Digital Commons Network^™

Β-Cell Impairment And Clinically Meaningful Alterations In Glycemia In Obese Youth Across The Glucose Tolerance Spectrum, Joon Young Kim, Hala Tfayli, Fida Bacha, Sojung Lee, Nour Gebara, Silva Arslanian

Children’s Nutrition Research Center Staff Publications

Background/aims: In obese youth, it is not clear what degree of β-cell impairment translates to glucose dysregulation commensurate with shifts from normal glucose tolerance (NGT) to impaired glucose tolerance (IGT) to type 2 diabetes. We aimed to investigate the quantitative relationship between β-cell (clamp-measured disposition index [DI]) and OGTT glucose area under the curve (G-AUC) in obese youth across the spectrum of glucose tolerance.

Methods: Data from 152 youth (58 African-American [AA] and 94 American-White [AW]; 73 NGT, 48 IGT, and 31 type 2 diabetes) who completed a 3-h hyperinsulinemic (80 mu/m2/min)-euglycemic clamp, and a 2-h hyperglycemic (225 mg/dL) clamp …

Variable Expression Of Msh6 In Endometrial Carcinomas With Intact Mismatch Repair And With Mlh1 Loss Due To Mlh1 Methylation, Nidhi Tandon, Courtney Hudgens, Bryan Fellman, Michael T Tetzlaff, Russell R Broaddus

Faculty, Staff and Student Publications

Immunohistochemistry for mismatch repair proteins MLH1, MSH2, MSH6, and PMS2 is an effective screen to detect individuals at risk for Lynch syndrome. College of American Pathologists guidelines stipulate that protein expression should be reported as present versus absent, as most patients with germline mutations in a mismatch repair gene have complete loss of protein expression in tumor cells. A similar approach is employed to screen for cancer patients eligible for immune checkpoint blockade. This "all or none" interpretive approach ignores substantial evidence that mismatch repair may be more finely regulated by other mechanisms. We have observed clinically that MSH6 expression …

Identification Of Novel Candidate Risk Genes For Myelomeningocele Within The Glucose Homeostasis/Oxidative Stress And Folate/One-Carbon Metabolism Networks, Paul Hillman, Craig Baker, Luke Hebert, Michael Brown, James Hixson, Allison Ashley-Koch, Alanna C Morrison, Hope Northrup, Kit Sing Au

Faculty, Staff and Student Publications

BACKGROUND: Neural tube defects (NTDs) are the second most common complex birth defect, yet, our understanding of the genetic contribution to their development remains incomplete. Two environmental factors associated with NTDs are Folate and One Carbon Metabolism (FOCM) and Glucose Homeostasis and Oxidative Stress (GHOS). Utilizing next-generation sequencing of a large patient cohort, we identify novel candidate genes in these two networks to provide insights into NTD mechanisms.

METHODS: Exome sequencing (ES) was performed in 511 patients, born with myelomeningocele, divided between European American and Mexican American ethnicities. Healthy control data from the Genome Aggregation database were ethnically matched and …

Prenatal Depression And Risk Of Short Interpregnancy Interval In A Predominantly Puerto Rican Population, Sami Backley, Alex Knee, Penelope Pekow, Glenn Markenson, Katharine O White, Corina Schoen, Lisa Chasan-Taber

Faculty, Staff and Student Publications

Background: Short interpregnancy interval (IPI) is associated with risk of adverse pregnancy outcomes; however, few studies have evaluated the role of depression as a risk factor for short IPI. Puerto Rican women in the United States experience disparities in adverse birth outcomes and have the highest birth rates.

Methods: We analyzed the association between prenatal depressive symptoms and IPI in Proyecto Buena Salud, a prospective cohort of predominantly Puerto Rican women in Western Massachusetts (2006–2011). Depression was measured using the Edinburgh Postnatal Depression Scale (EPDS) in early, mid, and late pregnancy. We calculated follow-up time as the difference between the …

Aerosol Generation With Common Rhinologic Devices: Cadaveric Study Conducted In A Surgical Suite, Bailey Leconte, Garren M I Low, Martin J Citardi, William C Yao, Arturo A Eguia, Amber U Luong

Faculty, Staff and Student Publications

No abstract provided.

