EAPRASnet

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EAPRASnet Survey on Child Health Inequalities among Migrant Children in the European Region

EAPRASnet Minutes

EAPRASnet Steering Committee Stefano del Torso (Chairman),Italy; Zachi Grossman, Israel; Adamos Hadijpanayis, Cyprus; Diego Van Esso,Spain. Email: info@eaprasnet.org

ABOUT EAPRASnet EAPRASnet (European Academy of Paediatrics Research in Ambulatory Settings network) is a practice-based research network that  was established in 2009. It consists of paediatric practitioners from practices in European and Mediterranean countries and research consultants from  Europe in collaboration with the EAP and AAP PROS.

WHAT IS THE MISSION OF EAPRASnet? The mission of EAPRASnet is to improve the health of European children and enhance the quality of  primary care paediatrics  by conducting  collaborative practice-based research.

WHAT ARE EAPRASnet OBJECTIVES? Establishment of a structure and process to study the care provided to children in community-based general paediatric primary care settings and the effectiveness of that care; provision of investigative experience to a large group of practitioners on the study of care and treatment issues in practice;  dissemination of study results to paediatricians and other primary care practitioners, public health groups and groups formulating guidelines, standards and recommendations so that they might act on this new information.

WHAT WILL EAPRASnet DO? EAPRASnet practitioners and researchers work together to generate research questions, design study materials and protocols, obtain research funding, collect study data, analyze collected data, and publish results. This collaboration is accomplished through EAPRASnet participants, , recruited and maintained by EAPRASnet national coordinators.

WHAT KINDS OF STUDIES WILL EAPRASnet BE DOING? The network is the research laboratory of the primary care setting and in the latest study, EAPRASnet has enrolled up to 2014 a total of 1.600 active pediatricians from 43 countries .

A recruitment survey showed that areas of most interest for research were: quality of care indicators, communication with parents, obesity, attention deficit hyperactivity disorder and effective well child care. Main incentives for participation in a research project were interest in the topic (81%) and effort to improve quality of care (71%). Lack of time was the leading reported obstacle (72%).

A second electronic survey assessing primary care pediatricians’ estimations and practices regarding parents’ vaccination refusal was sent to 395 EAPRASnet members, with a response rate of 87 %. Of respondents who vaccinate in their clinic, 93% estimated the total vaccine refusal rate less than1%. Sixty nine percent of all respondents prefer a shared decision making approach to handle parents’ vaccine hesitancy.

In 2012 a survey on Use of Antibiotics in Upper Respiratory Tract Infections has been performed to evaluate European primary care paediatricians’ knowledge, attitudes and practice regarding antibiotic prescribing for upper respiratory infections in order also to identify targets for future intervention studies.

In 2013 a survey on “Paediatrician’s practices and perspectives concerning Urinary Tract Infections (UTIs) in children 1 month to 36 months” has been performed in 6 different languages with a significant contribution by 1.140 paediatricians from 26 European countries.

A short survey on Antibiotic Treatment for Childhood Pneumonia (EMPARI) has been completed by 740 paediatricians and the results have been published.

More recently a survey on Electronic Health Research Records (EHRs) in ambulatory settings has been completed by 670 paediatricians from 26 European Countries. The results, showing that there is marked heterogeneity in the use and functionalities of EHRs used among child primary child healthcare providers in Europe. have also been published in 2016.

The results of the EAPRASnet survey to examine European paediatricians’ knowledge on migrant children’s health problems, needs, inequalities, and barriers to access health care have been accepted for publication in 2017 .  Widespread lack of guidelines and specific providers’ training should be addressed to optimize health care delivery to migrant children. 

In 2018 EAPRASnet is starting a new phase of its short history . A new survey for parents on Vaccination Confidence will be launched in the offices of primary care pediatricians and practitioners of 18 european countries to assess parental behavior regarding immunization of their children, and to examine factors that potentially influence their immunization decisions.

Hopefully, the new knowledge generated from the EAPRASnet studies could lead to changes in clinical guidelines or policy statements of paediatric pace-setting organizations, as has already happened with the AAP PROS studies influencing AAP policy.

1)  European Academy of Paediatrics Research in Ambulatory Setting Network. (EAPRASnet): A multi national paediatric network for better child health.  
delTorso S, GerberA, Drabik A, Hadjipanayis A, Nicholson A. Van Esso D, GrossmanZ. 
Child Care Health Dev 2010;36:385-91.

2) Perceptions of vaccine refusal in Europe PIDJ
Zachi Grossman MD, Diego Van Esso MD, Stefano delTorso MD, Adamos Hadjipanayis MD4, Anna Drabik MSc, Andreas Gerber MD PhD, Dan Miron MD
Primary care pediatricians’  2011; 30;3.

3) Antibiotic prescribing for upper respiratory infections: European primary paediatricians’ knowledge attitudes and practice. 
Grossman Z, Del Torso S, Hadjipanayis A, van Esso D, Drabik A, Sharland M.Acta Paediatr.
2012;101:935-40 

4) Current primary care management of children aged 1–36 months with urinary tract infections in Europe: large scale survey of paediatric practice 
Adamos Hadjipanayis, Zachi Grossman, Stefano del Torso, Diego van Esso, Hans Juergen Dornbusch, Artur Mazur, Anna Drabik, Giovanni Montini
Arch Dis Child 2015;100:341-7. doi: 10.1136/archdischild-2014-306119. 

5) Antibiotic preferences for childhood pneumonia vary by physician type and European region. 
Julia A. Bielicki, Charlotte I.S. Barker, Alike W. van der Velden, Mike Sharland, Diego van Esso,Adamos Hadjipanayis, Stefano del Torso and Zachi Grossman. 
ERJ Open Res 2016; 2: 00001-2016 | DOI: 10.1183/23120541.00001-2016

6) Primary care paediatricians’ use of electronic health records in Europe. 
Zachi Grossman, Stefano del Torso, Diego van Esso, Jochen Ehrich, Peter Altorjai, Artur Mazur, Corinne Wyder, Ana Margarida Neves, Hans Jurgen Dornbusch, Elke Jaeger Roman, Antonella Santucci, Adamos Hadjipanayis. 
Child Care Health Dev In Press. 2016 doi:10.1111/cch.12374

7) Migrant children’s health problems, care needs, and inequalities:European primary care paediatricians’ perspective
A. Carrasco‐Sanz  I. Leiva‐Gea, L. Martin‐Alvarez,  S. del Torso, D. van Esso, A. Hadjipanayis, A. Kadir, J. Ruiz‐Canela, O. Perez‐Gonzalez, Z. Grossman
Child Care Health Dev. 2017;1–5. DOI: 10.1111/cch.12538