Disparities in early childhood health outcomes following prenatal opioid exposure and protective health system factors: a population perspective

Opioid misuse affects almost 700,000 women of reproductive age in the USA, and infants exposed to opioids during pregnancy are more likely to be born preterm, small for their gestational age, and to develop neonatal opioid withdrawal syndrome. Beyond infancy, outcomes in opioid exposed infants are poorly understood. The objectives of this project are to characterize health outcomes during the critical period of birth to five years of age in children born to people with OUD, identify disparities among populations historically and currently under-represented in research, and ascertain protective health system factors using data from the Texas Neonatal Care Research Collaborative.

Funding Agency: National Institute on Drug Abuse
Funding period: 09/30/2024-07/31/2029

Development and Implementation of Culturally Sensitive Safety Planning to Reduce Suicide Risk in Adolescents Seeking Care in Rural Emergency Departments

Rural-residing children and adolescents in the USA experience substantially increased risks of mental and behavioral health conditions, suicide, and firearm-related deaths, and also experience unique barriers to care given geographic isolation and shortages of mental health professionals. This research will develop, implement, and evaluate technology-assisted, culturally sensitive safety planning and lethal means counseling in rural emergency departments for youth with suicidal ideation or attempt and their caregivers.

Funding Agency: National Institute of Nursing Research
Funding period: 09/23/2024-05/31/2029

Quality of Care for Children with Medical Complexity in the Military Health System and Associations with Maternal Behavioral Health

Children with medical complexity are a growing population characterized by health conditions that impact multiple body systems, greater need for health services utilization, and/or dependence on technology. The objectives of this project are to use population-level healthcare claims data from the Military Health System to expand our knowledge of childhood medical complexity epiemiology, healthcare quality, and associations with maternal mental/behavioral health in military beneficiaries.

Funding Agency: Defense Health Agency
Funding period: 07/01/2022-06/30/2024

Urban-Rural Disparities in Healthcare Quality for Children with Complex or Disabling Health Conditions

Of the 20% of children in the USA who reside in rural areas, children with complex or disabling health conditions may be at particular risk of adverse outcomes. Using five years of all-payer claims data from three states (Colorado, Massachusetts and New Hampshire), we aim to comprehensively evaluate urban-rural disparities in health care utilization and quality for children with complex or disabling health conditions.

Funding Agency: National Institute on Minority Health and Health Disparities
Funding period: 01/28/2020-11/30/2024

I*CARE: Improving Care – Accelerating Recovery & Education

Youth experiencing mental health crises may require hospitalization for their mental health condition, but there is a greater need than there are available beds, which may result in mental health boarding. Youth who are boarding are monitored for safety, but often do not receive treatment during this time. This project will redesign care for youth experiencing mental health boarding, providing a head start on recovery.

Funding Agency: Levy Serious Illness Incubator
Funding period: 01/01/2021-06/30/2022

Funding Agency: National Institute of Mental Health
Funding period: 08/01/2023-07/31/2025

Comparative effectiveness of Direct Admission and Admissions through Emergency Departments for Children

In partnership with three implementation sites in diverse regions of the USA, we aim to compare the effectiveness of a standardized direct admission approach to admission beginning in the ED for hospitalized children. This project is a 2-year stepped wedge cluster randomized controlled trial, which will lead to novel findings with relevance to the approximately 2 million children hospitalized each year in the USA.

Sponsor: Patient-Centered Outcomes Research Institute
Funding period: 08/01/2019-01/31/2023