Maternal Hookworm Infection And Its Effects On Maternal Health: A Systematic Review And Meta-Analysis, Tara E Ness, Vedika Agrawal, Kathryn Bedard, Lara Ouellette, Timothy A Erickson, Peter Hotez, Jill E Weatherhead

Library Staff Publications

Hookworm is an intestinal parasite that infects nearly 230 million people, with another 5.1 billion at risk, especially in poverty-stricken tropical and subtropical regions. Pregnancy is an especially vulnerable time for hookworm infection because of its effect on both maternal and subsequently fetal health. A systematic review and meta-analysis was conducted. The meta-analysis was performed on the association between maternal hookworm and maternal anemia, as well as maternal hookworm coinfection with malaria. The prevalence of hookworm ranged from 1% to 78% in pregnant women, whereas malaria prevalence ranged from 11% to 81%. Pregnant women with hookworm infection were more likely …

Donor And Transplant Candidate Selection For Solid Organ Transplantation During The Covid-19 Pandemic, N Thao N Galvan, Nicolas F Moreno, Jay E Garza, Susan Bourgeois, Marion Hemmersbach-Miller, Bhamidipati Murthy, Katherine Timmins, Christine A O'Mahony, James Anton, Andrew Civitello, Puneet Garcha, Gabe Loor, Kenneth Liao, Alexis Shaffi, John Vierling, Rise Stribling, Abbas Rana, John A Goss

Faculty, Staff and Students Publications

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a novel coronavirus responsible for a worldwide pandemic has forced drastic changes in medical practice in an alarmingly short period of time. Caregivers must modify their strategies as well as optimize the utilization of resources to ensure public and patient safety. For organ transplantation, in particular, the loss of lifesaving organs for transplantation could lead to increased waitlist mortality. The priority is to select uninfected donors to transplant uninfected recipients while maintaining safety for health care systems in the backdrop of a virulent pandemic. We do not yet have a standard approach to evaluating …

Pr Depression With Multilead St Elevation And St Depression In Avr By Left Circumflex Artery Occlusion: How To Differentiate From Acute Pericarditis, Zhong-Qun Zhan, Kjell Nikus, Yochai Birnbaum

Faculty, Staff and Students Publications

PR-segment depression with multilead ST-segment elevation and ST-segment depression in lead aVR are classic ECG manifestation of acute pericarditis. We present a patient, where the etiology of these ECG features was acute ST-elevation myocardial infarction due to left circumflex artery occlusion. To avoid misdiagnosis, unnecessary examinations, and inappropriate therapeutic decisions, the possibility of ST-segment elevation myocardial infarction should be kept in mind even when ECG changes typical for pericarditis are encountered in chest pain patients. Findings of QRS widening and QT interval shortening in leads with ST-segment elevation could help to differentiate acute ST-segment elevation myocardial infarction from acute pericarditis.

Chronic Ulcers And Malnutrition In An African Patient\, Timothy G Singer, Monica A Bray, Audrey Chan, Saki Ikeda, Brittany Walters, Maren Y Fuller, Carla Falco

Faculty, Staff and Students Publications

An 11-year-old female with a congenitally malformed left hand, sickle-cell trait, asthma, and history of appendicitis was transferred from Zambia for evaluation and treatment of widespread suppurative and ulcerative skin lesions that typically appeared following trauma to her skin. The ulcers first presented 3 years earlier but had markedly worsened in the 9 months prior to transfer, spreading circumferentially on her extremities and abdomen at the site of an appendectomy. They were painful and did not resolve with multiple courses of intravenous (IV) antibiotics and close management by a Pediatric Infectious Disease specialist working for a non-governmental organization (NGO) in …

