In This Issue
Research Spotlight:
Increasing WIC Participation through EBT
CPCE In the News:
COVID-19 News
Upcoming Events & Announcements
Recent Publications
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Improving Access to Increase WIC Participation through EBT
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Many government benefit programs exist to support the most vulnerable members of our society. Despite the health benefits related to participating in such programs, lack of accessibility and stigma often cause a discrepancy between the number of individuals who are eligible and the number who participate.
Historically, this was the case for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a federal program that provides nutritional support and education for pregnant and postpartum women, and children younger than 5 years, who are living in poverty.
Data collected by the US Department of Agriculture (USDA) found that only about 50% of eligible women and children receive WIC benefits, with WIC participation among eligible individuals varying widely across states.
Up until 2010, WIC benefits were distributed via paper vouchers, each corresponding to a separate covered food item. This required store cashiers to individually scan and review each voucher, making the checkout process logistically challenging and creating stigma around the use and redemption of WIC benefits.
In 2010, Congress passed the Healthy, Hunger-Free Kids Act, mandating all states switch from paper WIC vouchers to electronic benefits transfer (EBT) cards by 2020. A recent study by Aditi Vasan, MD, and CPCE Faculty Chén C. Kenyon, MD, MSHP, Chris Feudtner, MD, PhD, MPH and Alexander G. Fiks, MD, MSCE sought to find out if the transition from a paper voucher system to EBT cards was associated with increased WIC participation across multiple states.
The study leveraged state-level data from the USDA to assess trends in WIC participation over time, and publicly available survey data to assess state baseline demographic characteristics. The study analyzed data from October 1, 2014 through November 30, 2019.
Thirty-six states transitioned to EBT distribution of WIC benefits by November 2019. Researchers concluded that transitioning to EBT was associated with a 7.8% increase in program participation. In states where EBT was implemented, participation increased within 6 months of implementation and continued to increase for the subsequent three years. Overall, EBT adoption was associated with 220,000 additional WIC beneficiaries during the study period, suggesting that interventions focused on reducing the inconvenience and stigma associated with government benefit programs can lead to significant increases in program participation.
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COVID-19 News
Brian Jenssen, MD, MSHP, recently spoke with Medscape about a recent study analyzing the rise in childhood obesity rates during COVID-19. Read the article here.
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Upcoming Events & Announcements
13th Annual University of Pennsylvania Conference on Statistical Issues in Clinical Trials
April 12, 2021 | 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.
Virtual Population Health Spotlight Series
April 14, 2021 | 2 - 3 PM
Join us for the final Population Health event in the 2020-2021 series featuring Chandra L. Ford, PhD, associate professor of community health sciences and founding director of the Center for the Study of Racism, Social Justice & Health at the University of California at Los Angeles. Register here.
IRB Overview: Considerations for Qualitative and Minimal Risk Research
April 16, 2021 | 12 - 1 PM
Please join the Qualitative Methods, Global Health, Health & Behavior, and mHealth RAGs for a lecture from the CHOP IRB. Chrissy DeLussey, MS, CIP, and Susan E Levy, MD, MPH, CIP, will describe the levels of IRB review and distinguish between QI and research.
A Nourishing Prescription: Food as Medicine to Promote Health and Health Equity
April 23, 2021 | 12 - 1 PM
Join a panel of experts to discuss Food as Medicine programs, their outcomes, and the opportunities and challenges in sustaining them. Register here.
Registration Opens for 2021 Summer Institute on GIS & Public Health
Gain hands-on experience using Geographic Information Systems (GIS) and public health research, practice, and public policy. Learn more about the week-long course and register here.
Opportunities to Address Health Disparities and Advance Health Equity
Conference Scholarship Opportunities in Epidemiology and Multilingual Research Interests
CPCE is accepting applications for research staff members interested in attending the 2021 Society for Epidemiologic Research (SER) Annual Meeting. Given the methodological focus of SER, this opportunity will be most useful to staff with previous training in epidemiology (e.g. MPH or similar degree) who are currently using epidemiologic methods in their work. Additional details can be found here. Applications can be submitted by April 30, 2021 through the following REDCap form. This opportunity is intended for CPCE faculty and staff.
