What Can Appalachian Pediatric Networks Do to Improve Disaster Preparedness and Health Outcomes? Examining Characteristics of Pediatric Networks in the United States to Identify Differences between Appalachian and Non-Appalachian Collaborations

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Introduction: Living in the Appalachian Region of the United States (US) has been linked with poorer pediatric health outcomes, particularly for children in low income families living in rural areas. Purpose: We endeavored to describe the characteristics of the Appalachian and non- Appalachian pediatric emergency networks in the US and to determine if pediatric healthcare networks in the Appalachia differ from networks elsewhere in the U.S. according to size, whether they were inter- or intra-state, and intensity of collaboration. Methods: Data were collected using a two-stage survey process. The first survey was used to identify networks. The second survey assessed disaster preparedness capabilities and achievements of each identified network, degree of fund sharing, and the intensity and formality of information sharing among network partners. Networks were separated into Appalachia or non-Appalachia networks based on state location. Results: Appalachian networks were more likely to be interstate and operating at the highest stage of network development compared to non-Appalachian networks, but were less likely to share funding among network partners. Conclusion: Despite consistently insufficient pediatric capacity and repeated calls for collaboration among pediatric care providers, only three out of seventeen identified pediatric networks were operating in Appalachia. Operating in Appalachia was associated with less fund sharing, although Appalachian networks were more likely to have achieved the highest stage of network development. Developing new pediatric networks and increasing the intensity of collaboration (i.e., increased levels of fund sharing) among existing networks may improve disaster preparedness, network operations, collaboration, and health outcomes in Appalachian states.

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