Genetics Of Smoking Behaviors In American Indians, Jeffrey A Henderson, Dedra S Buchwald, Barbara V Howard, Patricia Nez Henderson, Yafang Li, Rachel F Tyndale, Christopher I Amos, Olga Y Gorlova, Collaborative To Improve Native Cancer Outcomes (Cinco), A P50 Center For Population Health And Health Disparities Program Project Sponsored By The National Cancer Institute

Faculty, Staff and Students Publications

BACKGROUND: The smoking behavior of American Indians (AI) differs from that of non-Hispanic whites (NHW). Typically light smokers, cessation interventions in AIs are generally less effective. To develop more effective cessation programs for AIs, clinicians, researchers, and public health workers need a better understanding of the genetic factors involved in their smoking behavior. Our aim was to assess whether SNPs associated with smoking behavior in NHWs are also associated with smoking in AIs.

METHODS: We collected questionnaire data on smoking behaviors and analyzed blood and saliva samples from two Tribal populations with dramatically different cultures and smoking prevalence, one in …

Improving Therapeutic Potential Of Non-Viral Minimized Dna Vectors, Lirio M Arévalo-Soliz, Cinnamon L Hardee, Jonathan M Fogg, Nathan R Corman, Cameron Noorbakhsh, Lynn Zechiedrich

Faculty, Staff and Students Publications

The tragic deaths of three patients in a recent AAV-based X-linked myotubular myopathy clinical trial highlight once again the pressing need for safe and reliable gene delivery vectors. Non-viral minimized DNA vectors offer one possible way to meet this need. Recent pre-clinical results with minimized DNA vectors have yielded promising outcomes in cancer therapy, stem cell therapy, stem cell reprograming, and other uses. Broad clinical use of these vectors, however, remains to be realized. Further advances in vector design and production are ongoing. An intriguing and promising potential development results from manipulation of the specific shape of non-viral minimized DNA …

Povidone-Iodine Solution As Sars-Cov-2 Prophylaxis For Procedures Of The Upper Aerodigestive Tract A Theoretical Framework, Syed H S Naqvi, Martin J Citardi, Davide Cattano, Luis Ostrosky-Zeichner, Mark I Knackstedt, Ron J Karni

Faculty, Staff and Student Publications

BACKGROUND: The COVID-19 pandemic has raised concerns of inadvertent SARS-CoV-2 transmission to healthcare workers during routine procedures of the aerodigestive tract in asymptomatic COVID-19 patients. Current efforts to mitigate this risk focus on Personal Protective Equipment, including high-efficiency filtration as well as other measures. Because the reservoir for SARS-CoV-2 shedding is in the nasopharynx and nasal and oral cavities, the application of viricidal agents to these surfaces may reduce virus burden. Numerous studies have confirmed that povidone-iodine inactivates many common respiratory viruses, including SARS-CoV-1. Povidone-iodine also has good profile for mucosal tolerance. Thus, we propose a prophylactic treatment protocol for …

Outcomes After In Utero Myelomeningocele Repair Based On Delivery Location, Eric P Bergh, Kuojen Tsao, Mary T Austin, Stephen A Fletcher, Suzanne M Lopez, Kenneth J Moise, Anthony Johnson, Ramesha Papanna

Faculty, Staff and Student Publications

Maternal and pediatric delivery outcomes may vary in patients who underwent open fetal myelomeningocele repair and elected to deliver at the fetal center where their fetal intervention was performed versus at the referring physician’s hospital. A prospective cohort study of 88 patients were evaluated following in utero open fetal myelomeningocele repair at a single fetal center between the years 2011–2019. Exclusion criteria included patients that delivered within two weeks of the procedure (n = 6), or if a patient was lost to follow-up (n = 1). Of 82 patients meeting inclusion criteria, 36 (44%) patients were delivered at …

