Pediatrics advanceAccess

Engaging Community to Identify Patient-Centered Lethal Means Safety Outcomes for Youth

Fri, 22 May 2026 00:00:00 GMT

Suicide is the second leading cause of death among United States youth.¹ Firearms are the most lethal means of suicide,² and access increases the risk of suicide death.³ Lethal means safety (LMS) planning involves decreasing access to firearms and other highly lethal means of suicide, and is one of the few evidence-based suicide prevention strategies.⁴

Defining Practice Ready: Ensuring Training and Certification Are Designed to Meet Patient Needs

Fri, 22 May 2026 00:00:00 GMT

Graduate medical education is grounded in a core commitment to the public: that individuals who complete a training program and are certified by their specialty board are “practice ready”—that is, they are able to meet the needs of their patients (and caregivers) upon entering practice. Beginning in 2028, the American Board of Pediatrics (ABP) aims to advance and operationalize this commitment by requiring program directors to attest that graduates are able to perform the essential activities of their discipline, as defined by the Entrustable Professional Activities (EPAs), to qualify for initial certification. To ensure that decisions about both graduation and certification eligibility are based on whether the new physician can meet the needs of their patients in real-world practice, we must clarify not only what graduates must do (the EPAs) but also how well and under what conditions and contexts they must perform them. This article provides that clarity: A “practice ready” trainee can provide safe and effective care without assigned supervision in the context of a posttraining collaborative practice environment in the discipline in which they have been trained. We unpack this definition and clarify key concepts, such as the importance of help-seeking and collaboration over independence, by introducing and applying a supervision scale to illustrative case examples. We conclude by outlining next steps for programs and future directions for the pediatric community and ABP, situating this foundational work within the broader implementation efforts required to ensure new pediatricians entering practice can meet their patients’ needs.

Predictors of E-Cigarette Quit Attempts and Cessation in Young Adults

Fri, 22 May 2026 00:00:00 GMT

10.1542/6392143221112Video AbstractPEDS-VA_2025-0752766392143221112

BACKGROUND/OBJECTIVES

Young adults, aged 18 to 24 years old, vape more than any other age group. Vaping is concerning due to health harms associated with nicotine and toxicant inhalation and potential for use to lead to smoking. Evidence on vaping cessation is limited. Using data from Wave 6 (2021) and Wave 7 (2022–2023) of the Population Assessment of Tobacco and Health Study, we examined factors associated with a vaping quit attempt and cessation.

METHODS

Participants were included if they were 18 to 24 years old, vaped regularly in 2021, and had a follow-up in 2022 to 2023. Numerous variables were assessed for an association with a vaping quit attempt or cessation.

RESULTS

In 2022 to 2023, 62.4% of young adults who vaped made a quit attempt and 18.6% quit. Making a quit attempt was associated with higher harm perceptions of e-cigarettes (odds ratio, 1.44; 95% CI, 1.13–1.84) and nicotine (odds ratio, 1.35; 95% CI, 1.11–1.64) and close family and friend disapproval (odds ratio, 2.53; 95% CI, 1.87–3.43). Dual use was associated with lower odds of a quit attempt (odds ratio, 0.58; 95% CI, 0.38–0.90). Vaping cessation was less likely in individuals with daily use (odds ratio, 0.45; 95% CI, 0.30–0.69) and in-home e-cigarette allowance (odds ratio, 0.58; 95% CI, 0.37–0.91). Use of quit methods was low, and cigarette substitution was the only method positively associated with vaping cessation (odds ratio, 2.61; 95% CI, 1.15–5.95).

CONCLUSIONS

Almost two-thirds of young adults tried to quit vaping, and concerningly, the only method associated with cessation was substituting combustible cigarettes. There is an urgent need to develop safe and effective vaping cessation treatments for young adults.

Pediatric Quality Measures in Vision Screening and Follow-Up

Thu, 21 May 2026 00:00:00 GMT

CONTEXT

Timely detection and management of vision problems is essential in children for optimal outcomes.

OBJECTIVE

To summarize pediatric quality measures for vision screening and follow-up in the United States.

DATA SOURCES

PubMed, Embase, CINAHL, Cochrane Central, and PsychINFO (2009–December 2024), plus gray literature from governmental and nongovernmental sources.

STUDY SELECTION

Relevant systematic reviews, original studies, and gray literature.

DATA EXTRACTION

Two reviewers extracted information using Distiller SR and Excel.

RESULTS

We identified 50 vision screening and 34 follow-up measures, mostly focused on early childhood in primary care settings. Sources included 6 systematic reviews (7 screening and 10 follow-up measures), 12 studies (36 screening and 24 follow-up), and 11 gray literature (8 screening and 2 follow-up). We found evidence of reliability, validity, usability, and feasibility for 21, 32, 21, and 28 screening measures and for 5, 21, 11, and 9 follow-up measures, respectively; 3 screening and 9 follow-up measures had evidence against feasibility. Several sources showed improvement with the use of specific tools or implementation practices. Reports described differences by population, state, institution, or provider. Barriers were related to data infrastructure, collection, and measure standardization. Evidence was limited on demographic variations, use and alignment across care levels, and associated outcomes.

