Sia then served his pediatric residency under Dr. Irvine McQuarrie at Kauikeolani Children's Hospital in Honolulu,[9] and obtained his license to practice medicine in Hawaii in 1958.
[10] As a young practicing pediatrician, Sia joined the early cadre of American Academy of Pediatrics consultants for Head Start and Parent Child Centers in Hawaii in the 1960s and developed a strong interest in prenatal, neonatal, and postnatal causes of physical and mental disabilities in children.
In a paper he presented in 1964 to the Hawaii Academy of Sciences on advances in neonatology, Sia cited progress in the care of premature babies but also noted that "completeness" of the first physical exam and the education of nurses to be on the alert for early signs of disabilities were possible ways to save newborns with previously lethal birth defects.
[14][15] The center's goal was to identify vulnerable families before their day-to-day stresses, isolation, and lack of parenting knowledge and good role models gave rise to abusive and neglectful behavior.
Armed with anecdotal evidence showing home visitors were able to promote effective parenting and ultimately improve outcomes, the group wrote a plan that incorporated a coordinated system of care that emphasized wellness and prevention for children, especially those with special needs.
[2] As the lead author of an often-cited article published by the journal Pediatrics in May 2004, Sia traced the development of the Medical Home concept.
Across the United States, according to the MCHB, the home visiting program has shown that it can reduce child maltreatment and increase children's readiness for school.
At a June 1987 conference called by Surgeon General C. Everett Koop and sponsored by the AAP and MCHB to address children with special needs, Sia and his delegation from Hawaii made a presentation of the Medical Home concept.
Koop appeared to embrace it by issuing a report that endorsed a system of family-centered, community-based, coordinated care for children with special needs.
This led to consultations to introduce the Medical Home training program to interdisciplinary teams of pediatricians, families, and other health care–related professionals in Florida, Minnesota, Nebraska, Pennsylvania, Washington and other states.
He launched several initiatives with a MCHB Health Education Collaboration grant in support of interprofessional training in early childhood, a Carnegie Corporation of New York Starting Points planning grant in early childhood, and Consuelo Foundation of Hawaii's Healthy and Ready to Learn grant–all with the emphasis on integrating the continuum of care of the Medical Home with other health, family, and community services from a holistic approach.
A three-year pilot project creating a Healthy and Ready to Learn Center in Hawaii began in 1992 and helped gauge the effectiveness of Sia's family-centered interprofessional collaboration approach.
In 2003, he created the Asia-US Partnership, a think tank based at the University of Hawaii medical school whose mission is to improve child health in Asia and the United States through cross-cultural exchanges with leaders in pediatrics.
[4] Sia has continued to serve as co-chairman of these events, including the sixth international conference, held in the Philippines capital of Manila, in May 2011.
"[32] While planting the seeds of the Medical Home concept in Hawaii, Sia embarked on a related advocacy campaign focused on emergency care for children.
[34] The program was launched after the October 1984 enactment of EMSC legislation (Public Law 98-555), a bipartisan measure sponsored by Inouye and Republican Senators Orrin Hatch of Utah and Lowell Weicker of Connecticut and endorsed by Surgeon General C. Everett Koop.
[38][39] Although he stepped down as chairman of the American Medical Association Section Council on Pediatrics in 2007, a post he assumed in 1983,[40][41] Sia continued to play a national role as an emeritus member of the executive committee of the National Center for Medical Home Implementation Project Advisory Committee, an organization he formerly served as chairman, for many years.