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Implementing an Intervention to Address Social Determinants of Health in Pediatric Practices

Award Number: R01HD090191
ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Project Summary It is known that social determinants influence children’s health trajectories, particularly for low-income children. Pediatric primary care provides a unique opportunity to address children’s social conditions; however, recent national data demonstrates that few providers routinely screen for unmet needs at visits. Our prior work has focused on developing a pediatric primary care-based intervention, “WE CARE,” aimed at addressing poor families’ material needs – food security, employment, parental education, housing stability, household heat, and childcare – by systematically screening for these needs and referring families to existing community-based services. To date, we have tested WE CARE primarily in community health centers (CHCs); our RCT demonstrated WE CARE’s efficacy on parental receipt of community-based resources. Although demonstrating WE CARE’s impact in this setting is important, over 80% of low-income children receive care from providers in traditional pediatric practices (i.e. non-CHCs). Given the Affordable Care Act’s mandate for high-value, patient- centered primary care and pediatric professional guidelines, along with WE CARE’s efficacy data, we believe we are well-positioned to test and implement WE CARE in traditional pediatric practices. We propose a large- scale, Hybrid Type 2 effectiveness-implementation trial in twenty eight pediatric practices in the US. A stepped wedge study cluster RCT design will be used to implement WE CARE in all practices using two common strategies used to integrate systems-based interventions into primary care – our previously facilitated “on-site” strategy in which content experts provide training sessions and on-going consultation; and a self-directed “web-based” method modeled after the American Academy of Pediatrics’ practice transformation strategy. The proposed study’s specific aims are to: 1) demonstrate the non-inferiority of the self-directed, web-based strategy for implementing WE CARE, in comparison to the facilitated on-site strategy; 2) demonstrate WE CARE’s effectiveness on increasing parental receipt of community resources; and 3) assess the sustainability of WE CARE in pediatric practices. We hypothesize that WE CARE will have equivalent fidelity via the two strategies. Based on our prior work, we hypothesize that WE CARE will significantly increase parental receipt of community resources six months post-visit compared to usual care. We also expect WE CARE to be sustained 1-, 2-, and 3-years post-implementation. We expect to gather data from over 9,000 chart reviews, 2,800 parent-child dyads, and 150 providers and office staff. Our proposal is innovative because it challenges current pediatric practice for addressing social determinants at visits. This proposal has significant public health implications for the delivery of primary care to low-income children and is aligned with the mission of the NICHD. Our long-term goal is to disseminate an evidence-based intervention that systematically addresses the social determinants of health to pediatric practices that provide care to low-income children throughout the US.


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: 2023 ( Subtotal = $0 )
2023	2022	UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL	55 LAKE AVE N	WORCESTER	MA	01655	WORCESTER	USA	Child Health and Human Development Extramural Research	002	6	12/23/2022	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$369,705
2023	2022	UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL	55 LAKE AVE N	WORCESTER	MA	01655	WORCESTER	USA	Child Health and Human Development Extramural Research	003	6	1/12/2023	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$0
2023	2022	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL	BOSTON	MA	02118	SUFFOLK	USA	Child Health and Human Development Extramural Research	001	5	12/23/2022	NON-COMPETING CONTINUATION	-$83,672
2023	2021	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL	BOSTON	MA	02118	SUFFOLK	USA	Child Health and Human Development Extramural Research	000	4	12/23/2022	NON-COMPETING CONTINUATION	-$286,033
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $564,844 )
2022	2022	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Child Health and Human Development Extramural Research	002	5	7/21/2022	NON-COMPETING CONTINUATION	-$464,099
2022	2022	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Child Health and Human Development Extramural Research	001	5	4/19/2022	NON-COMPETING CONTINUATION	$54,777
2022	2022	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Child Health and Human Development Extramural Research	000	5	1/20/2022	NON-COMPETING CONTINUATION	$492,994
2022	2022	UNIVERSITY OF MASSACHUSETTS	55 LAKE AVE NORTH	WORCESTER	MA	01655	WORCESTER	USA	Child Health and Human Development Extramural Research	003	6	7/21/2022	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$481,172
														Subtotal = $564,844

Issue Date FY: 2021 ( Subtotal = $550,975 )
2021	2021	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CENTER PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Child Health and Human Development Extramural Research	003	4	2/9/2021	NON-COMPETING CONTINUATION	$44,977
2021	2021	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CENTER PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Child Health and Human Development Extramural Research	002	4	1/14/2021	NON-COMPETING CONTINUATION	$505,998
2021	2020	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CENTER PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Child Health and Human Development Extramural Research	001	3	1/13/2021	NON-COMPETING CONTINUATION	$0
2021	2020	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CENTER PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Child Health and Human Development Extramural Research	000	3	11/24/2020	NON-COMPETING CONTINUATION	$0
														Subtotal = $550,975

Issue Date FY: 2020 ( Subtotal = $578,828 )
2020	2020	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CENTER PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Child Health and Human Development Extramural Research	000	3	2/7/2020	NON-COMPETING CONTINUATION	$578,828
														Subtotal = $578,828

Issue Date FY: 2019 ( Subtotal = $0 )
2019	2018	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CENTER PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Child Health and Human Development Extramural Research	000	2	5/6/2019	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2018 ( Subtotal = $595,914 )
2018	2018	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CENTER PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Child Health and Human Development Extramural Research	000	2	4/20/2018	NON-COMPETING CONTINUATION	$595,914
														Subtotal = $595,914

Issue Date FY: 2017 ( Subtotal = $676,300 )
2017	2017	BOSTON MEDICAL CENTER CORPORATION	88 EAST NEWTON ST	BOSTON	MA	02118	SUFFOLK	USA	Child Health and Human Development Extramural Research	000	1	7/19/2017	NEW	$676,300
														Subtotal = $676,300

Grand Total All Awards = $2,966,861

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Implementing an Intervention to Address Social Determinants of Health in Pediatric Practices

Award Number: R01HD090191

ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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