Pediatric Academic Societies and American Academy of Pediatrics Joint Meeting May 12-16, 2000 Hynes Convention Center, Boston

Friday, May 12

9:00 am - 12:00 noon - SPECIAL INTEREST GROUP

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

SG08 Serving the Underserved
Chairs: Jeffrey Brown and Ronald Samuels

At the STUS SIG meeting we will work on several initiatives that were started over the last couple of years, including:
•Finalizing the STUS case based curriculum.
•Development of a national meeting to create a curriculum to be used for teaching about STUS and advocacy training in pediatric residency programs.
•Continued collaboration with the AAP CATCH Program.
•Members of the AAP Committee on Community Health Services and the Section on Community Pediatrics will attend the meeting. This is a unique opportunity to collaborate with these colleagues at the first joint meeting of the APA and AAP.
•Continued work with the Advocacy Training SIG re teaching materials.

Come and join us at our annual meeting to continue this work and explore other projects in the future.

1:00 pm - 4:00 pm - APA COMMITTEES

Health Care Delivery Committee
Chair - Danielle Laraque, MD

The Health Care Delivery Committee (HCDC) is one of the five standing APA committees. The goals of this committee are to serve as a resource to APA members by disseminating information about health care delivery issues, recognize excellent models of care and establish collaborative relationships with other generalist organizations. Email dl2@columbia.edu for any items to bring to the HCDC. All members are welcome.

Public Policy Committee
Chair – Charles Oberg, MD, MPH

The Public Policy Committee members have continued to be active in public policy initiatives at both the Federal and State levels. The overriding emphasis and theme is to increase the health and well being of infants, children and adolescents through participation in the public policy and advocacy process. APA members interested in becoming more involved in public policy issues are encouraged to attend. Please email oberg001@umn.edu with any questions or items for the meeting.

1:00 pm - 4:00 pm - WORKSHOP

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

WS05 Achieving Cultural Competency In Pediatrics
The United States rapidly is growing more culturally diverse as we approach the 21st century. In several cities, whites are already in the minority. Culture has a profound impact on pediatrics, affecting a wide variety of aspects of clinical care, including outcomes, process measures, quality of care, satisfaction with care, obtaining an accurate history, and adherence. Cultural competency is defined as the ability to recognize and appropriately respond to key cultural characteristics that affect clinical care in the major cultural groups seen in your practice. In this workshop, participants will learn about a model of cultural competency that can be applied to any cultural group that might be encountered by the pediatrician. This model is based on five aspects of culture that affect clinical care: 1) normative cultural values; 2) language issues; 3) folk illnesses; 4) parent beliefs; and 5) provider practices. Latinos and African-Americans will be used to illustrate the most important ways that culture impacts pediatric care, drawing on the rich available literature and the personal experience of the workshop leaders.

Using an evidence-based approach derived from critical studies on the Latino and African-American cultures, workshop participants will learn and master the cultural competency model. Illustrative cases (including videotapes) will be presented to challenge participants and further solidify their skills. Participants can expect to acquire practical skills for recognizing and appropriately responding to crucial aspects of culture and language that affect pediatric care.

G. Flores and K. Fox, Department of Pediatrics and Pediatric Latino Clinic, Boston Medical Center and Boston University Schools of Medicine & Public Health, Boston

WS06 After Arrival: Caring For New Immigrant Children
At least 500,000 new immigrant children (refugees, adoptees, children traveling with or to visit family) arrive in the United States annually. Most pediatric practices in the United States work with these patients, who often have unique medical concerns.

The goal of this workshop is to increase providers’ knowledge about caring for new immigrant children. Using a case-based discussion format in three parts, we will: 1) Discuss medical issues common to immigrant children, such as health screening, immunizations and interpretation of tuberculin skin tests; 2) Provide strategies for working with interpreters, addressing families from diverse cultures and preparing immigrant children for optimal learning in school and 3) Describe legal considerations for these children, including benefits and entitlements available to some new arrivals, and INS regulations governing medical screening for visas and immigration status.

This workshop is intended for primary care providers who work with new immigrant children. This workshop will enable participants to: 1) Recognize medical issues specific to immigrant children; 2) Improve their skills working with interpreters, across cultures and with school systems; and 3) Identify legal considerations for immigrant children. We will distribute written resources useful to clinicians working with new immigrants.

