Pediatric Health Services Research Fellowship Program Research Projects

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Examples of Research Projects Being Conducted by Current Fellows

ECONOMIC RESOURCE NEEDS IN FAMILIES OF CHILDREN NEWLY DIAGNOSED WITH CANCER

Pedals for Pediatrics Grant/ Family Reach Foundation Grant
Principal Investigator: Kira Bona, MD

This study aims to prospectively identify the impact of pediatric cancer treatment on parental employment, family income, family material hardship, parental reports of emotional distress, rates of accessing existing governmental and private assistance programs, and provider knowledge of patient resource needs.  This study will provide the baseline data necessary for a subsequent evaluation of impact of economic resource needs on pediatric oncology health outcomes and evaluation of an intervention program.

ACUTE IMPACT OF PEDIATRIC STEM CELL TRANSPLANTATION ON PARENTAL EMPLOYMENT AND FAMILY FINANCES

Family Reach Foundation Grant
Principal Investigator: Kira Bona, MD

This study aims to prospectively identify the impact of pediatric stem cell transplant and subsequent home isolation on parental employment, family income, family material hardship, parental reports of emotional distress, rates of accessing existing governmental and private assistance programs, and provider knowledge of patient resource needs.  This study will provide the baseline data necessary for a subsequent evaluation of impact of economic resource needs on pediatric stem cell transplant health outcomes and evaluation of an intervention program.

EVALUATION OF PEDIQUEST IN CHILDREN WITH ADVANCED CANCER

Unfunded
Principal Investigator: Joanne Wolfe, MD, MPH
Kira Bona, MD, Co Investigator

This data analysis project is utilizing prospectively collected data from families of children living with advanced cancer to assess the financial impact on families. Domains of inquiry include impact of care on parental employment, family income.  Additionally, analysis will identify family predictors of increased financial impact. 

OUTCOMES IN PEDIATRIC AND TRANSPLANTATION SURGERY

Dr. Cauley has focused on the analysis of outcomes in pediatric and transplantation surgery. His first project included an assessment of risk in split liver transplantation. He has also analyzed recent transplantation allocation policies that have affected split liver transplantation. He is currently working on decision analyses in liver, kidney and pancreas transplantation. In pediatric surgery he has focused on risk stratification and cost analysis in congenital diaphragmatic hernia, one of the highest cost diseases treated by pediatric surgeons.

CHANGES IN HEALTHCARE UTILIZATION AMONG ASTHMATIC ADOLESCENTS AND YOUNG ADULTS

Principal Investigator: Kao-Ping Chua, MD

This study aims to examine the changes in healthcare utilization among adolescents as they transition into young adult hood.  Outcomes of interest include primary care visits, having a usual source of care, asthma medication prescription fills, and emergency department visits.  In a separate longitudinal analysis, we will examine the effects of gaining or losing health insurance on healthcare utilization in this population.

GENERAL HEALTH, INFLUENZA, AND INFLUENZA VACCINE BELIEFS AND BEHAVIORS AMONG COLLEGE STUDENTS WITH INFLAMMATORY BOWEL DISEASE

Principal Investigator: Hayden Schwenk, MD
The primary aim of this study is to describe and analyze the beliefs and behaviors of college students with inflammatory bowel disease (IBD) regarding general health care, influenza, and influenza vaccine.  A semi-structured interview format will be used to inform the answers to these questions and aid in the development of a cross-sectional survey distributed to a broader cohort of patients.  Ultimately, this information will aid in the iterative development of potential strategies to improve influenza vaccine utilization in this hard-to-reach population.

TRENDS IN THE UTILIZATION OF ENTERAL VANCOMYCIN FOR THE TREATMENT OF C. DIFFICILE INFECTION AMONG IN PATIENT PEDIATRIC PATIENTS AT CHILDREN?S HOSPITALS ACROSS THE UNITED STATES, 2006-2011

Principal Investigator: Hayden Schwenk, MD
The primary aim of this study is to describe the utilization of enteral vancomycin for the treatment of C. difficile infection (CDI) in pediatric inpatients among children’s hospitals in the United States between 2006 and 2011.  We are also interested in identifying clinical predictors for the use of enteral vancomycin and describing variations in the use of this agent between participating children's hospitals.  This study will contribute to the growing body of literature that aims to mitigate the considerable burden CDI currently has on diminishing healthcare resources.

EFFECTS OF PRENATAL MATERNAL EXPOSURE TO AMBIENT BLACK CARBON AND STRESS ON FETAL GROWTH IN AN URBAN COHORT

Ashwini Lakshmanan, MD with Rosalind Wright, MD MPH

While studies link ambient air pollution and psychological stress exposures in pregnant women to adverse birth outcomes, the extent to which air pollution impacts fetal growth independent of stress is unknown. Dr. Lakshmanan has examined associations among black carbon (BC), a surrogate of traffic-related particles, prenatal stress and fetal growth.

QUALITY OF LIFE AMONG CAREGIVERS AND FAMILIES OF PRETERM INFANTS ATTENDING HIGH RISK FOLLOW UP CLINICS AFTER DISCHARGE FROM THE NEONATAL INTENSIVE CARE UNIT

Funding: Boston Children's Hospital Patient Safety and Quality Program, Richardson Grant, BIDMC and Houseoffice Research Development Award, Medical Staff Organization, Boston Children's Hospital

Ashwini Lakshmanan, MD with Mandy Belfort, MD MPH

Ashwini’s research interests and goals have been to address disparities in health care delivery in the field of perinatal-neonatal medicine.  The burden of health and developmental sequelae related to preterm birth is widely recognized.  Few studies have examined the quality of life of the caregiver or family after taking a preterm infant home from the hospital.  Dr. Lakshmanan's aims are to: describe rates of suboptimal quality of life of caregivers and families of preterm infants after discharge from the NICU in a population of families with children with high risk needs; rates of increased financial burden among caregivers and families of preterm infants after discharge from the NICU in a population of families with children with high risk needs and to identify potentially modifiable correlates associated with these outcomes.

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