PROJECT SUMMARY/ABSTRACT
Candidate: Carolyn Foster, MD, MSHS is a pediatrician and junior clinical investigator focused on improving
the evidence-based for the care of children with chronic lung disease (CLD) of prematurity who require
invasive home mechanical ventilation (HMV). Dr. Foster’s long-term career goal is to become an independent
physician-investigator who works in cross-disciplinary teams to design and evaluate evidence-based health
care delivery interventions for children with medical technology dependence who require in-home services.
Research Context/Objective: Children with CLD of prematurity are a growing, costly group of patients with
high health care resource use and significant family caregiver burden. No empirically based parameters exist
to guide how this population is discontinued from invasive HMV, leading to lack of appropriate, timely
discontinuation of HMV. Therefore, the objective of this award is for Dr. Foster to learn how to assess the
multifaceted factors that contribute to HMV duration, and to pilot test the integration of these factors into clinical
management of children with CLD of prematurity, to safely shorten duration of HMV use.
Specific Aims: 1) Determine which patient level factors are associated with HMV duration; 2) Determine which
family caregiver and health service factors are associated with weaning of HMV support; 3) Develop and pilot
the feasibility, acceptability, and usability of integrating patient, family, and health service data elements into a
clinical management dashboard design to optimize HMV use in children with CLD of prematurity.
Research Plan: Dr. Foster will retrospectively analyze existing patients’ clinical data to evaluate the
association of patient medical factors (e.g., ventilator settings, oxygen use, weight, end-tidal CO2,) with HMV
duration (Aim 1); prospectively collect patient reported outcome (PRO) measures (i.e., validated surveys) to
elucidate which caregiver and system factors are associated with weaning of HMV support among current
HMV patients (Aim 2); and use a stakeholder-engaged Learning Health System approach to develop and pilot
the feasibility, acceptability, and usability (implementation) of a clinical HMV dashboard (Aim 3).
Career Development Plan/Environment: Through a combination of local and national didactic activities,
experiential learning, workshops, seminars, and professional activities, Dr. Foster will acquire expertise in
evaluating longitudinal health outcomes and health care utilization; patient-reported outcome (PRO) health
measurement science; and intervention design and pilot testing. Dr. Foster will strengthen her professional
skills needed for an independent physician-investigator career through close mentorship by an experienced,
complementary team of NIH-funded team mentors, advisors, and collaborators. Northwestern University and
Lurie Children’s Hospital will provide outstanding research infrastructures to enable a successful award and
are strongly committed to Dr. Foster’s transition to research independence.