L.M.H. Albers, E.D. Barnett, J. Ciborowski, P.L. Geltman, P.E. Klass, J. Zotter, Children’s Hospital & Boston Medical Center, Boston, MA Department of Public Health.

WS08 Community Oriented Primary Care: From Theory To Evidence Based Practice
Community Oriented Primary Care (COPC) is a modification of the traditional model of primary care practice, providing an evidence-based approach to the planning of clinical interventions, evaluations, and research that addresses the health care problems of a defined population. Although COPC is well established in other countries, its use in the United States has been limited due to a lack of skills and knowledge of COPC principles by U.S. practitioners and is particularly unfamiliar to most pediatricians and pediatric settings. We have demonstrated the potential for its use in the community training of academic pediatricians, especially those in urban areas, and as a tool to improve the validation and community acceptance of new approaches to clinical care and research. This workshop will seek to train fellows and faculty to apply the principles of COPC to innovative clinical pediatric practice and research. Through presentations, interactive discussions and participation in skills building exercises, this workshop will: (1) educate participants on the principles of COPC; (2) provide a framework to apply COPC to a variety of patient populations; (3) identify skills needed to implement COPC in their population; and (4) identify national and international resources for information on applying COPC principles. At the conclusion of this workshop, participants should gain sufficient knowledge to understand and begin to apply the principles of COPC to pediatric practice and clinical research in their community.

I. B. Horn, C. Focht, B. Gitterman, F. Mullan, Children’s National Medical Center, Washington, D.C.; George Washington University, Washington, D.C.

4:15 pm - 6:15 pm - POSTER SESSION I AND OPENING RECEPTION

Saturday, May 13

8:00 am - 10:00 am - SUBSPECIALTIES/THEMES (Original Science Abstract Program)

• Behavioral Pediatrics I (Platform)

10:15 am - 12:15 pm - TOPIC SYMPOSIUM

¨Child Health Services Research: Scientific Opportunities and Methods
Chair: Larry Kleinman, Lehigh Valley Hospital, Allentown

This session will discuss child health services research as an emerging field of applied science. The session will highlight both scientific opportunities and accomplishments. Dr. Kleinman will frame the context of health services research as an applied science. Dr. Simpson will elaborate on the continuum of child health services research, and the relationship of this work to the agenda of the Agency for Healthcare Research and Quality, and a principal federal agency for health services research. Dr. Stein will speak on the state-of-the-art in measuring the health and well being of children, emphasizing the methodological foundations of the work. Dr. Homer will address scientific methods in the quality of health care, from concept to measurement, to improvement and then back to measurement. The session will acknowledge specific controversies in the field and provide ample opportunity for discussion among participants and panelists.

Applied Science and the Context of Child Health Services Research
Larry Kleinman, Lehigh Valley Hospital, Penn State College of Medicine, Allentown

Child Health Services Research: Its Scope and Continuum
Lisa Simpson, Agency for Healthcare Research and Quality, Chevy Chase

Using Health Status Assessment in Children as an Outcome
Ruth E. Stein, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx

Quality of Care and Improving the Delivery of Child Health Services
Charles J. Homer, National Initiative for Children’s Healthcare Quality, Boston

10:15 am - 12:15 pm - SUBSPECIALTIES/THEMES (Original Science Abstract Program)

• Violence: A Family Affair (Poster Symposia)

1:30 pm - 2:30 pm - APS PRESIDENTIAL PLENARY - HOWLAND AWARD
Presidential Address - Rebecca H. Buckley, Duke University School of Medicine
John Howland Award Presentation - Samuel A. Katz

2:30 pm - 3:00 pm - JOSEPH W. ST. GEME, JR. LEADERSHIP AWARD
Joseph W. St. Geme, Jr. Award Presentation - Evan Charney, Dept. of Pediatrics, University of Massachusetts Medical Center, Shrewsbury
St. Geme Awardee Introduced by: Kenneth B. Roberts, Professor of Pediatrics, University of North Carolina School of Medicine, Greensboro

Presented on behalf of the American Pediatric Society, American Academy of Pediatrics, American Board of Pediatrics, Ambulatory Pediatric Association, Association of Pediatric Program Directors, Association of Medical School Pediatric Department Chairman and Society for Pediatric Research

