In This Issue
Research Spotlight:
Latest Round of CPCE Pilot Grants to Study Concussion Care, Pediatric Subspecialty Consultations
CPCE In the News:
COVID-19 News
Upcoming Events
Recent Publications
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Latest Round of CPCE Pilot Grants to Study Concussion Care, Pediatric Subspecialty Consultations |
CPCE congratulates our two most recent pilot grant awardees: Fairuz Mohammed, MPH and Andrew Kern-Goldberger, MD. Ms. Mohammed is a Clinical Research Project Manager with the Center for Injury Research and Prevention (CIRP) and the Minds Matter Concussion Program. Dr. Kern-Goldberger is a research track fellow in Pediatric Hospital Medicine and a student in the Masters of Science in Clinical Epidemiology (MSCE) degree program at Penn. |
For her pilot grant titled “Investigating Disparities in Pediatric Concussion Care,” Ms. Mohammed is joined by co-investigators Daniel Corwin, MD, MSCE, Christina Master, MD, and Kristy Arbogast, PhD. Concussions are a growing public health problem in youth. Proper evaluation and treatment may mitigate prolonged recovery, highlighting the critical nature of adherence to care recommendations and access to appropriate specialists. While emerging studies have begun to describe disparities in pediatric concussion care presentation, disparities in adherence to treatment plans are not well understood. Ms. Mohammed and her team will apply a mixed-methods approach to address this knowledge gap. Aim 1 will use electronic health records to evaluate the association between socio-demographic factors and adherence to clinical care recommendations among patients presenting to the primary care network of CHOP for concussion evaluation. Aim 2 will conduct in-depth interviews about barriers to care adherence with these patients and their caregivers. By identifying disparities and barriers to concussion care adherence, this project will inform future prospective interventional trials aimed at reducing these disparities. |
Dr. Kern-Goldberger will be joined by co-investigators Jeffrey Gerber, MD, PhD, MSCE, Christopher Bonafide, MD, MSCE, and Yun Li, PhD, for his project titled “Predictors and Patterns of Subspecialty Consultation Practices Among Pediatric Hospitalist Physicians.” Inpatient subspecialty consultation is a common and costly practice in hospital medicine. Its use is highly subjective and varies between physicians, and unnecessary consultations can adversely impact quality of care and patient and family outcomes. While there is emerging literature in adult medicine, the predictors and patterns of pediatric subspecialty consultation are virtually unknown. Dr. Kern-Goldberger and his team will survey 80+ hospitalist physicians at CHOP and link responses to data obtained from the EHR to identify physician level, patient level, and service line level predictors of subspecialty consultation for children with high-volume/low complexity conditions and low-volume/high-complexity conditions. They will assign physicians to high, medium, and low consultation utilization rankings, and subsequently conduct qualitative semi-structured interviews with subsets of high- and low- utilizing physicians about their attitudes and beliefs surrounding consultative practices. In the long term, this work will expand to multiple children’s hospitals in the Pediatric Research in Inpatient Settings (PRIS) network, and will incorporate the perspectives of additional stakeholders including families and subspecialist consultants to design and implement best practices around consultation utilization.
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Shelby Davies, MD, Nadia Dowshen, MD, MSHP, Deborah Thomas, PhD, Sarah Wood, MD, MSHP: A Multimodal Approach to Understanding the Barriers and Facilitators to Adolescent Menstrual Health Equity
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Kate Wallis, MD, MPH, Katherine Kellom, AB, Priscilla Ortiz, PhD, CMI, Julia Hah, MSW: Experiences in Telemedicine for Children with Suspected Autism Spectrum Disorder in Developmental-Behavioral Pediatrics During the COVID-19 Pandemic
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Deanna Marshall, MPH, Xi Wang, PhD, Diana Montoya-Williams, MD, and Meredith Matone, DrPH, MHS: Investigating Disparities in Prenatal Care Access and Outcomes during the COVID-19 Pandemic among Immigrant Mothers in Pennsylvania
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COVID-19 News
A team of CHOP and Penn researchers published new work in JAMA Pediatrics January 29, 2021 which indicates maternal antibodies to SARS-CoV-2 transfer across the placenta, providing some protection to babies born to exposed mothers. The team includes CPCE members Dustin Flannery, DO, MSCE, Miren Dhudasia, MPH, Sagori Mukhopadhyay, MD, MMSc, Jeffrey Gerber, MD, PhD, and Karen Puopolo, MD, PhD. Eighty-three women included in the study were found to have antibodies, and 72 of their babies were also also tested positive for antibodies. The timing and severity of the mother’s COVID-19 disease is probably a factor in the transfer of antibodies. This work appeared in various news sources, including Sciencelive.com, The Philadelphia Inquirer, and The New York Times. While these results are encouraging, many questions remain. “We see our work as a first step,” Dr. Puopolo said in the Inquirer. “Our work doesn’t comment on whether or not pregnant women should be vaccinated.”
