Pediatricians and School Absenteeism: A Survey of Knowledge, Attitudes, and Practices

Background: Chronic school absenteeism is associated with poor educational and health outcomes. Causes include acute and chronic illness and social determinants of health. The American Academy of Pediatrics (AAP) policy statement, “The Link Between School Attendance and Good Health,” describes the critical role pediatricians play in addressing chronic absenteeism however pediatrician knowledge of and comfort with addressing chronic absenteeism has not been explored. Aims were to determine clinician: 1) knowledge, attitudes, and practice around school attendance; 2) comfort and experience interacting with schools.

Methods: An electronic survey was administered to clinically practicing members of the Washington, DC chapter of the AAP. Descriptive analysis was applied to report on knowledge, attitudes, and practices. Regression analyses were employed to determine individual and practice characteristics associated with contacting schools regarding health or academic concerns.

Results: Response rate was 31% (n = 136). 98% of clinicians agreed that addressing school attendance is within their scope of practice. Clinicians had higher odds of contacting schools for patient-related: a) health concerns if they had previously contacted for academic concerns, OR 10.3 (CI 33.2-34.8); and b) academic concerns if they endorsed familiarity with chronic absenteeism, OR 18 (CI 1.6-201). They had lower odds of contacting for health (OR 0.1 [CI 0.01-0.8]) or academic (OR 0.21 [CI 0.07 – 0.60]) concerns if they endorsed the barrier ‘lack of experience, training, or knowledge’

Conclusion: Our study found wide acceptability for addressing school attendance in pediatric practice. Additional clinical training and resource building to address school attendance are needed, including cross-sector approaches to align resources and support families with school attendance.