Outcomes After In Utero Myelomeningocele Repair Based On Delivery Location, Eric P Bergh, Kuojen Tsao, Mary T Austin, Stephen A Fletcher, Suzanne M Lopez, Kenneth J Moise, Anthony Johnson, Ramesha Papanna

Faculty, Staff and Student Publications

Maternal and pediatric delivery outcomes may vary in patients who underwent open fetal myelomeningocele repair and elected to deliver at the fetal center where their fetal intervention was performed versus at the referring physician’s hospital. A prospective cohort study of 88 patients were evaluated following in utero open fetal myelomeningocele repair at a single fetal center between the years 2011–2019. Exclusion criteria included patients that delivered within two weeks of the procedure (n = 6), or if a patient was lost to follow-up (n = 1). Of 82 patients meeting inclusion criteria, 36 (44%) patients were delivered at …

Cd123 As A Biomarker In Hematolymphoid Malignancies: Principles Of Detection And Targeted Therapies, Hanadi El Achi, Edouard Dupont, Shilpa Paul, Joseph D Khoury

Faculty, Staff and Student Publications

CD123, the α chain of the interleukin 3 receptor, is a cytokine receptor that is overexpressed in multiple hematolymphoid neoplasms, including acute myeloid leukemia, blastic plasmacytoid dendritic cell neoplasm, acute lymphoblastic leukemia, hairy cell leukemia, and systemic mastocytosis. Importantly, CD123 expression is upregulated in leukemic stem cells relative to non-neoplastic hematopoietic stem cells, which makes it a useful diagnostic and therapeutic biomarker in hematologic malignancies. Varying levels of evidence have shown that CD123-targeted therapy represents a promising therapeutic approach in several cancers. Tagraxofusp, an anti-CD123 antibody conjugated to a diphtheria toxin, has been approved for use in patients with blastic …

Integration Of Behavioral Health Services Into Primary Pediatric Care: The Behind The Scenes Story Of A Pilot Study In Southeast, Texas, Stephanie Chapman, Nancy Correa, Angela Cummings, Bethanie S. Van Horne, Heidi Schwarzwald

Journal of Applied Research on Children: Informing Policy for Children at Risk

Behavioral health integration in primary care is identified as an important strategy to achieve early identification and treatment of behavioral health disorders. This paper describes a pilot project designed to test the feasibility and sustainability of integrating behavioral health into pediatric primary care clinics. Five private, fee for service pediatric primary care practices were identified in the greater Houston area to establish behavioral health integration. The practices were supported with establishment of behavioral health integration, specifically with recruitment of the behavioral health provider, training of the clinical and administrative teams, and development of interdisciplinary clinical protocols. Difficulties in implementation included …

Implementation Evaluation Of An Education Program In Pediatric Clinics, Yen H. Nong, Kimberly Kay Lopez, Dorothy Mandell

Journal of Applied Research on Children: Informing Policy for Children at Risk

Background: A public health approach to child maltreatment prevention relies on programs that impact the underlying drivers of maltreatment and that can easily be implemented. Stress in the family, mental illness, unrealistic expectations, and lack of knowledge have all been shown to be preceding factors in maltreatment risk. To help address some of these risks, an education program consisting of the Period of PURPLE crying, a social and economic stressor questionnaire, and the Parenting Action Plan was designed for maternal caregivers of newborns at pediatric clinics. This paper explores implementation challenges and successes of the education program, and describes strategies …

Association Of Visceral Adipose Tissue And Subclinical Atherosclerosis In Us-Born Mexican Americans But Not First Generation Immigrants, Clarence Gill, Miryoung Lee, Kristina P Vatcheva, Nahid Rianon, Beverly Smulevitz, David D Mcpherson, Joseph B Mccormick, Susan P Fisher-Hoch, Susan T Laing

