Pediatricians’ Perceptions of Screening Feasibility and Reported Responsibility over Screening Choices: Results from a National Survey

​Sisk B, Coker T, Garner A, Gottschlich E, Kornfeind K, Lipkin P, Bauer N

Accepted for 2020 Pediatric Academic Societies Annual Meeting

Background: Pediatricians are recommended to implement a range of screenings, but more research is needed on pediatricians' perceptions of the feasibility of screenings and their reported responsibility to make choices regarding the screening process.

Objective: Examine pediatricians' perceptions of screening feasibility and reported responsibility over screening choices.

Methods: Nationally representative 2019 Periodic Survey of non-retired, US-based American Academy of Pediatrics members (residents/subspecialists excluded). Survey collected data on pediatrician characteristics, screening feasibility (agreement that number/frequency of screenings are feasible; 5-point Likert scale), and screening choices (how responsible respondent is for choosing what conditions to screen for/tool used; 4-point Likert scale). Analysis restricted to those who provided direct patient care (N=710). Separate multivariable logistic regressions examined characteristics associated with screening feasibility and choices (covariates: gender, age, area, full-time, setting, owner, and patient insurance).

Results: Survey response rate was 47% (731/1560). Just over half of respondents agreed/strongly agreed that the number (56%) and frequency (68%) of recommended screenings are feasible, and a substantial share reported they are mostly/completely responsible for choosing conditions to screen for (63%) and the screening tool that is used (54%; Table 1). Regression results (Table 2) indicated that having ≥ 46% of patients on public insurance was significantly associated with agreeing that the number (AOR=1.86; 95% CI=1.22-2.82) and frequency (2.30; 1.45-3.65) of screenings are feasible; working in a group practice (relative to medical school/hospital) was also associated with reporting feasibility. Practice owners were significantly more likely than employees to report responsibility for choosing conditions to screen for (2.47; 1.55-3.93) and the screening tool used (4.92; 3.09-7.84); other characteristics associated with being more likely to report responsibility over making screening choices included working in a small practice and working full-time.

Conclusion: About half of pediatricians agreed that the number of screenings are feasible. Six in 10 indicated having responsibility over choosing what conditions to screen for, but almost half reported little or no role in choosing which tool to use. Owners and small practice pediatricians were more likely to have responsibility over screening choices.              

Table 1. Pediatricians' Perceptions of Screening Feasibility and Reported Responsibility over Screening Choices