CPCE is also accepting applications for scholarships to attend PAS or other conferences. Applicants who are interested in multilingual research methods, or who have an interest in developing resources for the inclusion of families with limited English proficiency in research, are encouraged to apply. To submit your request, please complete this REDCap form, describing the relevant workshops, seminars, or other training opportunities that you will attend and how they will contribute to the development of these skills and/or resources. This opportunity is intended for CPCE and PolicyLab members. If you have any questions, contact Lia Foster.
*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
Neonatal blood culture inoculant volume: feasibility and challenges
Clinicians often express concerns about poor sensitivity of blood cultures in neonates resulting from inadequate inoculant volumes. Karen Puopolo, MD, PhD, Miren Dhudasia, MPH, and Sagori Mukhopadhyay, MD, MMSc, sought to determine the inoculant volume sent for neonatal sepsis evaluations and identify areas of improvement. The study determined that obtaining recommended inoculant volumes is feasible in the majority of neonates, and measuring inoculant volumes can focus improvement efforts and improve test reliability.
Although adolescents’ medical needs are often addressed quickly, youth remain hospitalized because further psychiatric treatment is not immediately available. Stephanie Doupnik, MD, MSHP, Cadence Bowden, MSW, MPH, and Diana Worsley, MPH conducted semi-structured interviews to better understand the experiences of caregivers whose children are "boarding" in a medical hospital while awaiting inpatient psychiatric treatment. Themes that emerged included positive hospital and provider experiences; frustration with the medical and mental health care systems; information needs; fears about inpatient psychiatric units; practical challenges and emotional needs; difficulties with caregiver-child communication; difficulties with clinician-caregiver communication; and need for self-care and support.
Despite evidence-based guidelines recommending early palliative care, it remains unclear how to identify and refer oncology patients, particularly in settings with constrained access to palliative care. Kelly Getz, PhD, MPH and her colleagues conducted a retrospective study to determine if PRO data can identify latent phenotypes that characterize indications for specialty palliative care referral. They identified four PRO phenotypes: (1) Low Symptoms (n = 295, 39.6%), (2) Moderate Pain/Fatigue + Mood (n = 180, 24.2%), (3) Moderate Pain/Fatigue + Appetite + Dyspnea (n = 201, 27.0%), and (4) High Symptoms (n = 69, 9.3%).
Disruptions in STI testing infrastructure during the COVID-19 pandemic threaten to impact STI service delivery for adolescents. Within a large pediatric primary care network, Stephen Bonett, PhD, MA, RN, Danielle Petsis, MPH, Nadia Dowshen, MD, MSHP, Sarah Wood, MD, MSHP and their research team conducted a retrospective study to compare STI testing encounters between the pandemic period and an analogous pre-pandemic period. Gonorrhea and chlamydia test volumes decreased sharply and test positivity increased during the pandemic period.
Sabrina Gmuca, MD, MSCE and her team used the "Promoting Resilience in Stress Management" (PRISM) intervention as an exemplar for how the Obesity Related Behavioral Intervention Trials (ORBIT) intervention-development model may be applied to: (1) create an initial palliative care intervention; (2) adapt an existing intervention for a new patient-population; (3) expand an existing intervention to include new content; and, (4) consider dissemination and implementation of a research-proven intervention. Key lessons included the need to ground intervention-development in evidence-based theory; involve patient, clinician, and other stakeholders at every phase of development; "meet patients where they are at" with flexible delivery strategies; invest in the time to find the right scientific premise and the right intervention content; and, perhaps most importantly, involve an interdisciplinary research team.
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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 News is edited by Deanna Crusco. Please feel free to contact us with questions or feedback.
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