December 6, 2019
In This Issue

Research Spotlight:
New Healthcare Delivery Science Research Grant Competition

Upcoming Events

Recent Publications
New Healthcare Delivery Science Research Grant Competition
CPCE has teamed up with the Possibilities Project and the Center for Healthcare Quality and Analytics (CHQA) to offer a new internal research grant program committed to funding research that can improve the quality of care provided to children at CHOP.

Most large corporations have Research and Development (R&D) departments whose responsibility is to innovate and test new products and services in order to better serve their customers and maintain a competitive edge in the marketplace. While CHOP has a world class Research Institute, few of the studies conducted by CHOP investigators are designed to answer clinical and operational questions with the goal of immediately turning the knowledge gained into a new or revised approach to organizing and delivering clinical care at CHOP. The new Healthcare Delivery Science Research program aims to address this gap. The expectation is that successful research findings will be ready for translation into healthcare delivery at CHOP by the end of the 18-month funding period. Projects will be funded for up to $50,000, and applications are due January 15, 2020.

View more details, including an application template, here. 
Upcoming Events

Community-Driven Research Day
Date: December 9, 2019
Time: 9:00 am - 12:00 pm
Location: Thomas Jefferson University, Eakins Lounge, 1020 Locust St., Philadelphia, PA
Community-Driven Research Day (CDRD) encourages collaborations between researchers and community based organizations (CBOs) and community groups who have research questions that they are interested in answering, specifically in ways that address social determinants of health. This year's theme is Partnering for Healthy and Safe Communities. Al Richmond, MSW, Executive Director of the Community-Campus Partnerships for Health, will deliver the keynote address. Poster submissions are due December 2. Non-presenting individuals should register by December 5. Learn more here.

Structural Inequalities Workshop
Date: December 10, 2019
Time: 9:00 am - 12:00 pm
Location: Church of the Advocate, 1801 West Diamond Street Philadelphia, PA
In this supplement to Community Driven Research Day, join Al Richmond, MSW, for a thoughtful discussion of the role of partnerships in dismantling racism in our efforts to achieve health equity. Al is Executive Director of Community-Campus Partnerships for Health, a nonprofit membership organization that promotes health equity and social justice through partnerships between communities and academic institutions. Register here.

CPCE/PolicyLab Seminar Series: Stephanie Mayne, PhD, MHS
Date: December 13, 2019
Time: 12:00 - 1:00 pm
Location: Roberts, 2nd Floor, 2-180
Stephanie Mayne, PhD, MHS will present "Influence of neighborhoods on health behaviors and outcomes." RSVP to CPCE@email.chop.edu.

CHOP Grand Rounds: Shonna Yin, MD
Date: December 18, 2019
Time: 8:00 - 9:00 am
Location: CHOP Main, Stokes Auditorium or view remotely at Roberts 10-110.
H. Shonna Yin, MD, MSc, is a general pediatrician and an Associate Professor of Pediatrics and Population Health at the NYU School of Medicine / Bellevue Hospital Center. She is an NIH-funded researcher whose work centers on the issue of health literacy and its implications for child health. A large focus of her work involves examining the intersection between health literacy and medication safety, including the development and evaluation of low literacy strategies to improve parent understanding of medication instructions. 
Recent Publications

Scott Lorch, MD, MSCE and colleagues examined medical and developmental outcomes over the first 2 years of life in infants born extremely premature with bronchopulmonary dysplasia (BPD), comparing the outcomes of infants discharged on supplemental oxygen via nasal cannula and infants with similarly severe respiratory illness discharged breathing room air. Using a propensity score-matched cohort-study, they found that postdischarge oxygen was associated with increased resource use and marginally improved growth but no difference in neurodevelopmental outcomes.

Data on the prevalence and clinical course of pertussis in infants with pneumonia in low- and middle-income countries is lacking. A team including Kristen Feemster, MD, MPH, MSHP and Andrew Steenhoff, MBBCH, DCH evaluated a cohort of HIV-unexposed uninfected (HUU), HIV-exposed uninfected (UEH), and HIV-infected infants with pneumonia in Botswana and found low prevalence of pertussis among infants and young children with pneumonia.

Adolescents and young adults (AYA) whose cancer has been cured remain at risk for numerous physical and psychological late effects after completing cancer treatment. Lisa Schwartz, PhD, Christopher Bonafide, MD, MSCE, Alexandra Psihogios, PhD, and Nadia Dowshen, MD, MSHP and their team ran a pilot randomized trial to assess the feasibility and accessibility of a text messaging intervention to engage with survivors and promote well-being and health knowledge and behaviors. Texting Health Resources to Inform, motiVate, and Engage (THRIVE) demonstrated high acceptability and feasibility as an intervention to improve health and well-being of AYA survivors.

A wide range of disease processes can result in pediatric heart failure, including primary cardiomyopathy and palliated complex congenital heart disease (CHD). In this commentary, Joseph W. Rossano, MD, MS and his colleagues discuss poor pediatric health outcomes and the need for greater scrutiny and earlier pediatric cardiology consultation. They clarify that pediatric heart failure is distinct from adult heart failure, which may account for therapies being less effective for. His team recommends the following steps to achieve improved outcomes and resource utilization: 1) improving clinician ability to diagnose heart failure efficiently, 2) supporting heart failure investigations that are pediatric specific to develop tailored and more efficacious therapies, and 3) advocating for integrated, multidisciplinary care models to better support pediatric heart failure as a chronic disease.

Robert Grundmeier, MD and colleagues sought to determine the clinical characteristics, epidemiologic features, and natural history of food protein-induced enterocolitis syndrome (FPIES), a non-IgE-mediated food allergy, in relation to major atopic manifestations. They examined a primary care birth cohort of 158,510 pediatric patients and found that the incidence of FPIES was initially low, but increasing. FPIES patients have high rates of atopic comorbidity but longitudinal analysis suggests that this is not direct causation but instead a shared predisposition to both types of allergy. 

Although physician communication is an important factor for driving patient compliance with vaccine schedules and recommendations, patient psychological factors suggest that communication strategies may also have differential effects. Researchers including Kristen Feemster, MD, MPH, MSHP used an online sample of parent participants to investigate how psychological reactance impacts perceptions about physician communication and prioritizations of vaccinations. Results showed that those with higher psychological reactance prioritize vaccination less and that this relationship is driven by perceptions of physician communication quality and vaccine safety.

A team including Nadia Dowshen, MD, MSHP published recommendations on sexual and reproductive health for transgender and gender-expansive youth. They review topics that include contraception and menstrual suppression, fertility preservation and family building, and the prevention and treatment of sexually transmitted infections (STIs) and HIV. Her team emphasizes the safety and efficacy of hormonal contraceptives for youth on testosterone therapy. They recommend counselling all transgender youth on fertility preservation and reproductive options before the start of pubertal blockers and/or gender-affirming hormones, which may affect long-term fertility options. As transgender individuals have elevated rates of HIV and STIs compared to their peers, providers should be informed about HIV pre-exposure prophylaxis (PrEP) and HIV post-exposure prophylaxis (PEP).  

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.