Board of Trustees of the Leland Stanford Junior University

Problem:

The large, diverse population of children in Northern California need subspecialists in DBP and general pediatric health care providers specially trained in DBP to screen, assess, diagnose, treat, and manage developmental and behavioral problems. The field needs research. Service systems need leadership to increase accessibility, integration, and comprehensiveness.

Goals and Objectives:

The first goal is to train DBP subspecialists. Objectives are to enroll 5 fellows over 5 years; create a curriculum that addresses MCH priorities and emphasizes cultural competence and family-centered care (FCC); prepare fellows and medium term trainees to conduct research; and provide community leadership experiences to DBP fellows and to other pediatric fellows, residents, medical students and health professionals in training. The second goal is to increase the capacity in this region to assess and manage DBP problems. Objectives are to provide a one-month rotation to 26 residents and a meaningful longitudinal experience to 52 residents per year; collaborate with regional DBP training programs; provide clinical experiences to other health professionals; and support community pediatricians to accomplish culturally competent screening and management of common DBP problems. Activities Undertaken to meet Project Goals: Fellowship training occurs at Stanford University and Lucile Packard Children’s Hospital (LPCH) at Stanford. Stanford runs excellent cultural competence programs. LPCH includes FCC as its primary mission. Training of subspecialists and generalists in the community builds on an exciting First 5 San Mateo County project to increase developmental screening and support families and early childhood centers in meeting developmental and emotional needs of children. HP 2010 Objectives: The major Healthy People 2010 goals that the project addresses are as follows: 6-2. Reduce the proportion of children/ adolescents with disabilities who are reported to be sad, unhappy, or depressed; 16-14a, b, and c: Reduction in Developmental Disabilities (MR, CP, ASD) in children; 1-4. Increase the proportion of persons who have a specific source of ongoing care; 16-22 Increase the proportion of children with special health care needs who have access to a medical home; 18-6 and 18-7 Increase the number of persons seen in primary health care who receive mental health screening and assessment and treatment.

Coordination:

The core faculty and fellows meet weekly. Core faculty members have specific responsibilities within the program and maintain contact with colleagues in the research or service community. Meetings with State Title V and county leadership occur quarterly.

Evaluation:

Formative evaluations: (1) find out the extent to which program implementation is achieved; (2) assess the training program as it progresses; and, (3) determine improvements needed to attain the training objectives. Summative evaluations include products indicating the trainees have achieved competencies in clinical skills, research, and community leadership. Changes in community screening rates and services to children evaluate goal 2.