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Upcoming Events
2021 Martin Luther King, Jr. Health Equity Symposium
Date: February 3, 2021
Time: 12:00 - 1:30 pm
The Penn Medicine Office of Inclusion and Diversity presents their annual symposium involving topics about health equity and disparities. Dorothy Roberts PhD, MPH, MA will present "The History and Future of Race, Health and Justice." Dr. Roberts is the 14th Penn Integrates Knowledge Professor and George A. Weiss University Professor of Law & Sociology at the University of Pennsylvania, with joint appointments in the Departments of Africana Studies and Sociology and the Law School, where she is the inaugural Raymond Pace and Sadie Tanner Mossell Alexander Professor of Civil Rights. She is also the founding director of the Penn Program on Race, Science, and Society. Learn more and register here.
Virtual Community Meeting: Preventing Accidental Youth Firearm Injury and Death
Date: February 4, 2021
Time: 6:00 - 7:30 pm
Presented by CHOP PolicyLab, the Center for Violence Prevention, and the West Philadelphia Promise Zone. Learn more and register here.
CPCE/PolicyLab Virtual Seminar Series*
Date: February 5, 2021
Time: 12:00 - 1:00 pm
Alexander Fiks, MD, MSCE and Jeffrey Gerber, MD, PhD, MSCE will present “Reduced antibiotic prescribing for children with respiratory illness.” This event is co-hosted with the Clinical Trials Research Affinity Group.
Dornsife School of Public Health Virtual Population Health Spotlight Series
Date: February 10, 2021
Time: 2:00 - 3:00 pm
Join the Drexel University Dornsife School of Public Health for a virtual Population Health Spotlight Series on “Racism and Health: Evidence and Action” featuring Aletha Maybank, MD, MPH. Dr. Maybank currently serves as the chief health equity officer and group vice president for the American Medical Association (AMA) where she focuses on embedding health equity across all the work of the AMA and leading the Center for HealthEquity. She joined the AMA in April 2019, to launch AMA’s Center for Health Equity as their inaugural Chief Health Equity Officer. Prior to joining the AMA, Dr. Maybank served as the Founding Deputy Commissioner for the Center for Health Equity at the NYC Department of Health and Mental Hygiene (2014). Read more and register here.
11th Annual Community-Driven Research Day (CDRD)
Date: February 11, 2021
Time: 10:00 am - 12:30 pm
We are pivoting from the normal in-person face-to-face interaction during this event, and the 2021 CDRD event will be held virtually with a theme of Resilience and Action to Improve Health. The new format will include live, 3-minute presentations from local CBOs and community groups about their organization and research questions of interest; as well as keynote speaker Barbara Israel, DrPh, of the University of Michigan's School of Public Health and the Detroit Community-Academic Urban Research Center. Learn more and register here.
Structural Racism - The Ultimate Social Determinant of Health: Environmental Justice
Date: February 11, 2021
Time: 12:30 - 1:30 pm
Join Penn Public Health for a conversation about structural racism and environmental justice. Register here.
Epidemiology and Race: Why and How We Study Racial Health Disparities
- PART 1, Thursday, February 25, 4:30-6:00 pm: The panel (Wayne Giles, Chanelle Howe, Sherman James, and Jennifer Manly) will explore the history of census data, how data on race are collected and studied, and the implications of how these data are used in population health science.
- PART 2, Friday, February 26, 10:00-11:30 am: The panel (Amani Allen, Ndidiamaka Amutah-Onukagha, Joseph Graves, Pat O’Campo) will address whether epidemiology has made a difference in race-related health disparities.
- PART 3, Friday, February 26, 12:30-2:00 pm: The panel (Anjum Hajat, John Jackson, Arjumand Siddiqi, John Rich) will suggest the big unanswered questions for epidemiology with respect to race and how this can guide the future of the field.
Cohosted by Boston University School of Public Health and Society of Epidemiologic Research. Learn more and register here.
Drexel University Dornsife School of Public Health 2021 Population Health Symposium
Dates: April 7-8, 2021
This year’s inaugural symposium will bring together researchers, health practitioners, students, and the public at large to learn about the intersection of racism and health and discuss how we can collectively propose sustainable solutions towards health equity. Learn more and register here.
