A novel telemedicine optimized burn intervention (TOBI) for pediatric burn-injured patients and their caregivers - Abstract Summary
The goal of this K23 award is to provide the training and research experience necessary for me to become a
leading researcher in the development of technology-based resources that improve the quality of care for
pediatric surgical patients and their families. Because burn patients and their caregivers often live long
distances from regional burn centers, access to expert burn care is limited, resulting in a negative effect on
adherence to treatment and a higher risk of wound complication. Based on clinical experience in our outpatient
burn clinic, I designed and piloted TOBI, a smartphone app aimed at enabling burn experts to direct burn
wound care while the patient and caregiver are home through text messaging and video-conferencing.
As a dual board-certified General and Thoracic Pediatric Surgeon at the Medical University of South Carolina
(MUSC), I have a broad-based experience in clinical practice ranging from routine outpatient procedures to
complex congenital problems in infancy, with a special interest in pediatric burn injury. My clinical experience
treating pediatric burn injury and interest in patient-centered outcome research led to this K23 proposal. I
propose to receive additional training in the following areas: 1) mHealth training and evaluation; 2) qualitative
data collection and analysis; 3) biostatistics and clinical trial design; 4) remote healthcare monitoring
implementation; 5) grant writing and project management skills; and 6) ethics and the responsible conduct of
research within these domains. My mentorship team includes senior level investigators with active federally-
funded research projects, extensive experience mentoring early-career investigators, and expertise in the
following areas: iterative design, development, and evaluation of technology-based MH interventions
(Ruggiero), qualitative research methods (Barroso), clinical trial design and evaluation (Mueller), and
implementation of mHealth platforms in surgical disease (Evans). First, I propose to refine TOBI using
qualitative research directed at stakeholder feedback. Second, I will perform a feasibility RCT conducted with
64 patient/caregiver dyads recruited from our outpatient burn clinic and randomly assigned to TOBI vs
standard face-to-face burn care. Primary outcomes (wound healing, complications, and infection) will be
assessed over the course of burn treatment. Last, strategies for implementation will be assessed via qualitative
methods with stakeholders from other pediatric burn centers who will trial TOBI during the grant period. This
will inform the next phase of this research, which will be a large-scale hybrid effectiveness-implementation
trial of TOBI (NIH R01). This research complements my training and career trajectory, and will, ultimately,
provide valuable data toward understanding how mHealth can improve access to healthcare for
vulnerable populations.