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Welcome to the Wisconsin Chapter of the American Academy of Pediatrics blog! It is my sincere hope that this endeavor will serve as a vehicle for informing you about the myriad of activities going on in pediatrics throughout our state, and more specifically about the things your chapter is doing for you and the children you serve. My vision is that this blog will serve as part diary, part sounding board as I go through my tenure as your chapter president, along with additional contributions from your other chapter officers and from Kia LaBracke, our Executive Director. I welcome your feedback, either as a comment here or as an email to president@wiaap.org .

 

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Top tags: AAP  ALF  Leadership  advocacy  cancer  hpv  legislation  mental health advocacy  opioids  Poverty  Resolutions  substance use disorders  vaccines 

Combatting Opioid Addiction in Wisconsin

Posted By Kia LaBracke, Thursday, December 15, 2016

WIAAP testified at a recent hearing of the Governor's Task Force on Opioid Abuse (view here, around minute 200:00) and participated in the latest meeting of the Wisconsin Coalition for Prescription Drug Abuse Reduction, convened by Dr. Timothy Westlake of the Medical Examining Board. Lt. Governor Rebecca Kleefisch and Rep. John Nygren, co-chairs of the Task Force, and collaborators from most health systems, public health and other advocates discussed electronic Prescription Drug Monitoring Program (e-PDMP), medication-assisted treatment (MAT) and models for expanding treatment options in the medical home.

Wisconsin stands at the forefront of actionable solutions to the alarming and deadly opioid addiction epidemic. Thanks to the dogged efforts of state Rep. John Nygren and the legislation known as the H.O.P.E. Agenda (Heroin, Opioid Prevention and Education), since 2013 our state has passed a remarkable 17 proposals dealing not only with heroin but prescription drug use and addiction. Attorney General Brad Schimel has bolstered Wisconsin Department of Justice efforts through the successful "Dose of Reality" campaign, focusing in on the dangers of prescription painkillers.

We bring a valuable pediatric perspective to state efforts, including a focus on infant and early childhood as well as school-based mental and behavioral health interventions, and are exploring a pediatric-focused CME curriculum for satisfying the new educational requirement on opioid prescribing.

There is no one solution, but to see the vast array of stakeholders who are not only taking an interest but taking a responsibility to attack this problem is impressive. The medical community is embracing the opportunity to improve their practices - not just in prescribing but in first line treatment of patients with addictions. As with any other mental or "brain" health disorder, primary care clinicians are seeing more and more of their patients needing this type of care and possible referral and therapies. Only can communities can knit together resources to ensure those supports are in place. Our job is to make sure the best practices for kids, and their caregivers, stay at the forefront of the discussion.

Tags:  advocacy  legislation  opioids  substance use disorders 

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Pediatricians and HPV Vaccine Reluctant Parents

Posted By Eyla Boies MD FAAP FABM, Friday, July 29, 2016

Parents who are otherwise on board with routine childhood vaccines balk when I recommend the HPV vaccine along with the Tdap and meningococcal vaccine at the 11 year check-up. A recent survey found only 38% of adolescent girls and 14% of adolescent boys complete the three dose series of HPV vaccine. There are currently 12,000 new cases of and 4,000 deaths attributable to just cervical cancer each year in the US.

Research has shown that pediatricians are part of the problem. Why? Either we do not perceive the HPV vaccine to be as necessary as other vaccines, and/or our messaging is not as effective for the HPV vaccine.

Funded through an AAP Educational Grant supported by Merck, the AAP CA Chapter 3 teamed up with San Diego physicians to produce a video and webinar to help pediatricians better communicate to parents the importance of immunizing against HPV at 11 or 12 years of age. 

The video includes eight vignettes with local San Diego pediatricians. It shows mock clinical encounters with patient/parent actors, with role playing ways to recommend the HPV vaccine and strategies to respond to concerns. Dr. Maya Kumar, an adolescent medicine specialist at UCSD, moderates the videos and provides a treasure trove of information regarding HPV infections and the vaccine.

Key takeaway messages:

  • 40% of HPV related cancers occur in males
  • Lifetime probability of contracting HPV is 85% for females and 90% for males.
  • 50% of HPV infections are with serotypes associated with cancer
  • 80 million doses of HPV vaccine have been administered
  • HPV vaccine has been around for 10 years
  • No serious side effects
  • More effective immune response when give early rather than mid or late adolescence

The webinar includes four presentations covering up-to-date information about the burden of HPV-related disease, vaccine uptake, strategies for counseling parents and patients about the vaccine, HPV disease from the gynecologic perspective and utility of reminder recall systems. 

Dr. Mark Sawyer, an infectious disease specialist at UCSD School of Medicine and Rady Children’s Hospital and member of the AAP Red Book Committee, discusses the epidemiology of HPV-related disease and vaccine efficacy and safety.  Dr. Kumar, the video series moderator, reviews effective, evidence based counseling strategies to address the concerns of vaccine-hesitant parents, such as: 

“Why does my 11 year old need to be vaccinated against an STD?”

“I am worried about the side effects of such a new vaccine.”

“Why would my son need a vaccine that prevents cervical cancer?”

Dr. John Willems, senior consultant in the department of Obstetrics and Gynecology at Scrips Clinic Medical Group in San Diego discusses not only the burden of cervical and related cancers but the burden of screening for cervical cancer. Dr. Sawyer presents the work of Ms. Heidi DeGuzman, Chief of Community Pediatrics and Program director for the San Diego Immunization Partnership with UC San Diego, on HPV uptake in San Diego County, reminder recall, and the San Diego County immunization registry.

