A5027820482- Adolescent and Pediatric Healthcare
- Child and Adolescent Health
- Healthcare Policy and Management
- Primary Care and Health Outcomes
- Child and Adolescent Psychosocial and Emotional Development
- Emergency and Acute Care Studies
- Gastroesophageal reflux and treatments
- Childhood Cancer Survivors' Quality of Life
- Attention Deficit Hyperactivity Disorder
- Infant Development and Preterm Care
- Healthcare Systems and Technology
- Interprofessional Education and Collaboration
- Neurogenetic and Muscular Disorders Research
- Gastrointestinal motility and disorders
- Genomics and Rare Diseases
- Metabolism and Genetic Disorders
- Clinical Nutrition and Gastroenterology
- Food Security and Health in Diverse Populations
- Innovations in Medical Education
- Congenital gastrointestinal and neural anomalies
- Child Nutrition and Feeding Issues
- Patient-Provider Communication in Healthcare
- BRCA gene mutations in cancer
- Chronic Disease Management Strategies
- Medical Education and Admissions
University of North Carolina at Chapel Hill
2016-2025
University of North Carolina Health Care
2016-2023
Patient-Centered Outcomes Research Institute
2023
Duke University
2023
Cecil College
2016
National Institute for Public Health and the Environment
2004
Many infants, particularly those born premature or with medical complexity, require supplemental enteral nutrition upon discharge from birth hospitalization. Recent literature supports the safety of discharging infants nasogastric tube (NG) feeding. However, further evidence is needed to characterize populations suited for home NG feeding compared gastrostomy (GT) placement. This study aimed describe demographic and clinical differences between discharged hospitalization vs. GT retrospective...
Objectives/Goals: Youth with IBD have preventive, psychosocial, and acute care needs beyond those of peers, yet receipt services does not match needs. Our objectives are to assess the feasibility (1) an individualized plan intervention improve perceived measured quality (2) a pragmatic trial design embedded in pediatric practice. Methods/Study Population: This is pilot rollout-design randomized (n = 60) at regional academic medical center. Eligible patients 13–19 years old for least 3 months...
ABSTRACT Objectives: The aim of the study was to examine prevalence diagnosis and treatment for constipation among children receiving Medicaid compare healthcare utilization spending based on number complex chronic conditions (CCCs). Methods: Retrospective cohort 4.9 million ages 1 17 years enrolled in from 2009 2011 10 states Truven Marketscan Database. Constipation identified using International Classification Disease, 9th revision codes (564.0x), intestinal impaction (560.3x), or...
Pediatric hospital readmissions can represent gaps in care quality between discharge and follow-up, including social factors not typically addressed by hospitals. This study aimed to reduce the 30-day pediatric readmission rate on 2 general services through an intervention enhance spanning stay, discharge, follow-up process.A multidisciplinary team developed bundle based a needs assessment evidence-based models of transitional care. The included pre-discharge planning with transition...
Children with special health care needs (CSHCN) require comprehensive high levels of community and government assistance. Medical–legal partnerships may be particularly suited to address for this population. To explore this, we conducted in-depth telephone interviews families CSHCN cared in the primary practice our tertiary children’s hospital. The majority sample (N = 46) had been late on housing payments 17% homeowners threatened foreclosure. Families frequently reported denial public...
OBJECTIVE: Families raising children with autism contribute significant amounts to the cost of care. In this era health care reform, families have more insurance choices, but people are unfamiliar terms. This study uses 2 national data sets examine ratings from parents and child expenditures explore how these measures align. METHODS: Children who met criteria for special needs were continuously insured examined. Data National Survey With Special Health Care Needs 2009–2010 used parent report...
Adolescents with inflammatory bowel disease (IBD) are at an increased risk of anxiety and depression compared to peers, but availability mental health services in IBD clinics does not meet patients’ needs, use primary care for screening is low. This study provides qualitative data regarding adolescent caregiver perspectives on addressing IBD. Interviews were conducted adolescents caregivers Interview transcripts coded analyzed prominent themes. Thirteen fourteen interviewed. Three themes...
At least one in five North Carolinians is an informal caregiver for a relative or friend with serious health problem, illness, disability. Existing state-level systems are inadequate to support caregivers' needs. We propose 10 recommendations adopting life course perspective address needs across Carolina's diverse population.
We studied constipation-related health care among children before and after constipation admission. Index admissions for in 2010-2011 were identified the Truven Marketscan Database, which includes receiving Medicaid 10 states. measured number of spending outpatient visits 12 months index hospitalizations. also hospitalizations rehospitalization rate. There 780 admissions. The median was 1 (interquartile range [IQR] = 0, 3) 2 (IQR [0, 4]) admission ( P .001). Median $110 429]) $132 431]) .2)....
BACKGROUND AND OBJECTIVES: Although national bodies have proclaimed the importance of incorporating quality improvement (QI) into daily fabric clinical care, actual proportion practicing pediatricians who participate in QI activities on an annual basis is unknown. Correspondingly little known about pediatrician motivations for, attitudes about, and support received for participation. METHODS: Pediatric diplomates enrolling American Board Pediatrics’ Maintenance Certification program during...
Abstract Background Children with medical complexity (CMC) have inter-related health and social needs; however, interventions to identify respond needs not been adapted for CMC. The objective of this study was evaluate the feasibility implementing screening assessment within pediatric complex care programs. Methods We implemented systematic CMC (SSNAC) at two tertiary centers in three phases: (1) pre-implementation, (2) implementation, (3) implementation monitoring. utilized a multifaceted...
Results | The 2 NDDs that had the largest association with bullying exposure were ASD and ADHD (Figure 1).Special health care needs (SHCN) (OR, 1.9; 95% CI, 1.6-2.2),adverse childhood experience 1.6; 1.4-1.9),and disadvantaged neighborhoods 1.3; 1.1-1.5)were associated a higher risk of being bullied, while older age was lower for only some children 0.8; 0.7-0.9).Notably, interaction analyses showed (age 12-17 years) more likely to be bullied than younger (6-11 years).In addition, lack SHCN...
Background: The time of transition into adulthood, especially when leaving school, is a many autistic adolescents and young adults (AYA) may stop receiving mental health services that they have relied on, leading to worse outcomes. purpose this study was describe patterns service use during adulthood among AYAs. Methods: We performed cross-sectional using electronic records from years 2015 2019 one large university care system. included individuals ages 11–27 with at least clinical encounter...
As genomic medicine advances, the opportunity to incorporate additional genetic screening beyond current newborn presents both advantages and challenges primary care providers. UNC's Age-Based Genomic Screening (ABGS) is a novel program currently in development; its purpose build on success of state-mandated Newborn by incorporating targeted sequencing for select groups highly actionable conditions into routine at relevant time-points throughout childhood.