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A systems-level perspective to addressing health-harming legal needs via a joint Health Coalition and MLP network approach

Award Number: K01MD017635
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 07/20/2023
PERIOD OF PERFORMANCE END DATE: 08/31/2026

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A systems-level perspective to addressing health-harming legal needs via a joint Health Coalition and MLP network approach - Non-medical drivers of health (NMDoH) such as food insecurity, unstable housing, lack of transportation, and restricted access to health-related services are strongly associated with poor health outcomes and are disproportionately concentrated in economically disadvantaged populations. Medical-legal partnerships (MLPs) represent a promising systems-level strategy to address these complex issues by embedding legal expertise within clinical settings to resolve health-harming legal needs (HHLNs). While there has been great interest in MLP implementation, research on its efficacy and factors that predict implementation success is lacking in clinical settings. To date, few studies have been conducted in the Southern U.S., where regional context may shape how MLPs are delivered and experienced. Given this limited availability of research in support of effectiveness, we propose a systems-level approach to explore the impact of a patient-informed MLP intervention that resolves HHLNs in pediatric families enrolled across UT Physicians' multispecialty clinics. This approach integrates the community voice (patient) perspective to identify lived experiences (themes) within the clinic setting that may impede the screening and care coordination process. As such, we will use key informant interviews to qualitatively explore and identify themes that influence patients’ experiences with screening and resource access for HHLNs, with particular emphasis on factors that may impact utilization of an MLP program to resolve these needs (Aim 1). We will then leverage feedback from Aim 1 to build an evaluation framework and protocol for assessing the reach, effectiveness, adoption, implementation, and maintenance of a real-world MLP intervention (Aim 2a). This evaluation framework will be subsequently utilized in our quasi-experimental study to assess MLP effectiveness and factors that impact implementation in pediatric families who visit UT Physicians' multispecialty clinics (Aim 2b). Successful completion of this project will provide foundational data to inform future MLP implementation strategies, support care coordination efforts responsive to key NMDoH, and guide the submission of a competitive R01 trial evaluating MLP effectiveness in a broader pediatric population. Study findings will support system-level improvements in connecting patients to services that address both clinical and non-clinical contributors to health. My prior research has focused on the influence of demographic, contextual, and behavioral factors on health related outcomes in economically disadvantaged populations. Under the mentorship of Drs. Sharma, Murphy, Liaw, and Huber, this K01 award will support my continued training in qualitative and quantitative research methods, systems-oriented intervention design, and implementation science.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $0 )
2026	2025	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON	7000 FANNIN ST FL 9	HOUSTON	TX	77030	HARRIS	USA	Minority Health and Health Disparities Research	000	3	1/5/2026	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2025 ( Subtotal = $104,409 )
2025	2025	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON	7000 FANNIN ST FL 9	HOUSTON	TX	77030	HARRIS	USA	Minority Health and Health Disparities Research	000	3	4/15/2025	NON-COMPETING CONTINUATION	$104,409
														Subtotal = $104,409

Issue Date FY: 2024 ( Subtotal = $108,009 )
2024	2024	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON	7000 FANNIN ST FL 9	HOUSTON	TX	77030	HARRIS	USA	Minority Health and Health Disparities Research	000	2	1/30/2024	NON-COMPETING CONTINUATION	$97,209
2024	2024	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON	7000 FANNIN ST FL 9	HOUSTON	TX	77030	HARRIS	USA	Minority Health and Health Disparities Research	001	2	5/29/2024	NON-COMPETING CONTINUATION	$10,800
														Subtotal = $108,009

Issue Date FY: 2023 ( Subtotal = $104,409 )
2023	2023	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON, THE	7000 FANNIN ST	HOUSTON	TX	77030	HARRIS	USA	Minority Health and Health Disparities Research	002	1	7/25/2023	NEW	$104,409
2023	2023	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON, THE	7000 FANNIN ST	HOUSTON	TX	77030	HARRIS	USA	Minority Health and Health Disparities Research	000	1	7/20/2023	NEW	$104,409
2023	2023	UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON, THE	7000 FANNIN ST	HOUSTON	TX	77030	HARRIS	USA	Minority Health and Health Disparities Research	001	1	7/24/2023	NEW	-$104,409
														Subtotal = $104,409

Grand Total All Awards = $316,827

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A systems-level perspective to addressing health-harming legal needs via a joint Health Coalition and MLP network approach

Award Number: K01MD017635

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 07/20/2023

PERIOD OF PERFORMANCE END DATE: 08/31/2026

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