Enhanced Community-Based Asthma Monitoring Through Novel Technology
Pilot Project Leader: Abigail Strang, MD, Nemours
The primary objective of this project is to pilot test implementation of a protocol for enhanced asthma monitoring using novel technology, including mobile spirometry and remote study visits, for rural and medically underserved children with persistent asthma in Delaware and to determine its feasibility, acceptability, and accessibility. Additionally, the project aims to explore patient and family demographic characteristics and social factors associated with successful completion of the program and to explore the preliminary effect of the enhanced asthma monitoring program on asthma control and sleepiness as a measure of daytime functioning.
The results from this pilot study will be used to develop expanded intervention trials to assess the efficacy
of similar enhanced asthma monitoring interventional programs on asthma-specific outcomes.
Enhancing Implementation of School-based Antiracism Interventions
Pilot Project Leader: Danielle Hatchimonji, Ph.D., Nemours
The long-term goal of this research program is to use a community-based participatory research approach
to develop, test, and disseminate technology-enhanced social-emotional interventions that support educators in combatting both individual and structural racism. The research team is currently conducting an open pilot in a single Delaware K-8 school of “Actions Against Racism” (AAR) educator trainings geared toward improving educator skills and confidence for engaging in color conscious racial socialization with students.
The proposed community-engaged project moves this program of research forward by gathering information about current implementation practices and beginning the process of translating live AAR educator trainings into a web delivery format. The research team will build on existing partnerships with the Delaware Department of Education and educators throughout Delaware to document existing practices to combat racism and racial disparities. Because efforts to confront racism are often met with resistance, the team will also collect data on implementation barriers and facilitators to better understand the implementation landscape. The team will use these data to inform the translation of AAR live educator trainings into a web-based delivery, while continuously assessing the acceptability of this format.
Improving Equity in Pediatric Type 1 Diabetes Behavioral Care and Research
Pilot Project Leader: Julia Price, PhD, Nemours
The aim of this multimethod community engaged research is to develop pediatric Type 1 Diabetes (T1D) stakeholder partnerships that are essential to studies to improve equity in behavioral T1D intervention research and care. The project will develop strategies to increase engagement of African American families and/or families from low-income households in pediatric T1D behavioral intervention research and explore perspectives on existing pediatric behavioral T1D interventions from youth with T1D and their families who are underrepresented in research in this area.
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Results from this project will advance inclusion of underrepresented groups in future pediatric T1D
behavioral intervention studies, significantly improving the utility and relevance of this research in caring for families.
Developing a Caregiver-Based Inoculation Intervention to Prevent the Initiation of Unhealthy Alcohol Use in Adolescent Girls
Pilot Project Leader: Scott Siegel, PhD, Christiana Care
The overarching objective of this research is to develop a culturally-informed intervention designed to reduce the risk of engaging in unhealthy alcohol use for adolescent girls of color. This prevention intervention will be developed within an inoculation theory framework, a well-established approach to health communications that has been shown to outperform other types of messages for a range of health topics, including alcohol use.
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The first aim of this study is to conduct focus groups of Black/African-American and Hispanic/Latina/Latinx girls ages 13-17 from low-income communities in the qualitative assessment of candidate inoculation messages developed to reduce the risk of initiating unhealthy alcohol use. The second aim of this study is to conduct semi-structured interviews with a subset of the girls’ caregivers (i.e., parents/guardians) to assess their perspectives on acceptability of helping to deliver an inoculation-based intervention to their daughters.
Development of an Interactive Website to Support Decision Making at Periviable Gestations (<25 weeks)
Pilot Project Leader: Ursula Guillen, MD., Christiana Care
Decision aids (DA) are tools used to inform patients about potential outcomes and risks and benefits. This research team systematically developed 3 different DAs for antenatal counseling at 22-25 weeks’ gestational age (GA). These DAs have helped families make a decision when faced with a periviable delivery. Further individualization is needed to consider the specific social, cultural, and religions/spiritual values of each family. The research team hypothesizes that combining these decision aids into a unique web application will improve the quality of counseling and will help parents make informed decisions consistent with their values.
The proposed project will create an interactive website to improve the usefulness of three already-existing decision aids. This application will adapt and tailor the presentation of information based on goals and values identified by individual parents. In addition, we will also create new stand-alone vignettes to incorporate into the new website by updating the currently existing video aid. We will refine the new tool through focus groups and one-on-one interviews. Finally, we will assess the validity and helpfulness of the new tool in the target patient population.
Community Perspectives on Pediatric Health System Social Determinants of Health Screening & Community Resource Referrals
Pilot Project Leader: Abby Nerlinger, MD, MPH, Nemours
The long-term goal of this project is to incorporate CBO perspectives into healthcare system SDOH screening, referral, and closed-loop communication practices. The overall objective for this proposal is to conduct community-engaged quantitative surveys of CBOs, leading to a cross-sectional study of CBO characteristics and community resources in Delaware.
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The following specific aims will help attain the overall objective: 1) Assemble a Community Advisory Panel to guide community-engaged project design, including identification of CBOs that partner with healthcare systems in Delaware and development of surveys; 2) Using quantitative surveys of CBOs, conduct a cross-sectional study describing available community resources and CBO attitudes related to health system referrals; and 3) Characterize the relationship between population level social need and available community resources. Aim 3 will integrate survey data and population level data including the Child Opportunity Index and Delaware 211 information to quantify the relationship between social need and resources through both statistical methods and geocoding.