Reprinted with permission of AAP News, January 2005

Academy demonstrates enduring
commitment to research

from the AAP Department of Practice and Research

In the last several decades, research is one of the key ways in which the Academy has pursued its mission to advance children's health.

The level of the Academy's investment in advocacy for research and conduct of original research is exceptional among medical societies. Through these efforts, key advances have been made in health services and health policy research for children.

In 1974, the Academy created the Committee on Pediatric Research (COPR). From its inception, COPR has focused on advocating for needed research, providing congressional testimony on research issues, promoting funding for research and training, and promoting pediatric representation on federal study sections.

One example of COPR's influence is the addition of designated pediatric awards in the National Institutes of Health's loan repayment program. From 2003-'04, 526 Pediatric Research Loan Repayment awards were made, providing vital support for young investigators to pursue research for children.

Since the 1970s, the Academy also has conducted research on issues related to the delivery, quality and financing of children's health care. The Academy has taken on research that as a national organization it was uniquely qualified to conduct or in areas where pediatric research lagged. The research has been funded by the Academy as well as through competitive federal research grants, foundations and corporate support.

A hallmark of the Academy's research is collaboration, drawing on the expertise of AAP committees, sections and staff and working with investigators from universities around the country. AAP members who have given generously of their time to be involved in data collection have been essential to the development of AAP research.

The Academy's enduring commitment has allowed the development of the following long-term research programs, which are housed in the Department of Practice and Research:

• Children's health insurance. The Academy's research began in the 1970s with the first studies of pediatricians' participation in Medicaid. Since then, research related to children's insurance coverage and access to care has been a major thrust of the Academy's research agenda. Through annual Medicaid state reports, ongoing studies of insurance cost and coverage, and surveys of pediatricians and state Medicaid directors, AAP research provides the knowledge base for advocacy at the chapter and national levels.

• PROS network. Created as a vision by pediatric leaders in 1986, Pediatric Research in Office Settings (PROS) is a nationwide network of nearly 2,000 practitioners in more than 700 practices. By bringing together office-based pediatricians with university investigators and AAP researchers, PROS identifies compelling but unanswered questions in primary care pediatric practice. More than 20 nationwide studies have been conducted, including management of children with psychosocial problems, age of onset of secondary sexual characteristics in girls and management of febrile infants.

• Periodic Survey. The Periodic Survey of Fellows was launched in 1987; today the 62nd Periodic Survey is in the field. The Periodic Survey was developed to consolidate the interests of individual AAP entities in surveying the membership and to bring a systematic, scientific approach to gathering information on members' practices and attitudes. Survey results have provided a wealth of data for the Academy and have been used by committees and sections to develop policy, educational offerings and programs. The Periodic Survey also is providing a critical means to monitor trends in pediatric practice.

• Workforce. Since the mid-1980s, the Academy has been monitoring key trends in the adequacy of the pediatric workforce to meet children's health care needs for primary and specialty care. One of the major projects included research support to the Future of Pediatric Education II project, where pediatric subspecialists were surveyed about their local practice environment and the future of their subspecialty. On an ongoing basis, the Academy surveys graduating residents and creates detailed maps tracking the ratio of children to pediatricians and other providers.

• Guideline development. In 1994, the Academy published its first in a series of evidence-based clinical practice guidelines that provide recommendations to primary care clinicians on common childhood conditions. The initial guideline on managing asthma was published in January 1994 with the second on hyperbilirubinemia published the following October. The guidelines are based on rigorous, systematic reviews of all known research in the area. Fourteen guidelines have been developed, covering critical issues such as treatment of attention-deficit/hyperactivity disorder and otitis media.

• Oral history. The Academy established the Pediatric History Center in 1992. One of its major initiatives is the Oral History Program, which collects and preserves interviews with individuals who have made important contributions to the improvement of child health. Since its inception, 53 interviews have been conducted. Published interviews are available on the Member Center of the AAP Web site, www.aap.org/moc.

• Outcome research. In 1992, the Academy began a series of projects to improve the ways in which children's health outcomes are measured. The development of measures for children has lagged behind those for adults. Activities to address this gap have included developing new measures and gathering other researchers in state-of-the-art national meetings to address such issues as children's capacity to report for themselves and adequacy of measures for racial and ethnic minorities. Other projects include the National Survey of Early Childhood Health, a new survey of parents of infants and toddlers.

In 1999, the Academy further expanded its commitment to promotion of pediatric research with the establishment of the Center for Child Health Research based at the University of Rochester, N.Y. The center was created as an intellectually independent entity with its own board of directors, reflecting the Academy's belief that health issues facing children are too complex to be addressed in isolation by individual professions or academic disciplines. Through its consortia, the center is setting the agenda for pediatric research in critical areas affecting children's health, including tobacco prevention and mental health. Center publications, such as the 2004 About Children, are providing new findings and expert synthesis of data to guide child advocacy and improve pediatric practice.

For more information about these research areas or about projects or publications, visit the AAP Web site at www.aap.org/research or e-mail research@aap.org.

October excerpt

November excerpt

December excerpt

February excerpt

March excerpt