OBJECTIVES: We tested a Public Health Service 5As-based clinician-delivered smoking cessation cou... more OBJECTIVES: We tested a Public Health Service 5As-based clinician-delivered smoking cessation counseling intervention with adolescent smokers in pediatric primary care practice. METHODS: We enrolled clinicians from 120 practices and recruited youth (age ≥14) from the American Academy of Pediatrics Pediatric Research in Office Settings practice-based research network. Practices were randomly assigned to training in smoking cessation (intervention) or social media counseling (attentional control). Youth recruited during clinical visits completed confidential screening forms. All self-reported smokers and a random sample of nonsmokers were offered enrollment and interviewed by phone at 4 to 6 weeks, 6 months, and 12 months after visits. Measures included adolescents’ report of clinicians’ delivery of screening and counseling, current tobacco use, and cessation behaviors and intentions. Analysis assessed receipt of screening and counseling, predictors of receiving 5As counseling, and ef...
Primary care pediatricians increasingly care for children's mental health problems, but littl... more Primary care pediatricians increasingly care for children's mental health problems, but little is known about practice-level variation in diagnosis and psychotropic medication prescribing practices. This retrospective review of electronic heath records from 43 US primary care practices included children aged 4 to 18 years with ≥1 office visit from January 1, 2009, to June 30, 2014. We examined variability in diagnosis and psychotropic prescribing across practices using logistic regression with practice fixed effects and evaluated associations of the availability of colocated or community-based mental health providers or the proportion of children in foster care with diagnosis and prescribing using generalized linear mixed models. Among 294 748 children, 40 932 (15%) received a mental health diagnosis and 39 695 (14%) were prescribed psychotropic medication. Attention deficit/hyperactivity disorder was most commonly diagnosed (1%-16% per practice). The proportion of children rece...
![Figure][1] Dr. Gotlieb Within the next few months, many physicians will be well on their way to... more ![Figure][1] Dr. Gotlieb Within the next few months, many physicians will be well on their way to making sure electronic data arriving at and leaving their offices is consistent with Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations. HIPAA’s Transactions
![Figure][1] Dr. Gotlieb The first anniversary of the Health Insurance Portability and Accountabi... more ![Figure][1] Dr. Gotlieb The first anniversary of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule is a good time to review where this legislation has taken us as pediatricians and “covered entities.” For those who believed HIPAA would bring the end of
The new second edition of "Caring for Adolescent Patients" is a practical, clinical gui... more The new second edition of "Caring for Adolescent Patients" is a practical, clinical guide intended to assist health care professionals who provide primary care services to adolescents. This publication is a collection of resources covering common medical issues; reproductive health care; emotional, behavioral and mental health issues; adolescent sexual behavior and sexual health; orthopedics and sports medicine; financial, legal and ethical issues; and more.
Topics in What's New in Adolescent Clinical Care? include "The Non-Medical Use of Prescr... more Topics in What's New in Adolescent Clinical Care? include "The Non-Medical Use of Prescription Drugs," "Screening for Substance Abuse in the Office Setting," "Strength Based Interviewing," "Dropout Crisis Impacting America: Can We Turn It Around?" "Management of the Adolescent Concussion Victim," "Adolescent Contraceptive Care for the Practicing Pediatrician," "Social Networking and Adolescents," "An Approach to Obesity Management in Primary Care," "Understanding Adolescent Brain Development and its Implications for the Clinician," and "Adolescent Contraceptive Care for the Practicing Pediatrician."
Reference terminologies such as SNOMED CT may have voids in their representation of concepts impo... more Reference terminologies such as SNOMED CT may have voids in their representation of concepts important to the practice of pediatrics. In this project, relevant pediatric concepts were extracted from an American Academy of Pediatrics guideline and were mapped to SNOMED CT. Concepts were identified that should be included in the standard reference terminology. A process for formally evaluating voids in reference terminologies for concepts needed in pediatric clinical decision-making is planned as a next step.
Competing priorities in pediatric practice have created challenges for practice-based research. T... more Competing priorities in pediatric practice have created challenges for practice-based research. To increase recruitment success, researchers must design studies that provide added value to participants. This study evaluates recruitment of pediatricians into a study, before and after the development and addition of a quality improvement (QI) curriculum approved for American Board of Pediatrics Maintenance of Certification (MOC) Part 4 Credit as an enrollment incentive. Researchers implemented multiple outreach methods to enroll pediatric practices over 28 months. Field note review revealed that many physicians declined enrollment, stating that they prioritized MOC Part 4 projects over research studies. A QI curriculum meeting standards for MOC Part 4 Credit was developed and added to the study protocol as an enrollment incentive. Enrollment rates and characteristics of practitioners enrolled pre- and post-MOC were compared. Pre-MOC enrollment contributed 48% of practices in 22 months...
PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly at Amer Acad ... more PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly at Amer Acad of Pediatrics on January 30, 2006 www.pediatrics.orgDownloaded from
The newly developing field of telemedicine has the potential to benefit pediatric care by increas... more The newly developing field of telemedicine has the potential to benefit pediatric care by increasing access to pediatric specialists and services. This report explores the current uses and limitations of telemedicine in pediatrics.
