{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T17:47:11Z","timestamp":1793209631134,"version":"4.5.0"},"reference-count":36,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVES:<\/jats:title>\n                  <jats:p>Multiple early childhood screenings are recommended, but gaps persist in implementation. Our aim for this project was to improve screening, discussion, referral, and follow-up of development, autism spectrum disorder (ASD), maternal depression, and social determinants of health (SDoH) to 90% by July 2018.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>This 1-year national quality improvement collaborative involved 19 pediatric primary care practices. Supported by virtual and in-person learning opportunities, practice teams implemented changes to early childhood screening. Monthly chart reviews were used to assess screening, discussion, referral, and follow-up for development, ASD, maternal depression, and SDoH. Parent surveys were used to assess parent-reported screening and referral and\/or resource provision. Practice self-ratings and team surveys were used to assess practice-level changes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Participating practices included independent, academic, hospital-affiliated, and multispecialty group practices and community health centers in 12 states. The collaborative met development and ASD screening goals of &amp;gt;90%. Largest increases in screening occurred for maternal depression (27% to 87%; +222%; P &amp;lt; .001) and SDoH (26% to 76%; +231%; P &amp;lt; .001). Statistically significant increases in discussion of results occurred for all screening areas. For referral, significant increases were seen for development (53% to 86%; P &amp;lt; .001) and maternal depression (23% to 100%; P = .008). Parents also reported increased screening and referral and\/or resource provision. Practice-level changes included improved systems to support screening.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Practices successfully implemented multiple screenings and demonstrated improvement in subsequent discussion, referral, and follow-up steps. Continued advocacy for adequate resources to support referral and follow-up is needed to translate increased screening into improved health outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2019-2328","type":"journal-article","created":{"date-parts":[[2020,8,7]],"date-time":"2020-08-07T12:26:10Z","timestamp":1596803170000},"source":"Crossref","is-referenced-by-count":26,"title":["Increasing Early Childhood Screening in Primary Care Through a Quality Improvement Collaborative"],"prefix":"10.1542","volume":"146","author":[{"given":"Kori B.","family":"Flower","sequence":"first","affiliation":[{"name":"Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;"},{"name":"Population Health Improvement Partners, Cary, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Massie","sequence":"additional","affiliation":[{"name":"Population Health Improvement Partners, Cary, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Janies","sequence":"additional","affiliation":[{"name":"American Academy of Pediatrics, Itasca, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane B.","family":"Bassewitz","sequence":"additional","affiliation":[{"name":"American Academy of Pediatrics, Itasca, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tumaini R.","family":"Coker","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, University of Washington and Seattle Children\u2019s Research Institute, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Gillespie","sequence":"additional","affiliation":[{"name":"The Children\u2019s Clinic, Portland, Oregon;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle M.","family":"Macias","sequence":"additional","affiliation":[{"name":"Division of Developmental-Behavioral Pediatrics, Medical University of South Carolina, Charleston, South Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toni M.","family":"Whitaker","sequence":"additional","affiliation":[{"name":"Division of Developmental Pediatrics, Department of Pediatrics, The University of Tennessee Health Science Center, Memphis, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Zubler","sequence":"additional","affiliation":[{"name":"Learn the Signs. 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