5 pm - 7:15 pm - POSTER SESSION II

Sunday, May 14

7:00 am - 8:00 am - PUBLIC POLICY LEGISLATIVE BREAKFAST SYMPOSIUM

¨Medical Science and the Brave New World of Electronic Publishing
Moderator: James Perrin, Editor, Journal of the Ambulatory Pediatric Association
Speakers: Jerold Lucey, Editor-in-Chief, Pediatrics and Alvin Zipursky, Editor, Pediatric Research

8:00 am - 10:00 am - TOPIC SYMPOSIUM

¨The Neurobiologic Basis of Behavior and Development
Chair: James M. Perrin, Mass General Hospital for Children, Boston

This session will describe recent work linking developmental aspects of brain function and structures with understanding of child development, developmental disabilities, and child and adolescent behavior. Expanding knowledge in areas of brain development, anatomic structures, and molecular biology of the central nervous system broaden the base for understanding clinical phenomena. New work has helped to characterize environmental and central nervous system influences on child and adolescent behavior. Recent long-term follow-up data from the Infant Health and Development Program inform regarding the predictors of outcomes for children at developmental risk.

Brain Development and Developmental Disabilities
Mark L. Batshaw, Children’s National Medical Center, George Washington University School of Medicine, Washington

Neurobiologic Representations fo the Social World: Developmental Considerations
Felton Earls, Harvard Medical School, Boston

The Infant Health and Development Project: Implications for Neurobiologic Basis of Development
Marie McCormick, Harvard School of Public Health, Boston

8:00 am - 10:00 am - SUBSPECIALTIES/THEMES (Original Science Abstract Programs)

• Health Care Delivery in Underserved Populations (Platform)
• Sudden Infant Death Syndrome (Poster Symposia)

9:00 am - 12:00 noon - WORKSHOP

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

WS19 Children’s Health 2000 Won’t Happen Without Reimbursement/Financing
One can teach and preach combined inissions of clinical care, research, education and advocacy issues, but it cannot be achieved without adequate financing and reimbursement for professional and hospital services. The formal educational preparation and in- training experience of most doctors is usually deficient and poorly coordinated.

This workshop will present an overview of reimbursement and financing principles for the pediatric generalist and medical and surgical subspecialist, whether engaged in private solo, multispecialty, HMO or academic practices in the following areas:
1. The medical encounter - an overview from patient care through reimbursement.
2. Understanding medical finance - the basics.
3.Application of medical finance - understanding the business of practice revenue.
4. Needs for medical finance - different settings, yet similar needs. How do different practice settings impact reimbursement? facility vs. non-facility fees.
5. Sources of reimbursement / finance and different payment arrangements.
6. Who controls / does what related to coding and RVU’S.
In conclusion, the attendee will be given direction for future study and sources of information.

S. Berman, The Children’s Hospital, Denver; R.A. Molteni, Children’s Hospital, Seattle; C.M. Vanchiere, Children’s Clinic of SW La., Lake Charles

9:00 am - 12:00 noon - SPECIAL INTEREST GROUPS

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

SG16 International Health
Chairs: David Shay and Anna Mandalakas

This SIG has combined forces with the International Health Section of the AAP to offer a program directed to those interested in or curious about international aspects of child health. This year’s program is specifically designed to help prepare pediatricians or other child health care workers who may be interested some day in volunteering in the developing world. All are welcome.

Subjects to be discussed will include:
1. preparing for international volunteerism
2. advances and challenges in pediatric tropical medicine
3. the state of the world’s children – where are we? (a presentation by Dr. Robert J. Haggerty)
4. dealing with complex humanitarian emergencies.

SG17 Literacy Promotion in Primary Care
Chairs: Robert Needleman and Perri Klass

This SIG will provide a forum for directors of primary care literacy programs modeled after Reach Out and Read to discuss program innovations, successes, and ongoing challenges. As in previous years, topics will include clinician and volunteer training, recruitment, fund-raising, publicity, books, and other program logistics. Participants are encouraged to bring examples of recently-developed educational materials, photos, and vignettes. We will also review current research in the field, including a discussion of current studies by SIG participants. A special session will be set aside for work on the collaborative Before-and-After-Books-and-Reading (BABAR) study, which now has more than 20 sites, and more than 900 completed interviews. Another special session will serve as an introduction to ROR for physicians and others interested in beginning a clinic-based literacy program. Teaching modes will include videotape and live demonstration, role-play, discussion, and small-group problem solving. Those interested are encouraged to contact ROR at www.reachoutandread.org.

