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July 7, 2008

Pediatricians' Involvement in Community Child Health From 1989 to 2004

Author Affiliations

Author Affiliations: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Drs Minkovitz and Chandra and Ms Grason); Division of Health Services Research, American Academy of Pediatrics, Elk Grove Village, Illinois (Ms O’Connor); RAND Corporation, Arlington, Virginia (Dr Chandra); Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York (Dr Aligne); Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, Maryland (Dr Kogan); and Goldsboro Pediatrics, Goldsboro, North Carolina (Dr Tayloe).

Arch Pediatr Adolesc Med. 2008;162(7):658-664. doi:10.1001/archpedi.162.7.658

Objectives  To explore pediatricians' current involvement in community child health activities, to examine trends in community involvement from 1989 to 2004, and to compare perspectives and skills related to community involvement among those participating and not participating in community activities.

Design  Cross-sectional analysis of 3 American Academy of Pediatrics Periodic Surveys of Fellows.

Participants  In the 1989, 1993, and 2004 surveys, 1024, 1627, and 1829 pediatricians participated, respectively (response rates: 70.3%, 65.2%, and 57.6%).

Main Outcome Measures  Involvement, skills, and perspectives related to community child health activities.

Results  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. Pediatricians increasingly reported that these activities were volunteer rather than paid (48.6% in 1989, 57.8% in 1993, and 79.6% in 2004). More participants in community child health activities vs nonparticipants viewed their current level of involvement as “just right” (52.5% vs 24.9%), reported themselves to be very responsible for children's health (42.2% vs 24.9%), expected their community work to increase during the next 5 years (63.5% vs 54.1%), and reported higher skills in 6 areas (all P < .001).

Conclusions  Although there has been decreased participation in community child health, most pediatricians expect their community efforts to increase. Because most community activities are volunteer, challenges to address include incorporating community involvement into employment and identifying strategies to facilitate voluntary civic engagement.