P3.K204: Educating Pediatric Residents on Immigrant/Refugee Health, Resources, and Legislative Advocacy for these Families

Background: 1 in 4 children in the US are children in immigrant families (CIF), representing a diverse growing demographic that pediatricians will encounter and need to address. Paterson, NJ is home to 40.4% of its county's total immigrant population. Based on data from the last 3 years, majority of pediatric residents at St. Joseph’s hospital felt uncomfortable and unknowledgeable in addressing needs of CIF.

Project Description: Supported by an AAP Community Pediatrics Training Initiative’s grant, the goal of this project was to increase comfort and competence of residents to address, and be legislative advocates for specific needs and issues facing immigrant/ refugee patient populations.

We implemented a new immigrant health and legislative advocacy curriculum including 3 dedicated interactive didactic sessions and 2 Grand Rounds speakers from NJ AAP. To aid residents in implementing this curriculum in patient encounters, we formulated EMR smart phrases, lab order sets, and a resource packet in English/ Spanish for distribution to families. We hosted an educational summit on child immigrant health to collaborate with state/community partners and all NJ pediatric residency programs. The summit had ~150 attendees and featured a keynote address on medical and legal care for CIF, 13 resident advocacy research projects, 18 state/community partners resource tables, a legislative advocacy presentation, and a small group interactive case discussion specifically mixed to facilitate collaboration between medical professionals and community/state partners.

Quantitative and qualitative data from two sets of pre & post surveys from residents and summit participants were analyzed, including level of comfort and knowledge of CIF care, and frequency of addressing various social determinants of health including legal status. Retroactive chart review of resident ambulatory CIF visits was analyzed.

Discussion: There was a significant increase in residents’ perceived comfort and knowledge of care of CIF, willingness to discuss legal status, and legislative advocacy skills after implementation of new curriculum, EMR tools and resource packet. Summit participants also had significant increase in comfort and majority indicated it increased their competence and would improve their performance/patient outcomes. CIF chart analysis showed improvement in documentation, referrals and use of smart phrases/labs; feedback was positive regarding ease of use, time efficiency, and improved patient care.

Conclusion: Child immigrant and refugee health curriculum is necessary for residents to feel more comfortable and knowledgeable in caring for this population. Hosting a summit on child immigrant health had a positive impact by facilitating collaboration with other NJ pediatric residency programs and local/state community partners. The long term goal of this project will be to improve and build this curriculum and incorporate a mandatory standardized form for CIF visits in our EMR incorporating the tools we developed to ensure the unique health needs of this population is universally addressed.