Pediatric Research in Office Settings
Improving Children's Health Through Health Services Research was a special 1-day meeting held June 26, 1999, in Chicago. The state of the science in children's health services research was explored, including public and private funding opportunities, networks for
conducting research, and uses of research in policy and practice. The meeting
was co-sponsored by the National Association of Children's Hospitals and Related
Institutions (NACHRI), with the Agency for Health Care Policy and Research (AHCPR),
the American Academy of Pediatrics (AAP), the David and Lucille Packard Foundation, the
Association for Health Services Research (AHSR), the Robert Wood Johnson Foundation, and Data
The mission of PROS is to improve
the health of children by conducting collaborative, practice-based research
in the delivery of primary care services. PROS, founded in 1986 by the American
Academy of Pediatrics (AAP), is supported, in part, by a grant from the Health
Resources and Services Administration, Maternal Child Health Bureau, U.S. Department
of Health and Human Services. Additional funding comes from a variety of public
and private sector sources.
PROS involves more than 1,450 pediatric
practitioners from over 500 practices in 57 "networks" organized at the State
level. Each State has a Chapter Coordinator who recruits practices, oversees
research activities, and attends two meetings annually with PROS research staff
The practitioners involved in PROS
are physicians (89 percent), nurse practitioners (10 percent), and physician's
assistants (1 percent). Ninety-three percent of those involved report patient
care as their primary professional activity with approximately 90 percent of
their time spent in general pediatrics. The demographics of PROS practitioners
are similar to those of the membership of the AAP—49 percent are female with
an average age of 45.
PROS practices differ from the membership
of the AAP in that these practices are more likely to be located in suburban
rather than urban settings. According to race, the patients served by PROS are
75 percent white, 17 percent African-American, and 8 percent other. The ethnicity
of patients is 13 percent Hispanic. All ages (birth to 21 years) are served
by PROS with declining percentages of patients in the older age groups.
With their expertise in primary care
practice, PROS practitioners and researchers work together to:
- Generate research questions.
- Design and conduct studies.
- Obtain research funding.
- Disseminate research findings.
Current PROS studies include:
- Life Around Newborn Discharge: Assess the judgments of pediatricians, obstetricians, and mothers about
readiness for hospital discharge and their relationships to mother and newborn
- Helping Improve Pediatric
Practice Outcomes: Develop and test "tool kits" of materials and techniques
to improve quality in the management of children with asthma.
PROS has completed a number of studies:
- Polio immunization delivery.
- Assessment of febrile infants
less than 2 years of age.
- Child behavior.
- Gastrointestinal outcomes.
- Management of acute asthma.
- Referral processes in primary
- Secondary sexual characteristics
in young girls.
- Preschool vision screening.
- Respiratory illness management.
- Implementing research in pediatric
The advantages of practice-based
research networks include:
- Non-referred study samples.
- Ability to conduct longitudinal
- Larger samples.
- Variety of practitioners.
- Information from settings where
- Samples which are diverse and
- Office intrusiveness.
- Inter-observer and equipment variability.
- Imprecise data collection.
- Lack of a pediatric registry to
- Maintaining practitioner involvement.
For additional information: PROS
Web page is located on the AAP Web page at http://www.aap.org/pros/
Flaherty, E.G. Pediatric
Research in Office Settings (PROS). Presentation Summary, Improving Children's
Health Through Health Services Research, Chicago, June 26, 1999. http://www.ahrq.gov/research/chsrpros.htm