Mobile Integrated Care for Childhood Obesity (MICCO)
Research Project Leader: Thao-Ly Phan, MD, MPH
MICCO aims to improve the model of care for families of children with obesity living in rural communities by increasing access to evidence-based obesity care and tailoring obesity care to the needs of rural communities. Stakeholder-engaged and qualitative methods were used to refine the care model, which includes access to community-based resources to address family needs, visits with interdisciplinary specialists to establish healthy lifestyle goals, and tools to promote healthy lifestyle behaviors. Components of the intervention are enhanced by outreach from community health workers and a mobile platform integrated with the electronic health record.
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The care model is now being tested in a pilot randomized controlled trial with families from primary care practices in rural Delaware. Family engagement in care, child adiposity, and disparities in these outcomes will be contrasted between groups. The project aims to change practice paradigms by focusing on psychosocial determinants of childhood obesity, employing community-based resources and care navigators, leveraging Nemours’ state-of-the-art and user-friendly technology, and engaging stakeholders in all aspects of the project to ensure sustainable impact for families in rural Delaware.​
HEARTPrep: A virtually-delivered psychosocial intervention for mothers expecting a baby with congenital heart disease
Research Project Leader: Erica Sood, Ph.D.
HEARTPrep is an innovative psychosocial intervention for mothers expecting a baby with congenital heart disease (CHD), delivered in English and Spanish via mobile app. This project will refine HEARTPrep based on user feedback, determine whether HEARTPrep produces clinically significant improvements in maternal mental health (Proof-of-Concept), and conduct a randomized controlled trial with English- and Spanish-speaking mothers to evaluate preliminary efficacy.
HEARTPrep has the potential to improve maternal wellbeing after prenatal diagnosis of CHD and alter perinatal mental health trajectories during a critical period for maternal-infant bonding and infant development. If determined to be efficacious, this model of psychosocial care could be adapted for other birth defects (3% of all births), given commonalities in maternal stress reactions and the disproportionate burden of perinatal mental health problems in disadvantaged groups.
Type 1 Together: A Peer Mentorship Program to Bolster use of Continuous Glucose Monitoring Systems among Adolescents with Type 1 Diabetes
Research Project Leader: Paul Enlow, PhD
The objective of this project is to refine and pilot-test Type 1 Together, a technology-enhanced intervention to increase use of CGM among adolescents with T1D. In Type 1 Together, families will work with other families who have experience using CGM (Peer Mentors), have access to technology supports through the Nemours App, and will consult with a community health worker. In the Peer Mentor component, youth and their caregivers will work with a mentor family to overcome common barriers to CGM use.
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The Technology Supports will include access to family-centered educational materials and a digital journal to facilitate patient-provider communication around issues with CGM. Finally, they will receive support from a community health worker with expertise in pediatric diabetes.
NEmours Move to Enhance Systemic hypertension confirmation in primary care Sites (NEMESIS)
Research Project Leader: Carissa Baker-Smith, MD, MPH, MS
Most cases of hypertension in youth remain undiagnosed. Geographic distance from subspecialists who provide ambulatory blood pressure monitoring (ABPM) for hypertension confirmation, as well as a lack of information about such devices, may contribute to poor rates of hypertension diagnostic confirmation.
This project will utilize geospatial visualization tools to map areas of need and inadequate access, guiding targeted service provision, and will develop educational tools to enhance the uptake of ABPM. These efforts are needed to improve cardiac health.
Developing Dissemination Strategies to Advance the Reach of T1D Psychosocial Care
Research Project Leader: Julia Price, PhD
​The purpose of this project is to improve dissemination of evidence-based psychosocial Type 1 Diabetes (T1D) care directly to families to increase knowledge, engagement and utilization of this care and ultimately improve overall health for all with pediatric T1D.
Guided by the Framework for Knowledge Transfer, the current study will identify key factors for effective family-focused dissemination strategies, select, create and tailor strategies, and explore family perspectives on these strategies. This study will employ mixed methods and a community-engaged research approach.