The webinar provided valuable information allowing me to educate parents better about the burden of HPV disease and the safety and efficacy of the vaccine.  I am convinced that medical history will show HPV vaccine as one of the most significant medical advances of first decade of the 21st Century, with the potential of dramatically reducing the incidence of HPV related cancers.

Tags:  cancer  hpv  vaccines 

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Keeping Children Safe: Changing The Script for How To Prevent Gun Violence in America

Posted By Jeff Britton, MD, FAAP (President, WIAAP), Monday, December 14, 2015
Updated: Saturday, January 23, 2016

Today marks the third anniversary of the school shootings at Sandy Hook Elementary School. I urge you to read this terrific blog post from Dr. Sandy Hassink, President of the American Academy of Pediatrics:

https://www.aap.org/en-us/aap-voices/Pages/KeepingChildrenSafe-Prevent-Gun-Violence.aspx

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#Everychildneeds

Posted By Jeff Britton, MD, FAAP (President, WIAAP), Friday, November 13, 2015
Updated: Saturday, January 23, 2016

On Tuesday, October 27th, I joined fellow WIAAP board members Dipesh Navsaria and Betsy Peterson on Capitol Hill in Washington, DC for the #everychildneeds Rally for Children. This was the culmination of another terrific AAP National Conference and Exhibition, and it was exciting to have the opportunity to have 18 Senators and Representatives speak to us passionately about the children’s issues they are focused on in Congress.

The day before, Betsy and I had the opportunity to visit with staffers from Senator Johnson, Senator Baldwin, and Representative Grothman. The message we brought was about the crucial role early childhood plays in long term development, health, and success. We discussed the ACEs study, Toxic Stress, Quality Early Childhood Education, and Reach Out and Read. Finally, we asked for extension of CHIP, which will be set to expire again in October 2016.

It’s easy to feel like an individual meeting with a staffer would be unlikely to have any effect. However, the staffers we met with made it clear that their bosses do listen to the input they receive from their constituents, and that personal meetings and phone calls have greater effect than mass email campaigns. Additionally, they reinforced that it is unique to have physicians advocating for their patients, rather than their profession or specialty. We left feeling like we indeed could make a difference. You can make a difference too.

The rally on Tuesday was a chance to see legislators from both houses and both parties come together over issues that indeed should be bipartisan – nutrition, injury prevention, public health. Thanks to these leaders and the great staff at the AAP Washington office, children’s issues will remain on the radar for Congress.  Check out this Storify link for more: https://storify.com/AmerAcadPeds/everychildneeds-rally-for-children-on-capitol-hill

So, what’s with the hashtag? The AAP has been using #everychildneeds as a Twitter hashtag through which to funnel messages about child health. If you tweet, please consider occasionally tweeting about the things you think every child needs – like access to healthcare, access to specialists, shelter, good nutrition, love. Oh – and be sure to check out #tweetiatrician as well, so you can join with the rest of us in the twitterverse. Follow the chapter @wiaap, Dipesh @navsaria, and me @sftydc.

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On Food, Quality and Teeth - Update from the Chapter

Posted By Jeff Britton, MD, FAAP (President, WIAAP), Tuesday, September 15, 2015
Updated: Saturday, January 23, 2016

What an exciting time to be part of the Wisconsin Chapter! I want to bring you up to speed on a few current events for WIAAP:

This week we launched our first annual food drive. Food insecurity is a problem that touches most, if not all, of our practices – yet it remains largely hidden from view. According to the Healthiest Wisconsin 2020 baseline study, 1 in 8 Wisconsin households are food insecure. The AAP is developing tools to help pediatricians ask about food insecurity and direct families to resources. In the meantime, it seemed reasonable to us that collecting food for local food banks was something we each could do in our offices to help these families locally.

Last spring we learned about the 211 Wisconsin services offered by the United Way. If you have a family in need of food, shelter, help with paying bills, finding child care, or other similar issues, have them call 211 – or have your staff call 211 for them.

WIAAP met with members of the Wisconsin Collaborative for Healthcare Quality (WCHQ) last week to begin discussions of the addition of pediatric quality measures to the WCHQ panel. The WCHQ measures are publically reported quality measures that serve as benchmarks across healthcare systems in the state. WCHQ has several pediatric measures under development, and we are encouraging them to look to the Chapter as a resource for helping assure that the measures make sense from a clinical care standpoint. We are also committed to helping provide the resources you need to improve your performance on these measures, once they are launched. We are gratified that WCHQ welcomed us into the discussion, and are hopeful that we will continue to remain involved. Much more is to come on this topic!

Finally, our fall meeting is on Thursday, September 24, at Aurora Medical Center Summit (just south of Oconomowoc on I-94). The business meeting starts at 10 AM, our afternoon “Open Forum” session on Oral Health starts at 1 pm. All Chapter Members are welcome. The afternoon session should be particularly interesting, as we will hear from Kevin Moore, the director of Wisconsin Medicaid, and Cliff Hartmann, a Pediatric Dentist and member of the Wisconsin Dental Association board. We will be holding preliminary discussions about dental access for children on Medicaid, with the important players all in the same room. Your input (and your passion about the subject) would be quite welcome; I sincerely hope you can be there. Register here.

It truly is a privilege to continue to lead your Wisconsin Chapter of the AAP. Hope to see you soon! I’ll be at the NCE in Washington in October, so look for me there.

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