10:15 am - 12:00 noon - SPR PRESIDENTIAL PLENARY & AWARDS AND E. MEAD JOHNSON AWARD LECTURES

Presidential Address: Thomas Hazinski,Vanderbilt University Medical Center

Student Awards: Kyle Cowan, Aaron M. Milstone, Christine Siambani

House Officer Awards: Douglas D. Fraser, Paul J. Galardy, Matthew A. Saxonhouse

Fellow Basic Awards: Christopher E. Belcher, Elif Erkan, Syed Zaidi

Fellow Clinical Awards: Michael J. Ackerman, Okan Elidemir, Mika Ramet

David Nathan Award: Lisa Wang

Young Investigator Award Lecture:
Brendan Lee - Identification of Molecular Genetic Defect for Cleidocranial Dysplasia & Nail-patella Syndrome

E. Mead Johnson Award Lectures:
Mark Kay - Seminal Scientific Contributions to the Field of Hepatic Gene Therapy
Gregg Semenza - Molecular Response to Hypoxia

1:15 pm - 2:00 pm - AAP PRESIDENTIAL PLENARY & JACOBI AWARD
Presidential Address: Donald E. Cook, American Academy of Pediatrics, Elk Grove Village
Jacobi Award: Catherine DeAngelis

2:00 pm - 5:00 pm - WORKSHOPS

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

WS33 Advocacy Training For Pediatric Residents: The Role Of The Community Pediatrician.
Child advocacy is central to the practice of pediatrics. Pediatricians have been exemplary child advocates at the local, state and national level. Paradoxically, only recently has training in advocacy been a requirement of residency training. There is no national consensus regarding a child advocacy curricula or how to teach it. As training programs develop their advocacy training programs, one potentially effective and rewarding model includes cooperative efforts with the AAP’s CATCH program.
Specific objectives include:
•Defining the role of CATCH and the AAP in resident advocacy training
•Learning about different models of curricula for advocacy training
•How to build institutional support for community based advocacy training
•How to incorporate community pediatricians into resident advocacy training

The workshop will use brief presentations about model programs from different training programs and interactive breakout groups. Reference material and resources will be distributed to attendees.

S.D. Blatt, J. Brown, A.S. Botash, J. Harisiades, D. Haut, D. Keller, T Tonniges. SUNY Health Science Center @ Syracuse, U of Colorado, Denver, Children’s Memorial Hospital, Chicago, AAP, Elk Grove Village, U of Massachusetts, Worcester

WS43 Working in International Child Health
Part 1: Children of the World 2000: An Overview
Ninety percent of children in 2000 will be born into the not-yet-industrialized parts of the world. This session will help child health professionals become aware of the difference in lifestyles and issues facing these children compared to those of children living in the western world. Participants will also gain awareness of how the health of all children impacts on all of the world’s people both now and into the 21st century.

Part 2: How to Help Children in Disasters
More than half of all people affected by disasters are children. Many will have long-term physical and mental health consequences. Their special needs and interests are often overlooked. This session will help child health professionals to understand the magnitude of the problem, to recognize the special needs of children in disaster situations, and to know how to help these children.

Part 3: Recommendations for Pediatricians Who Want to Work in International Health
Child health professionals with both short and long term experience in working internationally will compare their learning and provide recommendations for colleagues interested in becoming similarly involved.

K. Olness, Rainbow Babies and Children’s Hospital, Cleveland; B. Duncan, University of Arizona, Department of Pediatrics, Tucson; R. Haggerty, University of Rochester, Department of Pediatrics, Rochester; J. Kennell, Rainbow Babies and Children’s Hospital, Cleveland; R. Meier, Shriners Hospital for Children, Lexington

2:00 pm - 5:00 pm - SPECIAL INTEREST GROUP

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

SG21 Child Abuse
Chair: John Leventhal

2:30 pm - 4:30 pm - TOPIC SYMPOSIUM

¨Research in Office and Community Settings: Studying Pediatric Care in the Real World
Chair: Peter G. Szilagyi, University of Rochester School of Medicine, Rochester

