Pediatrician Knowledge of Early Intervention Process as Contributor to Disparities in Management of Development Delay

Abraham Gallegos; Alejandra Casillas; Paul J Chung; Rebecca Dudovitz

doi:10.1007/s10995-024-03972-w

Pediatrician Knowledge of Early Intervention Process as Contributor to Disparities in Management of Development Delay

Matern Child Health J. 2024 Sep 11. doi: 10.1007/s10995-024-03972-w. Online ahead of print.

Authors

Abraham Gallegos^{1

2

3}, Alejandra Casillas⁴, Paul J Chung^{5

6

7}, Rebecca Dudovitz⁶

Affiliations

¹ Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA. abraham.x1.gallegos@kp.org.
² Department of Pediatrics, UCLA Mattel Children's Hospital and Children's Discovery & Innovation Institute, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA. abraham.x1.gallegos@kp.org.
³ UCLA NRSA T32 Primary Care Research Fellowship, University of California, Los Angeles, Los Angeles, CA, USA. abraham.x1.gallegos@kp.org.
⁴ Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA.
⁵ Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA.
⁶ Department of Pediatrics, UCLA Mattel Children's Hospital and Children's Discovery & Innovation Institute, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA.
⁷ Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.

PMID: 39261399
DOI: 10.1007/s10995-024-03972-w

Abstract

Introduction: Lack of knowledge of Early Intervention (EI) is a barrier to developmental delay (DD) management. We aimed to examine the feasibility of measuring pediatricians' knowledge of EI, determine the distribution of EI knowledge, and determine factors associated with increased EI knowledge.

Methods: We conducted an exploratory cross-sectional study with a convenience sample from a local American Academy of Pediatrics chapter to administer a survey with 10 multiple-choice questions regarding the EI referral process, evaluation process, eligibility criteria and fee structure. Our outcome variable was a composite score of these 10 multiple-choice questions, Total Knowledge Score (TKS). Our predictor variables included physician characteristics (i.e., years of experience, percentage of patients seen with private insurance, receipt of EI training in the last 5 years) and practice characteristics (i.e., medical home status).

Results: Our sample consisted of a total of 194 pediatric residents/attendings. Multivariable regression demonstrated seeing ≥ 50% patients who were privately insured, increased experience, and receiving training in the last 5 years were associated with higher TKS.

Discussion: We were able to quantitatively evaluate physician's knowledge of EI and demonstrated that seeing a majority of privately insured patients, having more experience, and having received formal EI training in the last 5 years were associated with higher EI knowledge. This disproportionate distribution of EI knowledge has the potential to contribute to disparities in the management of DD. This may indicate that medical institutions, where physicians see a small percent of privately insured patients, need to hire more experienced physicians, and provide routine EI training.

Keywords: Developmental delay; Early intervention; Health disparities; Physician knowledge.

Grants and funding

T32HP19001/HRSA National Research Service Award