LIMITATIONS

Exclusion of non-US sources and studies before 2009.

CONCLUSIONS

Many pediatric vision screening and follow-up measures have evidence of reliability, validity, and usability, but feasibility is a concern. Research should prioritize feasible, standardized follow-up measures; integrated data systems; and evaluation, alignment, and stratification of measure outcomes.

Pediatric Quality Measures in Hearing Screening and Follow-Up

Thu, 21 May 2026 00:00:00 GMT

CONTEXT

Quality measures are needed to ensure that children receive timely screening and follow-up for hearing problems.

OBJECTIVE

To summarize pediatric quality measures for hearing screening and follow-up.

DATA SOURCES

We searched PubMed, Embase, CINAHL, Cochrane Library, and PsycINFO from 2009 to December 7, 2024, including gray literature from governmental and nongovernmental entities.

STUDY SELECTION

Systematic reviews, original articles.

DATA EXTRACTION

Measure definitions, study characteristics, barriers, and research gaps.

RESULTS

We identified 27 hearing screening and 97 follow-up measures, mostly applied to newborns. In total, 9 systematic reviews identified 5 screening and 10 follow-up measures, 13 studies identified 13 screening and 47 follow-up measures, and 12 gray literature sources identified 11 screening and 42 follow-up measures. We found evidence for reliability, validity, usability, and feasibility in 8, 11, 3, and 4 screening measures, respectively, and for 22, 44, 17, and 13 follow-up measures, respectively. Of the follow-up measures, 14 had evidence against feasibility. Additionally, 8 screening and 8 follow-up measures demonstrated improvement in quality-of-care outcomes. Use of measures differed by state, targeted population, and clinician type. Barriers to measure implementation were related to data infrastructure, integration, collection, reporting, and lack of standardization.

LIMITATIONS

Searches focused on identifying measures used in the United States. Studies were not designed to assess measure characteristics.

CONCLUSIONS

Many pediatric hearing screening and follow-up measures have evidence of reliability, validity, and usability, although feasibility of follow-up measures is a concern. Future research should evaluate data infrastructure and systems for implementing follow-up and standardizing and stratifying screening and follow-up measures.

Pediatric Quality Measures in Developmental Screening and Follow-Up

Thu, 21 May 2026 00:00:00 GMT

CONTEXT

Timely identification and management of developmental problems are essential for children.

OBJECTIVE

To summarize quality measures for developmental screening and follow-up among children in the United States.

DATA SOURCES

PubMed, Embase, CINAHL, Cochrane Library, and PsychINFO from 2009 to December 7, 2024. Gray literature sources recommended by experts.

STUDY SELECTION

Systematic reviews, primary studies, and gray literature sources.

DATA EXTRACTION

Two reviewers extracted information on measure definitions, study characteristics, barriers, and research gaps.

RESULTS

We included 11 systematic reviews, 36 studies, and 11 gray literature sources and identified 67 developmental screening measures and 61 follow-up measures. Measures focused on early childhood in clinic settings. We found evidence for reliability, validity, and usability in 29, 25, and 30 screening measures, respectively, and 34, 39, and 36 follow-up measures, respectively, with evidence both for and against feasibility of measures. Eighteen studies showed improvement in measures with use of specific tools or implementation practices for developmental screening and follow-up. Differences in use of measures by state, population, institution, or clinician type were infrequently described. Barriers to measure implementation related to electronic health record data extraction, resource limitations, and burden of data collection and reporting. We found little evidence on reduced disparities associated with measure implementation.

LIMITATIONS

We excluded information from other countries, from before 2009, or about measures for behavioral, social, or emotional screening.

CONCLUSION

Many pediatric developmental screening and follow-up measures have evidence of reliability, validity, and usability, but feasibility is a concern. Future research should focus on feasibility, standardization, and stratification.

Measuring Hearing Vision and Developmental Screening and Follow-Up: Obstacles and Opportunities

Thu, 21 May 2026 00:00:00 GMT

For decades, improvement science has been built on the foundation provided by the Donabedian Triad: structure (the settings, policies, resources, and tools available to health care teams), process (the “set of activities that go on within and between practitioners and patients”¹), and outcomes (the “change in a patient’s current and future health status that can be attributed to antecedent health care”²). Quality measures represent “[a] standard for measuring the performance and improvement of population health or health plans, providers of services, and other clinicians in the delivery of health care services”³ and allow teams to assess whether the structures and processes we implement in practice in fact benefit the patients and communities we aim to serve. In this month’s Pediatrics, a trio of papers from the Pediatric Quality Measure Program (PQMP) lay out the current state of evidence for quality measures addressing 3 critical pediatric primary care activities: hearing,⁴ vision,⁵ and developmental⁶ screening and follow-up.