Research performed in pediatric offices and community settings has contributed substantially to improving the health of children. Office-based research can provide useful descriptive information about health conditions of children, improve the quality of care delivered by practitioners, and promote new innovations in health care delivery. Research in community settings such as schools and daycare sites and in children’s homes can focus on high-risk populations and on the "new morbidity" such as developmental and behavioral problems, social concerns, and mental health issues. Many future health problems will be prevented by targeting entire communities, rather than patients, for interventions, and employing public health and systems approaches focusing on community-level targets, measures, and outcomes. Research in office and community settings represents an overlapping domain of academic pediatrics, private pediatrics, and public health. This panel will (a) review the history and the future of office-based research (b) summarize critical practical issues regarding research in office and community settings, (c) discuss local research networks and the national PROS research network, (d) present specific examples of types of research that would most benefit from collaborations between academic pediatricians, private pediatricians, and public health and community-based child health experts.

Research in Office and Community Settings: The Past and the Future
Evan Charney, University of Massachusetts Medical School, Shrewsbury, MA

Doing Research in a Busy Private Primary Care Pediatric Office
Gordon B. Glade, Chairman PROS Steering Committee, American Fork, UT

Office-Based Research: A Community Pediatric Agenda
Thomas McInerny, University of Rochester School of Medicine and Dentistry, Rochester

Pediatric Research in Office Settings (PROS): A National Approach to Office-Based Research
Richard "Mort" Wasserman, University of Vermont/PROS Network, Burlington

Community Pediatrics Research and Vulnerable Populations: The Role of the New AAP Center for Child Health Research
Michael Weitzman, The Center for Child Health Research and the University of Rochester School of Medicine & Dentistry, Rochester

Collaborations Between Primary Care Pediatricians and Academic Departments
Elizabeth McAnarney, Children’s Hospital at Strong, University of Rochester Medical Center, Rochester

2:30 pm - 4:30 pm - SUBSPECIALTIES/THEMES (Original Science Abstract Program)

• Immunizations in Underserved Populations (Platform)

4:45 pm - 6:45 pm - POSTER SESSION III

Monday, May 15

8:00 am - 10:00 am - SUBSPECIALTIES/THEMES (Original Science Abstract Programs)

• Clinical Bioethics (Platform)
• Clinical Research in Emerging Countries (Poster Symposia)
• Sickle Cell and Endothelial Cell Interface (Poster Symposia)

8:00 am - 10:00 am - RICHARD E. ROWE AWARD
Richard E. Rowe Award Presentation - Mark W. Russell:
In vivo Transactivation of the alphaB Crystallin Promoter by Cardiac Transcription Factors Involved in Early Heart Development

8:30 am - 12:30 pm - APA PRESIDENTIAL PLENARY & ARMSTRONG LECTURE
Presidential Address: Ellen F. Crain, Albert Einstein College of Medicine, Bronx
Armstrong Lecture: Greenpeace

10:15 am - 11:45 am - STATE OF THE ART PLENARY

¨Pediatrics in the New Millennium: Compelling Issues in Public Policy - 7th Annual Public Policy Plenary
Chair: Myron Genel, Yale University School of Medicine, New Haven

This is the 7th annual Public Policy Plenary Symposium organized and sponsored by the Public Policy Council, which coordinates public policy activities for the APS, SPR and AMSPDC, in collaboration with the APA Public Affairs Committee. The year 2000 program will look forward to the new millennium and broadly examine the outlook for children’s health in three vital areas: (1) access to health care (2) testing and access of children to drugs and devices and (3) the pipeline for pediatric physician-investigators and the future of academic pediatrics. We have set aside significant time at the conclusion of the speakers’ formal presentations to permit interactive dialogue between members of the panel and the audience.

Children’s Access to Health Care - Removing the Financial Barrier
Joel J. Alpert, Immediate Past President of the American Academy of Pediatrics and Past President of the Ambulatory Pediatric Association, Boston University School of Medicine

Increasing Pediatric Access to Medical Therapies
Jane E. Henney, Commissioner, Food and Drug Administration, Rockville

The Pipeline of Physician-Scientist in Pediatrics
Leon E. Rosenberg, Princeton University; Lasker Trust/Funding First; and Former Dean, Yale University School of Medicine

Supported in part by an educational grant from the Columbus Children's Hospital, Columbus, Ohio

1:00 pm - 3:00 pm - SUBSPECIALTIES/THEMES (Original Science Abstract Program)