13th Annual University of Pennsylvania Conference on Statistical Issues in Clinical Trials
Date: April 12, 2021
Time: 8:30 am - 4:30 pm
Continuing its longstanding collaboration with the Department of Biostatistics, Epidemiology and Informatics at the University of Pennsylvania, the ASA, NISS and SCT is delighted to announce the 13th Annual Conference on Statistical Issues in Clinical Trials: Cluster Randomized Trials (CRTs) - Challenges and Opportunities. Learn more and register here.
*For CPCE/PolicyLab Virtual Seminar Series: If you would like to participate in any of the virtual events and did not receive an Outlook invitation, please contact crosss2@email.chop.edu.
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Recent Publications
Early identification of autism spectrum disorder (ASD) is associated with improved cognitive and behavioral outcomes. James Guevara, MD, MPH and his colleagues ran a randomized clinical trial to test the efficacy of family navigation (FN), an individually tailored, culturally informed care management strategy, to increase the likelihood of achieving diagnostic ascertainment among young children at risk for ASD. Family navigation improved the likelihood of diagnostic ascertainment among children from racial/ethnic minority, low-income families who were detected as at risk for ASD in primary care. Results suggest differential effects of FN by site and ethnicity.
No standardized measures exist to evaluate whether pediatric palliative and hospice care teams at home (PPHC@Home) meet the needs and priorities of children and their families. Chris Feudtner, MD, PhD, MPH and his colleagues developed and conducted a preliminary evaluation of a family-reported measure of PPHC@Home experiences. At the completion the process, the Experiences of Palliative and Hospice Care for Children and Caregivers at Home (EXPERIENCE@Home) Measure contains 22 of the most highly-valued items for evaluating PPHC@Home.
In order to determine risk of death or neurodevelopmental impairment (NDI) in infants with late-onset sepsis (LOS) versus late-onset, antibiotic-treated, blood culture-negative conditions (LOCNC), Sagori Mukhopadhyay, MD, MMSc, Karen Puopolo, MD, PhD, Scott Lorch, MD, MSCE, and their team ran a retrospective cohort study of infants at 22-26 weeks gestation, with birth weight 401-1000 g and surviving >7 days. Infants with LOS had higher risk of death, but not NDI, compared with infants with LOCNC. Surviving infants with LOCNC had higher risk of NDI compared with unaffected infants. Improving outcomes for infants with LOCNC requires study of the underlying conditions and the potential impact of antibiotic exposure.
Maternal mortality is higher among Black compared to White people in the United States. Researchers including Heather Burris, MD, MPH, Molly Passarella, and Scott Lorch, MD, MSCE performed a population-based retrospective cohort study to determine whether risk-adjusted Black-White disparities in maternal mortality during the delivery hospitalization vary by hospital types and compare risk-adjusted in-hospital maternal mortality among Black-serving and non-Black-serving teaching and non-teaching hospitals regardless of race. They conclude that in-hospital mortality during the delivery hospitalization among Black patients is more than double that of White patients. Their data suggest this disparity is due to both excess mortality among Black patients within each hospital type, in addition to excess mortality in non-teaching, Black-serving hospitals where most Black patients deliver.
In early 2019, a workshop identified eleven potential "next step" actions to improve access to high quality pediatric palliative care (PPC) services. Chris Feudtner, MD, PhD, MPH and his colleagues conducted a national survey of the PPC community to prioritize potential actions in terms of their "actionable importance." The resulting top 5 potential actions, in descending rank order, were: Determine what parents value regarding PPC; Define and disseminate core primary PPC curriculum; Develop PPC national representation strategy and tactics; Create PPC-specific program development toolkit; and, Analyze payment and financing ratios.
Gaps in preventive care may contribute to adverse outcomes among pregnant teens. This continuous retrospective cohort study by researchers including Emily Gregory, MD, MHS and her team quantified teen preventive care utilization before and after pregnancy. They found that in a primary care cohort of pregnant teens, gaps persisted in pediatric clinical follow-up after pregnancy. Particularly in situations where pregnancy led to a birth, pregnancy frequently prompted a transition away from pediatric care.
Kathleen Chiotos, MD, MSCE is among the authors of this white paper from the Society for Healthcare Epidemiology of America (SHEA) which identifies knowledge gaps and challenges in healthcare epidemiology research related to COVID-19. The research agenda calls for translational studies from laboratory-based basic science research to well-designed, large-scale studies and health outcomes research.
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About CPCE
We are a pediatric research center dedicated to discovering and sharing knowledge about best practices in pediatric care by facilitating, organizing and centralizing the performance of clinical effectiveness research -- research aimed at understanding the best ways to prevent, diagnose and treat diseases in children. CPCE’s multidisciplinary team conducts research on a diverse range of clinical effectiveness topics.
CPCE E-News is edited by Holly Burnside. Please feel free to contact us with questions or feedback. |
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