The AAP is taking bold, decisive steps to address racism, the mental health of children and pediatricians, vaccine hesitancy and paid parental leave — issues identified as priorities by attendees of the 2020 AAP Annual Leadership Forum (ALF).
Through the ALF resolution process, Fellows, chapters, committees, councils, sections and districts can provide input to the Board of Directors on the direction of AAP policies and activities. Resolutions submitted by individuals or groups should address the Academy’s mission, core values or strategic plan.
During the ALF, attendees vote on whether to adopt the resolutions and select the top 10 that they want the Academy to address urgently. While they are not binding, resolutions spur AAP initiatives. Following is an update on how the AAP is addressing issues identified as priorities at the 2020 ALF.
Racism, bias and discrimination
Three of the top 10 resolutions called for action on racism, bias and discrimination.
The No. 1 resolution recommended that the Academy address the impact of structural racism on health as a required medical competency, develop educational materials on implicit bias training and expand guidelines for anticipatory guidance on race and racism.
Another resolution asked for the inclusion of recommendations in Bright Futures and other AAP publications on how pediatricians can discuss exposure to racism and other forms of bias and discrimination with patients and families.
A third resolution called for the Academy to end the practice of using race as a proxy for biology or genetics in all educational events and literature and require race to be characterized as a social construct when describing risk factors for disease.
AAP response
Equity, diversity and inclusion long have been priorities for the Academy. In 2019, the AAP Board of Directors established an Equity Agenda, and its implementation is among the organization’s top strategic priorities for 2021.
A detailed Year 1 Work Plan is guiding AAP efforts to achieve health equity and become an equitable, diverse and inclusive organization. Work underway this year includes:
- promoting a diverse Academy membership, leadership and pediatric workforce;
- applying an equity lens to AAP policy, advocacy and education;
- equipping AAP members with the capacity to foster equity in their practices, institutions and communities;
- setting forth explicit and intentional action to support the Academy’s commitment to equity, diversity and inclusion; and
- ensuring this action permeates all aspects of the Academy’s functioning.
AAP groups, including Bright Futures and Medical Home Initiatives, will collaborate to address equity, racism and other forms of bias and discrimination as part of health supervision and anticipatory guidance. Materials will be developed, and educational opportunities will be offered to assist clinicians in discussing exposure to racism and other forms of bias and discrimination and in developing strategies/systems to support youths, families and communities.
The AAP Section on Minority Health, Equity and Inclusion has affirmed race as a social construct and acknowledges the role medicine must play in correcting the fallacy that race is a biological risk factor for health. The Academy believes providing education around race-based medicine is crucial. It will work to promote race as a social construct and not a proxy for biology or genetics as it implements the Equity Agenda Year 1 Work Plan.
Mental health
Four of the top 10 resolutions raised concerns about the mental health of children and physicians, which have been exacerbated by the pandemic.
The resolutions called on the Academy to do the following:
- collaborate with organizations that teach children mindfulness and mental fitness in schools (https://bit.ly/3jbbtev);
- advocate for funding for inpatient and outpatient mental health facilities and services that include support groups for families (https://bit.ly/36A0vK9);
- provide online training to help general pediatricians become more knowledgeable of and comfortable with diagnosing and managing basic psychiatric conditions (https://bit.ly/3oHymqI); and
- broaden activities to prevent physician burnout to include partnerships that explore potential systemic measures (https://bit.ly/39GaQpV).
AAP response
Advancing mental health care for children is a 2021 strategic priority, which the Academy is addressing through partnerships, advocacy and education.
The AAP and the National Center for School Mental Health received funding from the Centers for Disease Control and Prevention to expand an AAP-designed model that supports school districts as they engage in a systematic process to improve mental health services. Using the Training, Education, Assistance, Mentoring, and Support model, multidisciplinary teams will assess their schools’ mental health services policies, practices and infrastructure; identify and prioritize areas for improvement; develop and begin to implement action plans; and evaluate changes.
On the advocacy front, AAP efforts led to the inclusion of $80 million in the COVID-19 relief legislation passed in March for a program that increases access to mental health services for children and adolescents. The funding will be used to provide grants to states, the District of Columbia and territories for five years.
The AAP also joined the Children’s Hospital Association on a series of advertisements that call attention to the impact of the pandemic on young people’s mental health and how the government can ensure families have access to services.
Additionally, the AAP is updating its call to action for payers to improve mental health services in primary care to include increased access to inpatient and outpatient services, family support groups and outpatient services for early childhood mental health care.
Several initiatives are underway to educate pediatricians on the identification and treatment of pediatric mental health disorders, including The Pediatric Mental Health Minute Series. The series includes more than 15 short briefings with critical information and resources for providers and families accompanied by short videos.
The mental health needs of pediatricians also has been an area of focus, especially during the pandemic. The AAP Wellness Advisory Group has created numerous resources, including:
- the physician health and wellness webpage, http://bit.ly/2GUCsZL,
- monthly articles in AAP News, http://bit.ly/3b1ZUkp,
- a webinar titled Resilience in Stressful Times and Connecting During Times of Trauma, https://www.youtube.com/watch?v=nQm_8BhkWkY and
- Physician Resilience in the Time of COVID-19 Town Hall, https://bit.ly/3m9vX7O.
Vaccine hesitancy
One of the top 10 resolutions asked the Academy to establish a task force on immunization advocacy and hesitancy made up of primary care and specialty pediatricians who would work with community partners.
AAP response
Childhood immunizations and combating vaccine hesitancy have been AAP priorities for years. Recent efforts include the #CallYourPediatrician campaign, which uses humor and real-world conversations to remind parents that going to the pediatrician, even during COVID-19, is important and safe.
The AAP also commissioned Frameworks Institute, a social science research consulting firm, to better understand how the public perceives vaccines and aid in developing messages that will resonate with a variety of audiences. As part of this ongoing work, the AAP has convened a stakeholder group that comprises the chairs of a number of AAP councils, committees and sections to discuss vaccine confidence and provide input.
Paid parental leave
A resolution asked the Academy to advocate for a national paid family and medical leave program that mandates at least 12 weeks of parental leave after the birth of a newborn and for employers to develop mother/baby-friendly spaces to facilitate prolonged exclusive breastfeeding after a mother returns to work.
AAP response
The AAP’s Transition Plan: Advancing Child Health in the Biden-Harris Administration includes support for comprehensive paid family and medical leave. The AAP also is involved in federal advocacy efforts to:
- continue expanding bipartisan support for the AAP-endorsed Family and Medical Insurance Leave Act;
- ensure sufficient leave for families during the COVID-19 pandemic; and
- enact comprehensive universal paid family and medical leave.
This year, the Annual Leadership Forum will be combined with district meetings. The meeting, called the Leadership Conference, will be held Aug. 5-8.