• Immunizations: Health Services Research (Poster Symposia)

3:15 pm - 4:45 pm - STATE OF THE ART PLENARY

¨Achieving Good Health For the World’s Children
Chairs: Errol R. Alden, American Academy of Pediatrics, Elk Grove Village, and Jane Schaller, New England Medical Center, Boston

The health of the world’s children is important to the future of the world. This plenary session will explore basic principles of world health for children and suggest ways in which pediatricians all over the world can work together to achieve better and brighter futures for all of our children. The concept of a world community of pediatricians bearing a collective responsibility for the health of children will be explored. Existing standards will be discussed, including training and professional standards of our pediatric profession around the world, concepts of medical ethics which govern our behavior as physicians, and concepts of children’s rights which exist in international law and define world standards for the treatment of children. Adopting a broad definition of child health which includes physical, mental, and social health, the disease burdens of children around the world now and in the 21st century will be presented, along with some concepts of how these burdens might be lessened. Finally, the roles that pediatricians can play in humanitarian response to emergencies and disasters will be presented. Time will be allowed for discussion from members of the audience, who are encouraged to think about these issues in advance and be prepared to add their voices to the discussion.

World Community: Children and Pediatricians, A Collective Responsibility
Robert Haggerty, University of Rochester School of Medicine & Dentistry, Rochester

World Standards: Professional Standards, Medical Ethics, Children’s Rights
Jane G. Schaller, New England Medical Center, Boston

World Health: Disease Burdens for Children Now and in the 21st Century
Jerry Coovadia, University of Natal, South Africa

World Disasters: the Special Needs of Children
Karen Olness, Rainbow Babies and Children’s Hospital, Cleveland

Supported by an educational grant from Johnson & Johnson Pediatrics Institute

¨The Biologic, Sociologic and Psychologic Impact of Stress in Childhood
Chair: Jack P. Shonkoff, The Heller Graduate School, Brandeis University, Waltham

The impact of stress on the physical and mental health of adults has been extensively studied. Recent research has begun to examine its impact on children at all levels of their development. This state-of-the-art symposium examines current research and concepts on the impact of stress on the developing brain, on bio-behavioral responses in children, and in children in difficult social environments. Leading researchers in each of these areas will present aspects of their research that relates to cutting edge concepts in their field.

Molecules and Mechanisms of the Neuroendocrine Response to Stress During Early Postnatal Life: New Insights
Tallie Z. Baram, University of California at Irvine

Psychobiologic Reactivity to Stress: Implications for Pediatric Morbidities
W. Thomas Boyce, School of Public Health & Institute of Human Development, University of California, Berkeley

The Effects of Early Social Deprivation on Children
Felton Earls, Harvard School of Public Health, Cambridge

5:00 pm - 7:00 pm - POSTER SESSION IV

Tuesday, May 16

8:00 am - 10:00 am - TOPIC SYMPOSIUM

¨Youth Violence: Causes and Prevention
Chair: Frederick P. Rivara, Harborview Injury Prevention and Research Center, University of Washington, Seattle

Over the last decade, much attention has been given to the "epidemic" of youth violence. The number of deaths to youth has brought this issue to the attention of the medical and public health community. For many years, however, juvenile delinquency and violence has been carefully studied by psychologists, sociologists, and criminologists.
The goal of this symposium is to bring together the health and criminal justice perspectives on the problem of youth violence and discuss the underlying causes of youth violence, reasons for the recent rise and decline in violence, the continuity of behavior from childhood through adolescence and into adulthood, and the effectiveness of interventions in early childhood. The panelists are members of the National Consortium on Violence Research.

Reasons for the Recent Rise and Decline in Violence
Alfred Blumstein, H.J. Heinz III School of Public Policy and Management, Carnegie Mellon University, Pittsburgh and National Consortium on Violence Research

Continuity of Anti-social and Violent Behavior
Daniel Nagin, H.J. Heinz III School of Public Policy and Management, Carnegie Mellon University, Pittsburgh and National Consortium on Violence Research

Early Childhood Interventions to Prevent Youth Violence
Richard E. Tremblay, University of Montreal, Quebec Canada and National Consortium on Violence Research

8:00 am - 10:00 am - SUBSPECIALTIES/THEMES (Original Science Abstract Programs)