Faculty, Staff and Student Publications

Background Excess visceral adipose tissue (VAT) is a primary driver for the cardiometabolic complications of obesity; VAT-associated cardiovascular disease risk varies by race, but most studies have been done on Non-Hispanics. This study aimed to evaluate the clinical and metabolic correlates of VAT, its association with subclinical atherosclerosis, and the factors affecting this association in Mexican Americans. Methods and Results Participants (n=527) were drawn from the Cameron County Hispanic Cohort (CCHC), on whom a carotid ultrasound to assess carotid intima media thickness and a dual-energy X-ray absorptiometry scan to assess for VAT were obtained. Those in the highest quartiles of …

Antioxidant Carbon Nanoparticles Inhibit Fibroblast-Like Synoviocyte Invasiveness And Reduce Disease Severity In A Rat Model Of Rheumatoid Arthritis, Mark R Tanner, Redwan Huq, William K A Sikkema, Lizanne G Nilewski, Nejla Yosef, Cody Schmitt, Carlos P Flores-Suarez, Arielle Raugh, Teresina Laragione, Pércio S Gulko, James M Tour, Christine Beeton

Faculty, Staff and Students Publications

Reactive oxygen species have been involved in the pathogenesis of rheumatoid arthritis (RA). Our goal was to determine the effects of selectively scavenging superoxide (O2•−) and hydroxyl radicals with antioxidant nanoparticles, called poly(ethylene glycol)-functionalized hydrophilic carbon clusters (PEG-HCCs), on the pathogenic functions of fibroblast-like synoviocytes (FLS) from patients with rheumatoid arthritis (RA) and on the progression of an animal model of RA. We used human FLS from patients with RA to determine PEG-HCC internalization and effects on FLS cytotoxicity, invasiveness, proliferation, and production of proteases. We used the pristane-induced arthritis (PIA) rat model of RA to assess the benefits of …

Tumor Somatic Mutations Also Existing As Germline Polymorphisms May Help To Identify Functional Snps From Genome-Wide Association Studies, Ivan P Gorlov, Xiangjun Xia, Spiridon Tsavachidis, Olga Y Gorlova, Christopher I Amos

Faculty, Staff and Students Publications

We hypothesized that a joint analysis of cancer risk-associated single-nucleotide polymorphism (SNP) and somatic mutations in tumor samples can predict functional and potentially causal SNPs from GWASs. We used mutations reported in the Catalog of Somatic Mutations in Cancer (COSMIC). Confirmed somatic mutations were subdivided into two groups: (1) mutations reported as SNPs, which we call mutational/SNPs and (2) somatic mutations that are not reported as SNPs, which we call mutational/noSNPs. It is generally accepted that the number of times a somatic mutation is reported in COSMIC correlates with its selective advantage to tumors, with more frequently reported mutations being …

Factors Promoting Or Preventing Caregivers From Allowing Pediatric Participation In Research, José R. Fernández, Thomas Taylor, Yenni E. Cedillo, Beatriz Maciel, Daria Salyakina, Jennifer Mccafferty

Journal of Applied Research on Children: Informing Policy for Children at Risk

Introduction The likelihood of a child participating in a clinical trial is mostly independent of the child’s willingness to participate; children’s lack of autonomy obliges parental involvement, which is concurrently conditional to parental understanding, trust and endorsement of the research study. Objectives To identify potential predictors for allowing children to participate in clinical studies and to evaluate if motivators that promote or prevent parental support of children to participate in clinical studies differed according to racial/ethnic categorization.

