Mother and child with doctor

Influences of health and environmental deprivation on family relationships among children with chronic disease

Influences of health and environmental deprivation on family relationships among children with chronic disease

Families are often the primary source of close, comforting relationships for children and adolescents. Among chronically ill children, families play a critical role in managing aspects of the disease, often on a daily basis.

In this publication, authors including HIP Investigator, Dr. Elizabeth Cox used the Patient-Reported Outcomes Measurement Information System (PROMIS) Family Relationships measure over time to understand how family relationships are influenced by these three factors—the characteristics of the child and parent, environmental deprivation, and health over time, among children 8–17 years of age with one of three chronic illnesses (asthma, type 1 diabetes [diabetes], and sickle cell disease).

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Little girl sleeping hospital bed

Considerations to Support Use of Patient-Reported Outcomes Measurement Information System Pediatric Measures in Ambulatory Clinics

Considerations to Support Use of Patient-Reported Outcomes Measurement Information System Pediatric Measures in Ambulatory Clinics

Patient-reported outcome (PRO) measures quantify patient health and health-related experiences directly from the patient perspective, which is important for patient-centered care. PROs can be used to monitor trends in patients’ symptoms, function, or well-being; to inform decision-making; and to prompt additional patient education or referrals. Use of PRO scores in clinical practice has improved recall of patient concerns by clinicians, increased shared decision-making, and enhanced care processes and treatment planning.

The National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) provides standardized PRO measures for use in clinical practice, with specific measures available for adults, children from 8 to 17 years of age, and parent proxies for children 5-17 years old. In this publication, HIP Investigator Dr. Elizabeth Cox et al. sought to find the benefits of using PROMIS measures in pediatric clinical settings, health system and clinician leaders must attend to how the measures are implemented and used, as well as the support required to achieve this goal.

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Problematic Internet Use: A Longitudinal Study Evaluating Prevalence and Predictor

Problematic Internet Use: A Longitudinal Study Evaluating Prevalence and Predictor

Problematic internet use has been associated with poor academic performance, stress, and fewer positive health behaviors. Studies also have suggested bidirectional relationships between problematic internet use and other mental health conditions, such as depression.

In this publication, authors including HIP Investigator Dr. Elizabeth Cox evaluated the prevalence estimate and predictors of problematic internet use over time among college students and identified an intermediate-risk PRIUSS score toward earlier identification of being at risk.

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Girl in wheelchair

Stakeholder Perspectives in Anticipation of Sharing Physicians’ Notes With Parents of Hospitalized Children

Stakeholder Perspectives in Anticipation of Sharing Physicians’ Notes With Parents of Hospitalized Children

Sharing honest, unbiased health information with parents is endorsed by the American Academy of Pediatrics as an important way to improve the quality and safety of pediatric care. To increase information transparency, a growing number of hospitals have adopted inpatient portals, online applications on tablet computers that provide parents with real-time clinical information from the electronic health record (EHR) at their hospitalized child's bedside.

In this publication, authors including HIP Investigator, Dr. Ryan Coller Coller identified the perspectives of parent, physician, nurse, and hospital administrator stakeholders on the anticipated benefits and challenges of giving parents access to physicians’ notes during hospitalization and strategies on how to implement the note sharing process most effectively.

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Doctor working with mobile phone and stethoscope

Linking Parent Confidence and Hospitalization through Mobile Health: A Multisite Pilot Study

Linking Parent Confidence and Hospitalization through Mobile Health: A Multisite Pilot Study

In this publication, authors including HIP Investigator, Dr. Ryan Coller conducted a multisite pilot study of an mHealth platform with CMC caregivers (Assessing Confidence at Times of Increased Vulnerability [ACTIV]). ACTIV uses longitudinal text messaging to prospectively monitor parent confidence for their child to avoid hospitalization over the subsequent month. Their aim was to identify associations between ACTIV's repeated measures and CMC hospitalization, and to evaluate ACTIV's feasibility/acceptability when implemented within a complex care program.

