title: Promoting Early Brain and Child Development: Perceived Barriers and the Utilization of Resources to Address Them.
abstract: Efforts to promote early brain and child development (EBCD) include initiatives to support healthy parent-child relationships, tools to identify family social-emotional risk factors, and referrals to community programs to address family risk factors. We sought to examine if pediatricians perceive barriers to implementing these activities, and if they utilize resources to address those barriers.
  
  
  
  Data were analyzed from 304 nontrainee pediatricians who practice general pediatrics and completed a 2013 American Academy of Pediatrics Periodic Survey. Sample weights were used to decrease nonresponse bias. Bivariate comparisons and multivariable regression analyses were conducted.
  
  
  
  At least half of the pediatricians agreed that barriers to promoting EBCD include: a lack of tools to promote healthy parent-child relationships, a lack of tools to assess the family environment for social-emotional risk factors, and a lack of local resources to address family risks. Endorsing a lack of tools to assess the family environment as a barrier was associated with using fewer screening tools and community resources. Endorsing a lack of local resources as a barrier was associated with using fewer community resources and fewer initiatives to promote parent-child relationships. Interest in pediatric mental health was associated with using more initiatives to promote healthy parent-child relationships, screening tools, and community resources.
  
  
  
  Although the majority of pediatricians perceive barriers to promoting EBCD, few are routinely using available resources to address these barriers. Addressing pediatricians' perceived barriers and encouraging interest in pediatric mental health may increase resource utilization and enhance efforts to promote EBCD.
authors.affiliation: School of Medicine, Case Western Reserve University, Cleveland, Ohio. Electronic address: andrew.garner@UHhospitals.org.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Garner
authors.affiliation: Statistical Research Consultants LLC, Schaumburg, Ill.
authors.forename: Amy
authors.initials: A
authors.lastname: Storfer-Isser
authors.affiliation: University of California at Los Angeles, Los Angeles, Calif.
authors.forename: Moira
authors.initials: M
authors.lastname: Szilagyi
authors.affiliation: Albert Einstein College of Medicine/Children's Hospital at Montefiore, New York, NY.
authors.forename: Ruth E K
authors.initials: REK
authors.lastname: Stein
authors.affiliation: New York-Presbyterian Hospital-Weill Cornell Medical College, New York, NY.
authors.forename: Cori M
authors.initials: CM
authors.lastname: Green
authors.affiliation: Nathan Kline Institute of Psychiatric Research, Orangeburg, NY; Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY.
authors.forename: Bonnie D
authors.initials: BD
authors.lastname: Kerker
authors.affiliation: American Academy of Pediatrics, Elk Grove Village, Ill.
authors.forename: Karen G
authors.initials: KG
authors.lastname: O'Connor
authors.affiliation: Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY.
authors.forename: Kimberly E
authors.initials: KE
authors.lastname: Hoagwood
authors.affiliation: Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY.
authors.forename: Sarah
authors.initials: S
authors.lastname: McCue Horwitz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D005260:Female; D006293:Health Promotion; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology*; D008875:Middle Aged; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology; D018802:Patient-Centered Care; D000072143:Pediatricians / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D012044:Regression Analysis; D012307:Risk Factors; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D014481:United States
keywords: community resources; mental health; primary care; screening; social-emotional