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Firearm injuries are the leading cause of death among children and adolescents in the US. Safe storage of firearms in the home is one of the most effective ways of preventing firearm injuries in children. This feasibility study was conducted in both the pediatric and general Emergency Departments of a large urban academic medical center in a community with high rates of firearm injuries in children. The objective was to pilot a survey seeking to describe sociodemographic characteristics, firearm specific risk factors, and firearm storage practices of households with children in the community. One hundred participants completed a survey containing items regarding participant demographics, household features, firearm ownership, firearm characteristics, and storage practices. Descriptive statistics were used to define sociodemographic characteristics of the enrolled population, comparing those with firearms to those without, and to describe firearms and storage practices of firearm owners in households with children. Of 100 participants, 30 lived in households with firearms and children. Most firearms in homes with children were stored locked and unloaded most of the time; however, 30% of participants with firearms and children in the home reported not consistently storing a firearm locked and unloaded. The most common reason given for not storing a firearm in the safest manner possible was that storing a firearm locked and unloaded would make it difficult to access quickly. Engaging families with children in discussions around firearm prevention during Emergency Department visits is feasible and may have implications for future efforts to promote safe firearm storage practices. [ABSTRACT FROM AUTHOR]

Maryland's Behavioral Health Integration in Pediatric Primary Care (BHIPP) is a child psychiatry access program offering child-adolescent psychiatry consultation, resource and referral networking, and direct-to-patient mental health intervention. This study investigated characteristics of patients for whom primary care providers sought BHIPP services. Data from 6,939 unique patient contacts between October 2012 and March 2020 were collected on service type, demographic characteristics, presenting concerns, clinical severity, clinicians' diagnostic impressions, current treatments, and BHIPP recommendations. Descriptive statistics and latent class analysis were used. Of the 6,939 patient contacts, 38.6% were for direct-to-patient mental health intervention, 27.3% for child-adolescent psychiatry consultation, and 34.2% for resource and referral networking. In total, 50.3% of patients were female, 58.7% were White, and 32.7% were already receiving mental health services. Latent class analysis identified four classes of presenting concerns: anxiety only (44.2%); behavior problems only (30.7%); mood and anxiety (17.1%); and attention, behavior, and learning problems (8.0%). Compared with patients in the anxiety-only class, those in the attention, behavior, and learning problems class were more likely to receive direct-to-patient mental health intervention (OR=3.59), and BHIPP clinicians were more likely to recommend in-office behavioral interventions for those in the mood and anxiety class (OR=1.62) and behavior problems–only class (OR=1.55). Patients supported through BHIPP varied in presenting concerns, condition severity and complexity, current receipt of services, and BHIPP utilization. Latent class analysis yielded more clinically useful information about the nature and complexity of patients' concerns than did consideration of individual presenting concerns. [ABSTRACT FROM AUTHOR]

Objective: Child psychiatry access programs (CPAPs) help increase access to mental health services. This study aimed to provide information on the types of pediatric primary care clinicians (PPCCs) who call Maryland's CPAP.Methods: Descriptive statistics and multinomial logistic regressions were conducted with data from 676 PPCCs who called Maryland's CPAP at least once between October 2012 and June 2019.Results: On average, PPCCs contacted Maryland's CPAP 6.8 times. Providers who called seven or more times were more likely to have an allopathic or osteopathic medicine degree and to specialize in pediatrics. Providers calling from rural regions were less likely to call only for referrals.Conclusions: Most PPCCs contacted the CPAP for consultation or referrals but not both. PPCCs in rural areas were more likely to call for consultation, suggesting that they may be more likely to manage the care of patients with mental health conditions themselves, because of a lack of resources in their locations. [ABSTRACT FROM AUTHOR]

Young children first develop the social–behavioral skills needed to succeed in school from parents. However, most school-based interventions designed to bolster children's social–behavioral skills have focused on strengthening teachers' skills. This study examined the extent to which a 12-session group-based program for strengthening parenting skills, the Chicago Parent Program (CPP), could be implemented with fidelity in 12 urban schools serving a large population of young children (>95% African American or Latino) living in poverty. Parents of 380 prekindergarten students enrolled in the CPP. Data were collected on child behavior problems; parent satisfaction, attendance, and weekly practice completion; and implementation adherence and competence. Results indicated that CPP group leaders were highly adherent and competent; parents rated groups highly and attended an average of 8 sessions indicating CPP was implemented with high fidelity. Barriers and supports to implementation are reviewed, and implications for long-term sustainability of school-based interventions like CPP are discussed. [ABSTRACT FROM AUTHOR]

Social, emotional, and behavioral skills are foundational to learning and long-term success. However, poverty and exposure to adverse childhood experiences reduce the chances of children entering kindergarten socially-behaviorally ready to learn. This study examined the unique impact of 5-year-old children (N = 11,412) entering kindergarten not socially-behaviorally ready on three costly school outcomes by fourth grade in Baltimore City Public Schools: being retained in grade, receiving services and supports through an IEP or 504 plan, and being suspended/expelled. Controlling for all other types of school readiness, students not identified as socially-behaviorally ready for kindergarten were more likely to experience all three school outcomes. Findings underscore the importance of early prevention and intervention strategies targeting parents and social-behavioral readiness skills during the first 5 years of life. [ABSTRACT FROM AUTHOR]

This study examined the extent to which individual, peer, and family factors predicted the onset of community violence exposure in middle and high school, as well as the indirect effects of early factors. We were particularly interested in the timing of exposure to community violence during adolescence, and thus conducted survival analyses on data from 632 urban youth, followed from first grade through high school. Early aggressive behavior and poor academic readiness were associated with an earlier onset of community violence exposure in adolescence. The effects of early aggression on community violence exposure and victimization were accounted for, in part, by peer rejection and deviant peer affiliation; there was no evidence of moderation by gender or parental monitoring. Findings highlight potential targets for preventive interventions with youth at risk of community violence exposure. [ABSTRACT FROM AUTHOR]

Polygenic propensity for educational attainment has been associated with higher education attendance, academic achievement and criminal offending in predominantly European samples; however, less is known about whether this polygenic propensity is associated with these outcomes among African Americans. Using an educational attainment polygenic score (EA PGS), the present study examined whether this score was associated with post‐secondary education, academic achievement and criminal offending in an urban, African American sample. Three cohorts of participants (N = 1050; 43.9% male) were initially recruited for an elementary school‐based universal prevention trial in a Mid‐Atlantic city and followed into young adulthood. Standardized tests of reading and math achievement were administered in first grade. At age 20, participants reported on their level of education attained, and records of incarceration were obtained from Maryland's Criminal Justice Information System. In young adulthood, DNA was collected and extracted from blood or buccal swabs and genotyped. An EA PGS was created using results from a large‐scale genome‐wide association study on educational attainment. A higher EA PGS was associated with a greater log odds of post‐secondary education. The EA PGS was not associated with reading achievement, although a significant relationship was found with math achievement in the third cohort. These findings contribute to the dearth of molecular genetics work conducted in African American samples and highlight that polygenic propensity for educational attainment is associated with higher education attendance. [ABSTRACT FROM AUTHOR]