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Identifying and Mitigating Health Disparities Following a Neonatal Intensive Care Unit (NICU) Design Change from Open Bay to Single Family Rooms

Award Number: R16GM145585
ORGANIZATION: NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/01/2022
PERIOD OF PERFORMANCE END DATE: 05/31/2026

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Identifying and Mitigating Health Disparities Following a Neonatal Intensive Care Unit (NICU) Design Change from Open Bay to Single Family Rooms - Project Abstract With over 400,000 preterm births in the US annually, neonatal intensive care units (NICUs) are critical to providing high quality care and ensuring optimal health outcomes for neonates. Neonatal intensive care units (NICUs) began as open-bays (large rooms, variable size, and multiple newborns admitted), but the latest NICU design and a growing trend is single family rooms that typically have only one baby admitted per room and accommodate at least one parent rooming-in. The scholarly literature provides mixed- evidence on the impact of NICU design changes on patient health outcomes and patient experience of care. Also, a recent community needs assessment called to reduce disparities in maternal and child health by race and ethnicity. These lead us to conduct a mixed-methods process and outcome evaluation examining the impact of a NICU transition from open bay to single family rooms that occurred at Cone Health in Greensboro, NC. A theoretical benefit of single family room designs is increased parent-neonate bonding time, yet this assumes that parents routinely room-in with neonates. Black and low income parents may experience economic and transportation hardships that constrain their opportunity to room-in at the frequency of white and economically privileged parents. Thus, we hypothesize that single family rooms disproportionately benefit neonates from economically privileged families (predominantly white) compared to neonates from families with low incomes (predominantly Black and LatinX in our community). We will conduct a mixed-methods study that triangulates patient health outcome data, patient experience surveys, and in-depth interviews with NICU staff to explore whether different patient sub-populations unequally benefited from or were unintentionally harmed by a NICU design change from open-bay to single family rooms. A secondary data analysis will help us determine whether patient health outcomes and patient experience of care changed before vs. after the NICU transition from open-bay to single family rooms. We will examine health disparities across patient sub-populations, with special attention to race/ethnicity and socioeconomic status. We will then collect and analyze qualitative data to provide rich detail on processes that reproduce health disparities; we will explore barriers and facilitators to implementing strategies to mitigate unintended consequences, improve care delivery, improve health outcomes, and reduce health disparities among patient sub- populations. Using a community engaged approach with a Stakeholder Advisory Board, we will develop a conceptual framework on the impact of NICU design changes and disseminate lessons learned and actionable recommendations to drive systemic changes to policies and procedures at health systems to improve patient quality of care, improve health outcomes, and reduce health disparities.


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: 2025 ( Subtotal = $142,240 )
2025	2025	NORTH CAROLINA AGRICULTURAL AND TECHNICAL STATE UNIVERSITY	1601 E MARKET ST	GREENSBORO	NC	27411	GUILFORD	USA	Biomedical Research and Research Training	000	4	6/5/2025	NON-COMPETING CONTINUATION	$142,240
														Subtotal = $142,240

Issue Date FY: 2024 ( Subtotal = $142,240 )
2024	2024	NORTH CAROLINA AGRICULTURAL AND TECHNICAL STATE UNIVERSITY	1601 E MARKET ST	GREENSBORO	NC	27411	GUILFORD	USA	Biomedical Research and Research Training	000	3	5/31/2024	NON-COMPETING CONTINUATION	$142,240
														Subtotal = $142,240

Issue Date FY: 2023 ( Subtotal = $142,240 )
2023	2023	NORTH CAROLINA AGRICULTURAL AND TECHNICAL STATE UNIVERSITY	1601 E MARKET ST	GREENSBORO	NC	27411	GUILFORD	USA	Biomedical Research and Research Training	000	2	5/26/2023	NON-COMPETING CONTINUATION	$142,240
														Subtotal = $142,240

Issue Date FY: 2022 ( Subtotal = $142,240 )
2022	2022	NORTH CAROLINA AGRICULTURAL AND TECHNICAL STATE UNIVERSITY	1601 E MARKET ST DOWDY BLDG STE 418 221 DOWDY ADM BLDG	GREENSBORO	NC	27411	GUILFORD	USA	Biomedical Research and Research Training	001	1	8/8/2022	NEW	$0
2022	2022	NORTH CAROLINA AGRICULTURAL AND TECHNICAL STATE UNIVERSITY	1601 E MARKET ST DOWDY BLDG STE 418 221 DOWDY ADM BLDG	GREENSBORO	NC	27411	GUILFORD	USA	Biomedical Research and Research Training	000	1	7/27/2022	NEW	$142,240
														Subtotal = $142,240

Grand Total All Awards = $568,960

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Identifying and Mitigating Health Disparities Following a Neonatal Intensive Care Unit (NICU) Design Change from Open Bay to Single Family Rooms

Award Number: R16GM145585

ORGANIZATION: NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 08/01/2022

PERIOD OF PERFORMANCE END DATE: 05/31/2026

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