- Minority and Immigrant Child Health
- Health Services Research
Clinical Instructor, Pediatrics - General Pediatrics
Honors & Awards
KL2 Fellow, Spectrum, Stanford University (2013-2015)
Hispanic Health Services Research Scholar, Hispanic-Serving Health Professions Schools (2013-2014)
Minority Scholar, AcademyHealth/Aetna Foundation (2013)
Harry Lyon Machen Fellow, Child Health Research Institute at Stanford (2012-2013)
New Century Scholar, Academic Pediatric Association (2007-2009)
Humanism & Excellence in Teaching Award, Arnold P. Gold Foundation (2008)
Board Certification: Pediatrics, American Board of Pediatrics (2009)
Residency:Lucile Packard Children's Hospital (2009) CA
Medical Education:Stanford University School of Medicine (2006) CA
Doctor of Medicine, Stanford University, MED-MD (2006)
Bachelor of Arts, Stanford University, HUMBI-BAH (2000)
Fernando Mendoza, Postdoctoral Faculty Sponsor
Current Research and Scholarly Interests
I am interested in improving health and developmental outcomes for children born to immigrant families. Specifically, I am investigating the relationship of parental limited English proficiency to child health and developmental outcomes, particularly among children with special health care needs (such as children born with very low birth weight).
Current Clinical Interests
- General Pediatrics
Parental limited English proficiency and health outcomes for children with special health care needs: a systematic review.
2014; 14 (2): 128-136
One in 10 US adults of childbearing age has limited English proficiency (LEP). Parental LEP is associated with worse health outcomes among healthy children. The relationship of parental LEP to health outcomes for children with special health care needs (CSHCN) has not been systematically reviewed.To conduct a systematic review of peer-reviewed literature examining relationships between parental LEP and health outcomes for CSHCN.PubMed, Scopus, Cochrane Library, Social Science Abstracts, bibliographies of included studies. Key search term categories: language, child, special health care needs, and health outcomes.US studies published between 1964 and 2012 were included if: 1) subjects were CSHCN; 2) studies included some measure of parental LEP; 3) at least 1 outcome measure of child health status, access, utilization, costs, or quality; and 4) primary or secondary data analysis.Three trained reviewers independently screened studies and extracted data. Two separate reviewers appraised studies for methodological rigor and quality.From 2765 titles and abstracts, 31 studies met eligibility criteria. Five studies assessed child health status, 12 assessed access, 8 assessed utilization, 2 assessed costs, and 14 assessed quality. Nearly all (29 of 31) studies used only parent- or child-reported outcome measures, rather than objective measures. LEP parents were substantially more likely than English-proficient parents to report that their CSHCN were uninsured and had no usual source of care or medical home. LEP parents were also less likely to report family-centered care and satisfaction with care. Disparities persisted for children with LEP parents after adjustment for ethnicity and socioeconomic status.Parental LEP is independently associated with worse health care access and quality for CSHCN. Health care providers should recognize LEP as an independent risk factor for poor health outcomes among CSHCN. Emerging models of chronic disease care should integrate and evaluate interventions that target access and quality disparities for LEP families.
View details for DOI 10.1016/j.acap.2013.10.003
View details for PubMedID 24602575
Parental Limited English Proficiency and Health Outcomes for Children With Special Health Care Needs: A Systematic Review
2014; 14 (2): 128-136
View details for Web of Science ID 000333142500005
Global Health Training in Pediatric Residency: A Qualitative Analysis of Faculty Director Insights
2012; 12 (3): 238-244
Interest and participation in global health (GH) has been growing rapidly among pediatric residents. Residency programs are responding by establishing formal GH programs. We sought to define key insights in GH education from pediatric residency programs with formal GH tracks.Seven model pediatric residency programs with formal GH training were identified in 2007. Faculty directors representing 6 of these programs participated in expert interviews assessing 6 categories of questions about GH tracks: understanding how GH tracks establish partnerships with global sites; defining organizational and financing structure of GH tracks; describing resident curriculum and pre-trip preparation; describing clinical experiences of residents in GH tracks; defining evaluation of residents and GH tracks; and defining factors that affect development and ongoing implementation of GH tracks. Data were analyzed using qualitative methodology.All programs relied on faculty relationships to establish dynamic partnerships with global sites. All programs acknowledged resident burden on GH partners. Strategies to alleviate burden included improving resident supervision and providing varying models of GH curricula and pre-trip preparation, generally based on core residency training competencies. Support and funding for GH programs are minimal and variable. Resident experiences included volunteer patient care, teaching, and research. Commitment of experienced faculty and support from institutional leadership facilitated implementation of GH programs.Directors of 6 model GH programs within pediatric residencies provided insights that inform others who want to establish successful GH partnerships and resident training that will prepare trainees to meet global child health needs.
View details for Web of Science ID 000304212400014
View details for PubMedID 22503444
Successful renal transplantation in high-risk small children with a completely thrombosed inferior vena cava
2006; 82 (9): 1148-1152
Inferior vena cava (IVC) thrombosis is generally a contraindication to renal transplantation in small children because of the technical difficulty and limitations in allograft venous outflow drainage that risk graft thrombosis.The records of six consecutive children (9.9-27.4 kg) with end-stage renal disease and thrombosed IVCs were reviewed. Small deceased donor renal allografts were utilized in all cases where immediate posttransplant venous renal outflow would theoretically not exceed the drainage capacity of the iliac or adjacent pelvic collateral veins.There is 100% patient survival with two patients returning to dialysis at seven and three years posttransplantation. There were no surgical complications or delayed graft function. Postoperatively, progressive renal vein and simultaneous iliac venous enlargement was observed in five of six recipients concomitant with renal allograft enlargement. In these patients, maximum renal volume achieved was between 152 and 275 ml and last recorded Schwartz glomerular filtration rates ranged from 67 to 118 ml/min. The sixth allograft had an early, severe rejection episode that limited renal growth and attainment of good renal function. All patients demonstrated resumption of growth rates commensurate with age but without significant catch-up growth.A small deceased donor kidney can provide freedom from dialysis and better quality of life for small children with IVC thrombosis during an age when dialysis treatment is difficult and the complications of the thrombosed IVC may compromise life. Good renal function was attained in patients without rejection episodes. In those with rejection, our approach allowed for patient growth during allograft function, providing a bridge for a repeat transplant.
View details for DOI 10.1097/01.tp.0000236644.76359.47
View details for Web of Science ID 000242059600007
View details for PubMedID 17102765