When pediatric residency program leaders in Maine, Vermont and New Hampshire first got together five years ago, they could not have imagined the crises that lay on the horizon. Since then, the teams have collaborated on efforts to advocate for children and families, and support pediatric residents in the Northeast.
The three states had worked together for years, but a formal working relationship was launched with the Northern New England Advocacy Collaborative (NNEAC), a group that includes pediatric residency programs and state chapters.
The group’s mission includes training pediatricians to be lifelong advocates through learning experiences and skill development; developing and sharing curricula that are culturally sensitive and community specific; and fostering collaboration with community partners.
The NNEAC held its first residency summit in October 2018 at the Dartmouth-Hitchcock Medical Center in New Hampshire. The summit included spotlights on resident projects and a presentation from then AAP President-elect Kyle Yasuda, M.D., FAAP.
“Northern New England has not just a unique geographic characteristic to it but unique challenges for families that are different from urban areas,” said NNEAC Medical Director Steven Chapman, M.D., FAAP, director of the Boyle Community Pediatrics Program at Dartmouth Health. “We thought, we’re having the national AAP president-elect coming to Dartmouth, so we should broaden the audience and see what we can do together. I reached out to Vermont and Maine and asked if they’d like to come and join. The potential for this collaborative was really obvious at the first meeting.”
Since then, the NNEAC has been holding yearly summits to focus on advocacy work, resident projects and collaborating with the AAP.
“Every year, we try to have a theme,” said Brian P. Youth, M.D., FAAP, pediatric residency program director of Maine Medical Center. “(Last) year’s theme was on health equity. Those are the kinds of things that we get together and talk about what we’re all doing, what each state’s doing and how we can learn from each other. It doesn’t matter where you’re training. You’re dealing with common issues and themes. The goal is teaching that next group of leaders, i.e., the residents, how to be advocates at the state level, the national level and the individual level.”
Recent advocacy efforts include seeking action on gun safety measures, raising awareness of tobacco/e-cigarette dangers to teens, addressing the opioid epidemic and challenging vaccine exemptions.
Projects highlighted at past summits include managing neonates exposed to opiates, helping providers understand the nuances of children with autism, connecting refugee and migrant families to medical services and improving COVID-19 vaccination rates and equity.
“(In 2021), with COVID and the pandemic, we decided at a group meeting that all three states would do a collaborative project to raise awareness of the COVID vaccine for kids, especially those in underserved groups,” Dr. Youth said. “Each state worked in their own region, and we shared successes, what worked and what didn’t work.”
Other projects focused on screening patients for food insecurity by providing practices with resources to identify “hunger vital signs.” Residents in Vermont helped create resources for local high schools to help students talk about depression, anxiety and mental health challenges.
“Sometimes, it can be small things,” said Jill S. Rinehart, M.D., FAAP, pediatric residency program director at the University of Vermont Medical Center. “One of my residents is an amazing seamstress as well as being a pediatrician. She recognized children with G-tubes and other types of medical equipment end up spending a lot of time in bed because they don’t have adaptive clothing that can work around all the tubes and wires. She made some designs for the children to wear with superhero patterns and Elsa (from the movie “Frozen”) just to help kids feel comfortable and not be hanging out in a hospital gown. (Projects) can contribute through education or a systems change or a practical thing like clothing, and that’s pretty powerful.”
The team already is planning this year’s summit, set for September in Vermont. As host, Dr. Rinehart said topics are likely to include mental health and juvenile justice but can be adjusted to meet specific needs at that time.
“There’s a movie that was set in Vermont that talks specifically about children with incarcerated parents and the effect that has had on the generations to follow,” Dr. Rinehart said. “I think we’ll do a workshop around those issues to identify ways we can help our adolescents. Most of our residents come to our smaller programs because they’re interested in community medicine. This advocacy is very much a part of that journey into community medicine.”