OBJECTIVES: We tested a Public Health Service 5As-based clinician-delivered smoking cessation cou... more OBJECTIVES: We tested a Public Health Service 5As-based clinician-delivered smoking cessation counseling intervention with adolescent smokers in pediatric primary care practice. METHODS: We enrolled clinicians from 120 practices and recruited youth (age ≥14) from the American Academy of Pediatrics Pediatric Research in Office Settings practice-based research network. Practices were randomly assigned to training in smoking cessation (intervention) or social media counseling (attentional control). Youth recruited during clinical visits completed confidential screening forms. All self-reported smokers and a random sample of nonsmokers were offered enrollment and interviewed by phone at 4 to 6 weeks, 6 months, and 12 months after visits. Measures included adolescents’ report of clinicians’ delivery of screening and counseling, current tobacco use, and cessation behaviors and intentions. Analysis assessed receipt of screening and counseling, predictors of receiving 5As counseling, and ef...
Primary care pediatricians increasingly care for children's mental health problems, but littl... more Primary care pediatricians increasingly care for children's mental health problems, but little is known about practice-level variation in diagnosis and psychotropic medication prescribing practices. This retrospective review of electronic heath records from 43 US primary care practices included children aged 4 to 18 years with ≥1 office visit from January 1, 2009, to June 30, 2014. We examined variability in diagnosis and psychotropic prescribing across practices using logistic regression with practice fixed effects and evaluated associations of the availability of colocated or community-based mental health providers or the proportion of children in foster care with diagnosis and prescribing using generalized linear mixed models. Among 294 748 children, 40 932 (15%) received a mental health diagnosis and 39 695 (14%) were prescribed psychotropic medication. Attention deficit/hyperactivity disorder was most commonly diagnosed (1%-16% per practice). The proportion of children rece...
![Figure][1] Dr. Gotlieb Within the next few months, many physicians will be well on their way to... more ![Figure][1] Dr. Gotlieb Within the next few months, many physicians will be well on their way to making sure electronic data arriving at and leaving their offices is consistent with Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations. HIPAA’s Transactions
![Figure][1] Dr. Gotlieb The first anniversary of the Health Insurance Portability and Accountabi... more ![Figure][1] Dr. Gotlieb The first anniversary of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule is a good time to review where this legislation has taken us as pediatricians and “covered entities.” For those who believed HIPAA would bring the end of
The new second edition of "Caring for Adolescent Patients" is a practical, clinical gui... more The new second edition of "Caring for Adolescent Patients" is a practical, clinical guide intended to assist health care professionals who provide primary care services to adolescents. This publication is a collection of resources covering common medical issues; reproductive health care; emotional, behavioral and mental health issues; adolescent sexual behavior and sexual health; orthopedics and sports medicine; financial, legal and ethical issues; and more.
Topics in What's New in Adolescent Clinical Care? include "The Non-Medical Use of Prescr... more Topics in What's New in Adolescent Clinical Care? include "The Non-Medical Use of Prescription Drugs," "Screening for Substance Abuse in the Office Setting," "Strength Based Interviewing," "Dropout Crisis Impacting America: Can We Turn It Around?" "Management of the Adolescent Concussion Victim," "Adolescent Contraceptive Care for the Practicing Pediatrician," "Social Networking and Adolescents," "An Approach to Obesity Management in Primary Care," "Understanding Adolescent Brain Development and its Implications for the Clinician," and "Adolescent Contraceptive Care for the Practicing Pediatrician."
Reference terminologies such as SNOMED CT may have voids in their representation of concepts impo... more Reference terminologies such as SNOMED CT may have voids in their representation of concepts important to the practice of pediatrics. In this project, relevant pediatric concepts were extracted from an American Academy of Pediatrics guideline and were mapped to SNOMED CT. Concepts were identified that should be included in the standard reference terminology. A process for formally evaluating voids in reference terminologies for concepts needed in pediatric clinical decision-making is planned as a next step.
Competing priorities in pediatric practice have created challenges for practice-based research. T... more Competing priorities in pediatric practice have created challenges for practice-based research. To increase recruitment success, researchers must design studies that provide added value to participants. This study evaluates recruitment of pediatricians into a study, before and after the development and addition of a quality improvement (QI) curriculum approved for American Board of Pediatrics Maintenance of Certification (MOC) Part 4 Credit as an enrollment incentive. Researchers implemented multiple outreach methods to enroll pediatric practices over 28 months. Field note review revealed that many physicians declined enrollment, stating that they prioritized MOC Part 4 projects over research studies. A QI curriculum meeting standards for MOC Part 4 Credit was developed and added to the study protocol as an enrollment incentive. Enrollment rates and characteristics of practitioners enrolled pre- and post-MOC were compared. Pre-MOC enrollment contributed 48% of practices in 22 months...
PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly at Amer Acad ... more PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly at Amer Acad of Pediatrics on January 30, 2006 www.pediatrics.orgDownloaded from
The newly developing field of telemedicine has the potential to benefit pediatric care by increas... more The newly developing field of telemedicine has the potential to benefit pediatric care by increasing access to pediatric specialists and services. This report explores the current uses and limitations of telemedicine in pediatrics.
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Papers by Edward Gotlieb