Commentary From AAP Community Access to Child Health (CATCH) Program
For 30 years, the Community Access to Child Health (CATCH) program has been a flagship initiative of the American Academy of Pediatrics (AAP). CATCH provides grant funding to pediatricians and pediatric trainees to lead projects in their community that build broad-based partnerships. This hands-on approach allows them to learn critical skills to advance the health of all children so that every child in every community reaches optimal health and well-being. CATCH is aided by a network of volunteer pediatricians who provide technical assistance to grant applicants and to funded grantees. The articles chosen for this commentary reveal the evolution of CATCH and how the presence of this program has positively influenced the way pediatricians care for children.
Advancing the Pediatrician’s Skill of Prescribing Community
Amber Pendleton, MD, FAAP1, A. Barbara Oettgen, MD, MPH, FAAP2
Affiliations: 1Professor of Pediatrics, University of Louisville, Louisville, KY; 2Associate Professor, Pediatrics, Nationwide Children’s Hospital, Columbus, OH
Highlighted Articles From Pediatrics
- Hutchins VL, Grason H, Aliza B, Minkovitz C, Guyer B. Community Access to Child Health (CATCH) in the historical context of community pediatrics. Pediatrics. 1999;103(Suppl 4):1373-1383
- Soares NS, Hobson WL, Ruch-Ross H, Finneran M, Varrasso DA, Keller D. The influence of Community Access to Child Health (CATCH) program on community pediatrics. Pediatrics. 2014;133(1):e205-e212; doi:10.1542/peds.2013-1471
- Oettgen B, Ruch-Ross H, Barrett, HA, Bennett-Tejes D, Palmer K, Hobson W. The Community Access to Child Health (CATCH) Program: A 25-Year Retrospective. Pediatrics. 2019;143 (6): e20182551; 10.1542/peds.2018-2551
The third quarter century of Pediatrics has born witness to the inception and evolution of the AAP Community Access to Child Health (CATCH) program. As CATCH has advocated for pediatricians to help children achieve optimal health through collaboration with their communities, now the skill of prescribing community is as fundamental to pediatricians as prescribing medicine. While we have seen exciting new treatments and cures through pharmaceuticals, we have also learned that child health is most influenced through building healthy communities.
Just as pediatricians know the indications, doses, and risk factors for medicines, CATCH has facilitated gaining critical skills in advocacy, leadership, and community partnership to help children thrive. The evolution toward prescribing community started with a shift in philosophy to redefine the role of the pediatrician. The 1999 article, “CATCH in the Historical Context of Community Pediatrics,” reminded us that the first AAP president, Abraham Jacobi, MD, boldly stated, “We need to be rebels to push society to do what is right for children.”1
Over the next century, social action for the welfare of children blossomed, and many pediatricians began to address issues specifically affecting underserved children. Although individual pediatricians took Dr. Jacobi’s words to heart, at that time the AAP lacked the infrastructure to truly support and promote community advocacy work. Then in the 1960s-1980s, Philip Porter, MD, proved that one pediatrician can indeed make a difference. His work to improve access to care through coordination of existing community-based resources, such as home visitation and school-based health centers, led to the creation of a Robert Wood Johnson-funded initiative. This program, called Healthy Children, became part of the AAP in 1989.1
Beginning in the 1990s, F. Edwards Rushton, MD, helped the AAP Healthy Children program evolve into the funded grants program we now know as CATCH. He boldly encouraged pediatricians to see themselves to be as able as any other community leaders to create positive change for children. With this motivation to act, pediatricians began writing grants to lead community projects in every state bolstered by the CATCH program’s technical support.1,2
In 2003, “AAP CATCH: A Model for Supporting Community Pediatricians” eloquently highlighted how CATCH pediatricians were using their “social marketing skills to influence the use of existing community assets and resources to promote the well-being of children.” 3 It was also noted that pediatricians began filling formal CATCH leadership roles known as CATCH Chapter Facilitators in every state. These leaders networked and learned from one another and concurrently provided essential mentorship to grant applicants. This expansion of program bandwidth helped launch a CATCH grant program specifically for pediatric trainees.
The resident CATCH grant program highly influenced embedding the skill of prescribing community into pediatrics training. Community pediatrics and advocacy training are now core components of most residency programs. In fact, the Community Pediatrics Training Initiative uses the CATCH grant application as one of the training curricula tools. Surveys have shown that this training does in fact lead to long-term use of these skills and, not surprisingly, these skills have proven to be useful and meaningful for pediatricians.4,5
In 2019, “The CATCH Program: A 25-Year Retrospective” announced impressive historical program outcomes. The program had granted over 1,700 pediatricians more than $10 million to partner with their communities to create local solutions to child health problems.6 Every program funded increased access to care for an underserved population and targeted a wide breadth of topics including obesity, mental health, foster care, LGBTQ+, and refugee health.2, 6 The majority of these programs continued for years, and many grew into larger programs. In fact, grant-awarded pediatricians were early identifiers of emerging local child health problems that eventually garnered the attention of the entire nation.2,6
Built on the foundation of pediatricians acting as strong child health advocates, the AAP has evolved into an organization that also advocates for the wellness of its members. Not surprisingly, CATCH has helped pediatricians improve career satisfaction.6 As pediatricians gather powerful stories of injustice and hardship as well as strength and resilience, the emotional weight can be tough to carry. Advocacy through CATCH provides pediatricians with the ability to turn those experiences into meaningful community changes through building partnerships and connections. Now, prescribing community is woven into the fabric of their careers whether they are caring for children directly or advocating for healthier communities outside of clinic and hospital walls.
References
- Hutchins VL, Grason H, Aliza B, Minkovitz C, Guyer B. Community Access to Child Health (CATCH) in the historical context of community pediatrics. Pediatrics. 1999;103(Suppl 4):1373-1383
- Soares NS, Hobson WL, Ruch-Ross H, Finneran M, Varrasso DA, Keller D. The influence of Community Access to Child Health (CATCH) program on community pediatrics. Pediatrics. 2014;133(1):e205-e212; doi:10.1542/peds.2013-1471
- Burton OM. American Academy of Pediatrics Community Access to Child Health (CATCH) program: a model for supporting community pediatricians. Pediatrics. 2003;112(Suppl 3):735-737
- Minkovitz CS, Grason H, Solomon BS, Kuo AA, O’Connor KG. Pediatricians’ involvement in community child health from 2004 to 2010. Pediatrics. 2013;132(6):997-1005; doi: 10.1542/peds.2013-1917
- Minkovitz CS, Goldshore M, Solomon BS, Guyer B, Grason H. Five-year follow-up of community pediatrics training initiative. Pediatrics. 2014;134(1):83-90; doi: 10.1542/peds.2013-3357
- Oettgen B, Ruch-Ross H, Barrett, HA, Bennett-Tejes D, Palmer K, Hobson W. The Community Access to Child Health (CATCH) Program: A 25-Year Retrospective. Pediatrics. 2019;143 (6):e20182551; 10.1542/peds.2018-2551