Methods A stratified sample of 1,057 caregivers of children 1-18 years old who in 2015 resided in South Florida’s Miami-Dade, Broward, and Palm …

Adaptive Thermogenesis Enhances The Life-Threatening Response To Heat In Mice With An Ryr1 Mutation, Hui J Wang, Chang Seok Lee, Rachel Sue Zhen Yee, Linda Groom, Inbar Friedman, Lyle Babcock, Dimitra K Georgiou, Jin Hong, Amy D Hanna, Joseph Recio, Jong Min Choi, Ting Chang, Nadia H Agha, Jonathan Romero, Poonam Sarkar, Nicol Voermans, M Waleed Gaber, Sung Yun Jung, Matthew L Baker, Robia G Pautler, Robert T Dirksen, Sheila Riazi, Susan L Hamilton

Faculty, Staff and Students Publications

Mutations in the skeletal muscle Ca2+ release channel, the type 1 ryanodine receptor (RYR1), cause malignant hyperthermia susceptibility (MHS) and a life-threatening sensitivity to heat, which is most severe in children. Mice with an MHS-associated mutation in Ryr1 (Y524S, YS) display lethal muscle contractures in response to heat. Here we show that the heat response in the YS mice is exacerbated by brown fat adaptive thermogenesis. In addition, the YS mice have more brown adipose tissue thermogenic capacity than their littermate controls. Blood lactate levels are elevated in both heat-sensitive MHS patients with RYR1 mutations and YS mice due to …

Potential Scenarios And Hazards In The Work Of The Future: A Systematic Review Of The Peer-Reviewed And Gray Literatures, Paul A Schulte, Jessica M K Streit, Fatima Sheriff, George Delclos, Sarah A Felknor, Sara L Tamers, Sherry Fendinger, James Grosch, Robert Sala

Faculty, Staff and Student Publications

It would be useful for researchers, practitioners, and decision-makers to anticipate the hazards that workers will face in the future. The focus of this study is a systematic review of published information to identify and characterize scenarios and hazards in the future of work. Eleven bibliographic databases were systematically searched for papers and reports published from 1999 to 2019 that described future of work scenarios or identified future work-related hazards. to compile a comprehensive collection of views of the future, supplemental and ad hoc searches were also performed. After screening all search records against a set of predetermined criteria, the …

Feasibility And Potential Efficacy Of Commercial Mhealth/Ehealth Tools For Weight Loss In African American Breast Cancer Survivors: Pilot Randomized Controlled Trial, Jeanne M Ferrante, Katie A Devine, Alicja Bator, Ashley Rodgers, Pamela A Ohman-Strickland, Elisa V Bandera, Kevin O Hwang

Faculty, Staff and Student Publications

Weight management after breast cancer (BC) treatment in African American (AA) women is crucial to reduce comorbid conditions and health disparities. We examined feasibility and potential efficacy of commercial eHealth/mHealth tools for weight management in AA BC survivors in New Jersey. Participants (N = 35) were randomized to an intervention (SparkPeople) plus activity tracker, Fitbit Charge (n = 18), or wait-list active control group (Fitbit only, n = 17). Anthropometric, behavioral, and quality of life (QOL) outcomes were collected at baseline, 3, 6, and 12 months. Differences in outcomes were assessed using intent-to-treat analysis. Retention was 97.1%. Both groups lost …

Risk Prediction Rule For Advanced Neoplasia On Screening Colonoscopy For Average-Risk Individuals, Ala I Sharara, Ali El Mokahal, Ali H Harb, Natalia Khalaf, Fayez S Sarkis, Mustapha M El-Halabi, Nabil M Mansour, Ahmad Malli, Robert Habib

Faculty, Staff and Students Publications

BACKGROUND: In resource-limited countries, risk stratification can be used to optimize colorectal cancer screening. Few prospective risk prediction models exist for advanced neoplasia (AN) in true average-risk individuals.

AIM: To create and internally validate a risk prediction model for detection of AN in average-risk individuals.

METHODS: Prospective study of asymptomatic individuals undergoing first screening colonoscopy. Detailed characteristics including diet, exercise and medications were collected. Multivariate logistic regression was used to elucidate risk factors for AN (adenoma ≥1 cm, villous histology, high-grade dysplasia or carcinoma). The model was validated through bootstrapping, and discrimination and calibration of the model were assessed.

