February 15, 2019
In This Issue

Research Spotlight: Addressing the Rise of Teen Vaping

CPCE in the News:
E-cigarettes, JUUL and Vaping: What Pediatric Health Care Providers Need to Know

Upcoming Events

Recent Publications
Addressing the Rise of Teen Vaping

Last week, CPCE and the Mobile Health (mHealth) Research Affinity Group co-hosted a presentation by Brian Jenssen, MD, MSHP titled “Using Behavioral Economics and Digital Health to Address Teen Vaping and Smoking: Preliminary Findings and Lessons Learned.”

Dr. Jenssen discussed the rise of e-cigarettes among teens and the messaging that has likely contributed to their popularity. He went on to describe the Be Smokefree study, a work-in-progress which aims to compare three financial incentive structures on adolescent e-cigarette/cigarette users’ engagement with the Tobacco Quitline. The project received a $50,000 pilot grant from the Center for Health Incentives and Behavioral Economics (CHIBE) at Penn, and leverages the Way to Health platform to manage incentives via text message.

The presentation came shortly after Dr. Jenssen wrote a blog post for PolicyLab and featured in Cornerstone about the alarming increase in e-cigarette use among youth. Read more about the blog post in our “CPCE in the News” section below. He also worked with colleagues as part of the American Academy of Pediatrics (AAP) Section on Tobacco Control on a revised policy statement, “ E-Cigarettes and Similar Devices.”
E-cigarettes, JUUL and Vaping: What Pediatric Health Care Providers Need to Know

E-cigarettes have exploded in popularity among teens over the last decade, making them the most common tobacco product used by youth. In a recent blog post that originally appeared on the PolicyLab website, CPCE and PolicyLab faculty member Dr. Brian Jenssen discusses what pediatric healthcare providers need to know about e-cigarettes, JUUL, and vaping. Pediatricians see the majority of the U.S. child and adolescent population, and adolescents view pediatricians as trusted sources for credible health information which makes them uniquely positioned to screen for tobacco use in their patients, initiate treatment and connect adolescents to smoking cessation services. Dr. Jenssen urges pediatrician to work to fill in the gaps in research, identify proven methods to help kids and teens quit vaping, and educate patients and their families about the risks of e-cigarette use.

Upcoming Events

Automated Early Detection of Obstetric Complications: Research in Progress in an Integrated Health Care Delivery System
Date: February 22, 2019 
Time: 12:00 pm - 1:00 pm 
Location: CHOP Roberts Center for Pediatric Research, Conference Room 1-120 A&B 
CPCE & PolicyLab invite you to attend a research seminar with visiting speaker Gabriel J. Escobar, MD. Dr. Escobar is a research scientist at the Kaiser Permanente Northern California Division of Research, director of the Division of Research Systems Research Initiative; and Regional Director for Hospital Operations Research for Kaiser Permanente Northern California. His research interests include risk adjustment, predictive modeling, severity-of-illness scoring, the use of comprehensive inpatient and outpatient electronic medical records for health services research, and the use of real-time decision support tools that are embedded in the electronic record.  

Adherence Assessment and Promotion in Pediatric and AYA Oncology
Date: February 26, 2019
Time: 4:00 pm
Location: CHOP Colket Translational Research Building (CTRB) - 1200B
The CHOP Center for Childhood Cancer Research presents Ahna Pai, PhD, Professor of Pediatrics, Center for the Promotion of Adherence and Self-Management, Division of Behavioral Medicine and Clinical Psychology, University of Cincinnati / Cincinnati Children's Hospital Medical Center. View the event flyer.

Progress and Considerations for AAV Gene Therapies - Lessons from Hemophilia Clinical Trials
Date: February 27, 2019
Time: 12:00 pm - 1:00 pm
Location: CHOP Roberts Center for Pediatric Research, Conference Room 2-180
In this session hosted by the Clinical Trials Research Affinity Group (RAG) Lindsey George, MD, Attending Physician, Department of Hematology, Children's Hospital of Philadelphia, will discuss some of the challenges of gene therapy trials. Please RSVP to ClinicalTrialsRAG@email.chop.edu.

Save the Date: Career Pathways in Global Health
Date: April 6, 2019
Time: 10:00 am - 1:00 pm
Location: Perry World House, 3803 Locust Walk, Philadelphia, PA 
Global health is less about geography and more of a lens through which one approaches health care delivery and outcomes in the larger global context. The career paths in this field are as vast as the topic itself. Come learn about the career trajectories and work lives of featured speakers regarding local and global public health research and practice. More details available online.
Recent Publications

Antibiotics are the most common medications prescribed for infants in the neonatal intensive care unit
(NICU). This research from CPCE faculty members Dr. Karen Puopolo and Dr. Sagori Mukhopadhyay and colleagues from the NICHD Neonatal Research Network assessed the prevalence and outcomes of prolonged early antibiotics to extremely premature infants without culture-confirmed infection or necrotizing enterocolitis (NEC). Study findings showed a significant decline in the overall use of prolonged early antibiotics, however, significant center-specific antibiotic practice variation persists. 

Surgical site infections are the second most commonly reported healthcare-associated infections in adults and children. Critical gaps in our understanding of surgical site infections (SSI) prevent accurate identification of patients at increased risk for the development of SSI and appropriately targeted preventive interventions. This research from faculty members in our Pediatric Infectious Diseases Epidemiology and Antimicrobial Stewardship (IDEAS) Research Group describes the epidemiology of SSI after pediatric ambulatory surgery.

Do-not-resuscitate (DNR) orders are common among children receiving palliative care, who may nevertheless benefit from surgery and other procedures. Although anesthesia, surgery, and pediatric guidelines recommend systematic reconsideration of DNR orders in the perioperative period, data regarding how clinicians evaluate and manage DNR orders in the perioperative period is limited. Dr. Chris Feudtner and colleagues reviewed electronic medical records for children with DNR orders in place within 30 days of surgery and found that no documented systematic reconsideration took place in the perioperative period for over 40% of procedures. This highlights the need to improve how DNR orders are managed during the perioperative period.

Equal access to clinical trial enrollment is important to ensure that findings are generalizable to the broader population. This study from CPCE researchers Dr. Richard Aplenc and Dr. Brian Fisher and colleagues evaluated disparities in enrollment on pediatric oncology clinical trials. Understanding the etiology of these disparities will inform strategies to ensure balanced access to clinical trials across patient populations.

Unlike the adult heart failure patient population, there is scarce of information on the overall burden of heart failure in the pediatric population across geographies and within different age groups. Here, Dr. Joseph Rossano and colleagues conduct the first systematic review to describe and quantify the economic, humanistic, and societal burden of pediatric heart failure on patients and caregivers. This review provides valuable insights into burden of heart failure in children and adolescents, however, there is a need for larger population based studies with wider geographical coverage.

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.