community, attitudes, and self-reported practice behaviors. Qualitative comments from surveys and small group post-home visit debriefing sessions were coded and themes identified. RESULTS: After intervention, residents demonstrated a significant positive change (all P <.05) in the following: Adequacy of medical knowledge, understanding of home and community, excitement about home visits, and less concern about personal safety in the community. These changes were sustained in an end-of-residency survey administered 14 to 22 months after the intervention. Sixty-two percent reported a change in how they treated patients, and 94% indicated home visits should be part of the permanent curriculum. CONCLUSIONS: Conducting home visits was associated with residents' improved understanding of the community and home environment of their patients, which was sustained throughout the remainder of training. Residents reported that home visits provide an important educational experience and should be part of the permanent curriculum. Training programs should consider incorporating home visiting programs into curricula to improve resident knowledge of family home, community, and social determinants of health.
KW - Cultural sensitivity
KW - Graduate medical education
KW - Home visiting
KW - Medical home
KW - Primary care
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U2 - 10.1016/j.acap.2013.04.009
DO - 10.1016/j.acap.2013.04.009
M3 - Article
C2 - 24011747
AN - SCOPUS:84888352320
SN - 1876-2859
VL - 13
SP - 443
EP - 450
JO - Academic pediatrics
JF - Academic pediatrics
IS - 5
ER -