RESULTS: …

Details Matter: A Quality Improvement Study On Screening For Intimate Partner Violence At A Labor And Delivery Hospital, Nancy P. Correa

Journal of Applied Research on Children: Informing Policy for Children at Risk

Background: It is estimated that one in three women will experience intimate partner violence (IPV) in their life time. It is recommended that healthcare professional screen patients for IPV, but screening rates and positive disclosure rates remain low. Best practices for screening for IPV in the healthcare setting include screening alone, showing compassion and non-judgement, asking specific and direct questions, and using a framing statement before the screening occurs.

Methods: A review of the screening protocol for IPV at a labor and delivery hospital revealed high screening rates (88%), low positive disclosure rates (0.43%), and that some best practices were …

The Implementation And Scaling Of An Early Education Program, April Crawford, Phd, Cheryl Varghese, Phd, Pauline Monsegue-Bailey, Phd

Journal of Applied Research on Children: Informing Policy for Children at Risk

The current paper discusses the implementation and scaling of an early education program (Texas School Ready; TSR). Implementation and scaling of the TSR program was initially met with challenges such as participant/site recruitment, participant retention, and staff training. The three challenges are highlighted along with the ways in which delivery and support systems were used to address and mitigate these challenges. Additionally, we highlight several key continuous quality improvement measures (for administrators, coaches/coordinators, teachers, and students) that are used to monitor and improve the implementation of the TSR program across the state. Collectively, the delivery and support systems along with …

Should Nurses Screen Pediatric Medical Inpatients For Suicide Risk? Perspectives From Nurses And Their Patients, Abigail M. Ross, Elizabeth Wharff, Lisa Horowitz

Journal of Applied Research on Children: Informing Policy for Children at Risk

Background: Suicide is the second leading cause of death among adolescents; age-adjusted suicide rate increased 30% from 2000-2016. Medical illnesses are a known risk factor for suicide, establishing medical settings as a key venue for detecting suicide risk. Nurses have the potential to play a critical role in early detection of medically ill patients at elevated risk for suicide. Conducted in tandem with a larger instrument validation study, this study examines nurses’ awareness of pediatric medical inpatients’ experiences with being asked about suicide, their opinions about whether nurses should screen for suicide risk in the medical inpatient setting, and perceived …

Adopting And Growing A Community-Based Early Language Program: Challenges And Solutions For Implementation Success, Cary M. Cain, Kimberly Kay Lopez, Lynda Chima Aririguzo, Angela Cummings

Journal of Applied Research on Children: Informing Policy for Children at Risk

The number of interventions focused on early language development in young children has increased over the past decade. There is a paucity of research on the adoption and implementation of these programs in real-world community settings. This study presents findings from qualitative interviews with leadership, staff, and past participants of a community-based early language development intervention. Themes related to program implementation challenges and solutions are presented. Previous program participants (n=16) identified facilitators and barriers to successful program implementation and provided specific recommendations for program improvements. Interviews with the program leadership and staff (n=6) revealed two main themes: Servant leadership and …

Factors Influencing The Implementation Of Social Determinants Of Health Screening And Referral Processes In Pediatric Settings Serving Medically Complex Patients, Katelyn K. Jetelina, Patricia Rodriguez, Oluwaseun K. Oke, M. Sunil Mathew, Susan Schoppa, Quiera Booker-Nubie, Sarah E. Messiah

Journal of Applied Research on Children: Informing Policy for Children at Risk

Background: Equitable healthcare outcomes are compromised in the absence of strong medical care and social services linkages. In May 2019, Children’s Health, the largest health system for pediatric care in North Texas, initiated a three-pronged social determinants of health (SDOH) quality improvement (QI) project that included: 1) baseline and ongoing clinical team training; 2) implementation of an electronic health record (EHR)-embedded SDOH screening tool; and 3) patient referrals to community resources in three inpatient hospital units and one outpatient specialty clinic serving medically complex patients. The purpose of the study is to identify hospital unit/clinic-level implementation factors associated with …