• Breastfeeding (Platform)
• Childhood Asthma (Platform)

9:00 am - 12:00 noon - WORKSHOP

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

WS48 Improving Health Care For America’s Children: The National Initiative For Children’s Healthcare Quality
Despite clinicians’ best intentions, health services delivered to children fall short of evidence-based recommendations, primarily due to inadequate systems of care. Several demonstration projects have identified promising approaches to revising office-based systems, allowing physicians to identify and track preventive care, monitor quality of care, and document improvement in process and outcome measures. To accelerate this improvement process, investigators from several academic centers have joined forces with the Institute for Healthcare Improvement and the American Academy of Pediatrics to form the National Initiative for Children’s Healthcare Quality (NICHQ). The goal of NICHQ is to advance the quality of children’s health care by raising the will to improve care, developing better strategies to accomplish change, and directly assisting practices in their improvement activities. The objectives of this workshop are to familiarize participants with the rationale, tools and strategies developed for this initiative, including dissemination methods for clinical practice improvement, and to discuss the barriers to improvement in ambulatory settings. We will present examples of successful projects that have improved systems for preventive services and asthma in over 100 primary care practices. We will also share current and future directions of this new initiative.

C. Homer, C. Haraden, Institute for Healthcare Improvement, Boston; J. Stout, University of Washington, Seattle; P. Margolis, C. Lannon, University of North Carolina, Chapel Hill; R. Wasserman, University of Vermont, Burlington

9:00 am - 12:00 noon - SPECIAL INTEREST GROUPS

TICKETS NECESSARY FOR THIS EVENT. NO FEE IS REQUIRED BUT PRE-ENROLLMENT IS ESSENTIAL TO ATTEND.

SG26 Culture, Ethnicity & Health Care
Chair: Lee Pachter, Glenn Flores and John I. Takayama

This new SIG has been created to bring together 1) individuals who practice in culturally diverse settings, 2) clinical researchers interested in cultural influences in child health and development, and 3) faculty who are trying to incorporate cultural competency/cultural sensitivity training into med student, resident, fellow and faculty education. We see this SIG as providing a network for APA members who are interested in culturally sensitive/competent clinical service, research, and education. It is our hope that this first meeting will be used to set an agenda for the SIG in the coming months and years.

SG28 School & Community Health
Chairs: Elizabeth Edgerton and Elisa Alter Zenni

For the Spring 2000 meeting, the School and Community Health SIG will be having a joint meeting with the School Health Section of the AAP Based on last year’s meeting, there was interest in the areas of education, teaching and research.  Thus we will begin the session with presentations on current topics in School and Community Health.  We will then break into smaller subgroups to discuss the areas of interest raised from last years meeting to begin setting an agenda for future meetings.  If you are interested in presenting at the Spring meeting please contact Beth Edgerton (co-chair) at 310-328-0720 or by email: eedgerto@ucla.edu.

10:15 am - 12:15 pm - POSTER SESSION V

12:15 pm - 2:15 pm - HOT TOPIC

¨Underserved Children and their Families; Improvements or Impoverishment
Chairs: Benjamin Gitterman, Children’s National Medical Center, Washington and Peter Sherman, Montefiore Children's Hospital at Bronx

Over the past several years the United States has profoundly altered the manner in which health care and entitlement programs are delivered to our most vulnerable population; children growing up in poverty. This, along with an increased understanding of how the environment in which they live, impacts upon their health, has brought us to a cross roads in health care delivery as we enter the new millennium. What impact will these forces have upon this population? This panel will examine the question of whether we are entering an era of vast improvement or impoverishment in children’s health and welfare. Given the complexity and seriousness of these issues it is important that health care professionals have a strong voice in their outcome. This forum will lay the groundwork for planning future collaborative work in addressing the problems identified.

Serving the Underserved: Can Clinicians Meet the Needs?
Donna Bacchi, Texas Technical University, Lubbock

Status Report: The Health of Underserved Children in the New Millenium
Irwin Redlener, Montefiore Hospital and Medical Center, Bronx

The Impact of Environmental Health Issues on Underserved Children
Philip J. Landrigan, Mount Sinai School of Medicine, New York

Health of the Underserved in a Fiscally Conservative Political Environment
Richard Bucciarelli, University of Florida, Gainesville

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Last Modified: April 13, 2000