Boston University

Problem:

•Generate and disseminate new DBP information / models of care. •Enhance pediatric primary care's ability to address DBP issues, especially for children living in poverty. •Increase leadership and expertise in field of academic DBP. •Advance scientific knowledge in DBP.

Goals and Objectives:

Goal 1: To train a new cadre of leaders for the 21st century in the field of DBP Objective 1: Recruit at least one new fellow trainee / year Objective 2: 2/3 of long term fellows assume positions of leadership in DBP Objective 3: Long term fellows not in leadership positions continue to infuse DBP into their local communities Goal 2: To provide fellows with excellent training in all clinical aspects of DBP Objective 1: Each fellow will spend significant clinical time in the BMC DBP clinics for children ages 0-18 years Objective 2: Fellows will understand appropriate follow-up for patients from ages 0-21 years Objective 3: Emphasis will be placed on creating a therapeutic alliance with families, as well as sophisticated assessments of DBP problems at all ages Goal 3: To provide fellows with the theoretical and practical skills to conduct meaningful research in their professional careers. Objective 1: Each fellow will complete at least one research project during the course of the fellowship Objective 2: Fellows will attend at least two research method methodology courses at the Boston University School of Public Health (BUSPH) Objective 3: Fellows will participate in a bi-weekly research meeting which is specifically targeted to them. Goal 4: Fellows wll understand theories of adult learning and with multiple opportunities to teach DBP to a variety of medical and non-medical child professionals, in both formal and informal settings Objective 1: Fellows will teach the 3rd year medical students during their Pediatric rotation Objective 2: Fellows will provide training to pediatric residents during their one month DBP rotation Objective 3: Fellows will give a formal lecture at our annual CME course Goal 5: Fellows will gain expertise in understanding and addressing the special needs of families from multiple ethnic and racial backgrounds Objective 1: Fellows will learn sensitivity to these issues as part of their clinical work at BMC with families of variable ethnic and racial backgrounds Objective 2: Fellows will be exposed to these issues in the literature seminar through formal readings Objective 3: Fellows will learn how to incorporate issues of social class and ethnicity as part of any research methodology

Methodology:

- Fellows participate in a variety of supervised clinical activities in order to gain strong clinical competence and skill in addressing the behavioral, psychosocial and developmental aspects of caring for children and families in the context of their social environment. - Fellows, with strong faculty support, will conceptualize, conduct and write up an original research study. - Fellows will become involved BMC’s innovative programs that have been created to meet the needs of disadvantaged families. - Fellows will have opportunities to teach medical students, pediatric residents, primary care providers , and other child disciplines. - Fellows will be taught administrative skills through assuming administrative responsibility for an ongoing BMC program (eg, medical student teaching)

Coordination:

- The SPARK Center (formerly, Family Development Center) is funded by the Massachusetts Department of Social Services - Consultation to Bay Cove to Early Intervention Program - Consultation to the Boston Public Schools. - Coordination with Boston Healthy Start Program

Evaluation:

- Fellows Log: Documents fellows' exposure / participation to process objectives - Faculty Evaluation Form: Faculty assessment of fellow's progress in meeting trraining goals during each year - Program goals: % of long term trainees assuming leadership roles in DBP, papers published, programmatic succeess.

Experience to Date:

In the past year, our program has provided fellowship training to five pediatricians – one in the 3rd year, two in the 2nd, and two in the 1st. Out training efforts continue to be broad and extensive: Our annual two day CME course: “Developmental and Behavioral Pediatrics: Clinical Problems in Primary Care” hosted a 185 pediatric clinicians. The 14th year of our study of prenatally cocaine-exposed infants has continued, as well as new research on PTSD in children. Finally, we have continued to offer a one month DBP rotation for our 33 first year pediatric residents.