Pediatricians’ attitudes, practices, and perceived barriers to school readiness

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Publication year

2023

study description

Multicenter, cross-sectional descriptive study

core topic(s)

Early Literacy , Early Relational Health , Pediatric Primary Care , Shared Reading

Population Characteristics

International

Exposures, Outcomes, Other

Provider Knowledge, Attitudes, and Beliefs , School Readiness and Educational Outcomes

objectives

School readiness (SR) has been adopted by the American Academy of Pediatrics (AAP) as a component of health supervision, but the medical community’s role is unknown. We evaluated the pediatricians’ attitudes, practices, and perceived barriers to SR

outcomes evaluated

Evaluated the pediatricians’ attitudes, practices, and perceived barriers to SR

setting

Research conducted at seven training and research hospitals in Türkiye, specifically in the provinces of Ankara, Izmir, Istanbul, and Adana

methods

This multicenter, cross-sectional descriptive study was performed among general pediatricians, pediatric residents, subspecialists, and subspecialty fellows. A 41‐item survey was administered.

sample size

N=787 pediatricians, pediatric residents, subspecialists, and subspecialty fellows

measures

After an extensive literature review, the study team developed a 41-item survey. The survey was grouped into five sections: (1) Demographic information and practice characteristics; (2) Beliefs and attitudes about SR; (3) Clinical practices to promote SR; (4) Training and competence for SR; and (5) Perceived barriers to supporting SR

results

Forty-nine point two percent of the pediatricians defined SR as a multidimensional issue, as outlined by the AAP, whereas 50.8% defined it as the child’s set of skills or passing the SR tests. Three-quarters of pediatricians believed that SR assessment tests are necessary before starting school, and children who do not appear ready should wait a year. To promote SR, the rates of usually fostering at least four of the five “Rs” (reading, rhyming, routines, rewarding, relationships) and integrating developmental surveillance into daily practice were 37.8% and 23.8%, respectively. Only 2.2% of pediatricians usually inquired about eight adverse childhood experiences (ACEs), and 68.9% did not usually ask about any. Usually fostering at least four of the five “Rs” was associated with usually integrating developmental surveillance (p<0.001), usually inquiring about each ACE (p<0.001), and being perceived as responsible for promoting SR (p<0.01). Training on SR during pediatric residency was 2.7%. Time constraints and insufficient knowledge were the most common barriers

conclusions

Pediatricians were not familiar with the concept of SR and had some misconceptions. There is a need for additional training regarding pediatricians’ roles in promoting SR along with addressing multiple, modifiable barriers within the health system

limitations

There are some limitations to this study. Since participation in the survey was voluntary, a response bias is possible because more pediatricians with a greater interest in the topic may have completed the questionnaire. Because this study is based on self-report, pediatricians may not have fully reported their actual practices. Another limitation is the lack of standardized data collection instruments on the topic of SR, and the study’s dependency on a survey without reliability and validity