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WMJ: Impact of Race and Racism on Health

Identifying Substantial Racial and Ethnic Disparities in Health Outcomes and Care in Wisconsin Using Electronic Health Record Data

Identifying Substantial Racial and Ethnic Disparities in Health Outcomes and Care in Wisconsin Using Electronic Health Record Data

Although Wisconsin ranks highly in overall health care quality, the state performs poorly with respect to health disparities. To eliminate health disparities in Wisconsin, it is critical to understand where disparities exist.

Measuring disparities in health outcomes and care allows for benchmarking of current performance and monitoring changes over time. Measurement also allows stakeholders to prioritize efforts and develop and implement programs for the populations that are most impacted by disparities. Authors including HIP Investigator, Dr. Maureen Smith identified racial and ethnic disparities in health outcome and care measures in Wisconsin.

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View the Wisconsin Health Disparities Reports

View Wisconsin Health Disparities Report Appendices

Father and son wearing masks

COVID-19 and the Well-being of Children and Families

COVID-19 and the Well-being of Children and Families

Pandemics disturb individual and community well-being through direct effects of the illness and through emotional isolation, economic loss, work and school closure, and inadequate distribution of needed resources, among others.

Because data suggest that children might less frequently transmit or become severely ill from the virus, the unique consequences that COVID-19 exerts on children risk being overlooked. In this article, HIP Investigator Dr. Ryan Coller and Dr. Sarah Webber review findings on how COVID-19 has affected the physical and emotional health of US parents and children.

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Priorities and Outcomes for Youth-Adult Transitions in Hospital Care: Perspectives of Inpatient Clinical Leaders at US Children's Hospitals

Priorities and Outcomes for Youth-Adult Transitions in Hospital Care: Perspectives of Inpatient Clinical Leaders at US Children's Hospitals

Adults with chronic conditions originating in childhood experience ongoing hospitalizations; however, efforts to guide youth-adult transitions rarely address transitioning to adult-oriented inpatient care. A group of authors including HIP Investigator, Dr. Ryan Coller identified the perceptions of clinical leaders on important and feasible inpatient transition activities and outcomes, including when, how, and for whom inpatient transition processes are needed.

Authors found that children's hospital clinical leaders rated inpatient youth-adult transition activities and outcome measures as important and feasible; however, feasibility may ultimately drive implementation.

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Child in hospital with IV

The Intersection of Complex Care and Hospital Medicine: Opportunities to Advance Health for Chronically Ill Populations

The Intersection of Complex Care and Hospital Medicine: Opportunities to Advance Health for Chronically Ill Populations

Children with medical complexity (CMC) are a high-need, high-cost population representing 1% of all children yet accounting for nearly one-third of all child health-related costs. Parents of CMC take responsibility for the vast majority of caregiving and face many challenges in doing so. Caregivers themselves experience physical and mental health problems that can compromise their ability to effectively perform caregiving tasks. Additionally, direct clinical encounters for CMC in health care settings are often inefficient and poorly coordinated.

Pediatric hospitalists have an essential role to play in the development of innovative solutions to improve care for CMC. In response, hospitalists have been integral in refining and studying structured complex care programs for CMC. In this article, HIP Investigator, Dr. Ryan Coller et al. evaluated complex care program efforts to improve care for CMC.

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Codesign and Usability Testing of a Mobile Application to Support Family-Delivered Enteral Tube Care

Codesign and Usability Testing of a Mobile Application to Support Family-Delivered Enteral Tube Care

Enteral tubes are prevalent among children with medical complexity (CMC), and complications can lead to costly health care use. Using a human-centered codesign process, authors including HIP Investigator, Dr. Ryan Coller, created a highly usable mobile application to support enteral tube caregiving at home. Future work involves evaluating the feasibility of longitudinal use and effectiveness in improving self-efficacy and reduce device complications.

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