A5013261602- Childhood Cancer Survivors' Quality of Life
- Acute Lymphoblastic Leukemia research
- Adolescent and Pediatric Healthcare
- Food Security and Health in Diverse Populations
- Family Support in Illness
- Emergency and Acute Care Studies
- Neuroblastoma Research and Treatments
- Radiology practices and education
- Sarcoma Diagnosis and Treatment
- Innovations in Medical Education
- Glioma Diagnosis and Treatment
- Ultrasound in Clinical Applications
- Sexual Assault and Victimization Studies
- Chemotherapy-induced cardiotoxicity and mitigation
- Testicular diseases and treatments
- Clinical Reasoning and Diagnostic Skills
- Radiation Dose and Imaging
- Neonatal Health and Biochemistry
- BRCA gene mutations in cancer
- Hemoglobinopathies and Related Disorders
- Pleural and Pulmonary Diseases
- Reflective Practices in Education
- Pelvic and Acetabular Injuries
- Neonatal and Maternal Infections
- Infective Endocarditis Diagnosis and Management
Dana-Farber Cancer Institute
2021-2025
Boston Children's Hospital
2021-2025
Harvard University
2021-2025
Dana-Farber/Boston Children's Cancer and Blood Disorders Center
2023-2024
Children's Center
2013
Cohen Children's Medical Center
2013
North Shore University Hospital
2012
Northwell Health
2012
Subspecialty pediatrics have lagged behind primary care in recognizing adverse social determinants of health (SDOH) as salient to outcomes, key drivers inequity, and worthy systematic investigation.1 A population frequently hospitalized with chronic illness well-defined inequities is children cancer. More than 1 5 pediatric oncology families report low-income, at least household material hardship (HMH; food, housing, or utility insecurity) diagnosis.2 Identifying whether from marginalized...
Importance Whether population-based racial and ethnic survival disparities for children with high-risk neuroblastoma persist in the clinical trial setting is unknown. Objective To investigate among treated on frontline trials. Design, Setting, Participants This retrospective cohort study used data from Children’s Oncology Group (COG) trials January 1, 2007, to December 31, 2016, a freeze June 30, 2021. Children were analyzed 2 cohorts: induction/consolidation participants post-consolidation...
Cardiomyopathy is a leading cause of late morbidity and mortality in childhood cancer survivors (CCS). Evidence-based guidelines recommend risk-stratified screening for cardiomyopathy, but the management approach abnormalities detected when asymptomatic young adult CCS poorly defined.The aims this study were to build upon existing by describing expert consensus-based cardiomyopathy practices, approach, clinical rationale with screening-detected identify areas controversy practice.A...
Parent psychological distress during childhood cancer treatment has short- and long-term implications for parent, child, family well-being. Identifying targetable predictors of parental is essential to inform interventions. We investigated the association between household material hardship (HMH), a modifiable poverty-exposure defined as housing, food, or utility insecurity, severe among parents children aged 1-17 years with acute lymphoblastic leukemia (ALL) enrolled on multicenter...
Abstract Social determinants of health (SDoH) are associated with stark disparities in cancer outcomes, but systematic SDoH data collection is virtually absent from oncology clinical trials. Trial‐based essential to ensure representation marginalized populations, contextualize outcome disparities, and identify health‐equity intervention opportunities. We report the feasibility a pediatric multicenter therapeutic trial‐embedded investigation. Among 448 trial participants, 392 (87.5%) opted‐in...
Abstract Background Children living in poverty and those of marginalized race or ethnicity experience inferior disease outcomes across many cancers. Whether survival disparities exist osteosarcoma is poorly defined. We investigated the association between race, ethnicity, proxied exposures event-free overall for children with nonmetastatic receiving care on a cooperative group trial. Methods conducted retrospective cohort study US patients nonmetastatic, aged 5-21 years enrolled Children’s...
10010 Background: Children who are Black, Hispanic or of proxied low socioeconomic status experience inferior survival outcomes despite receipt uniform treatment on Children’s Oncology Group (COG) trials. Investigation mechanisms underlying these disparities and evaluation interventions to address them has been limited by inadequate data. Prior COG trials have collected child race, ethnicity, insurance zip code—non-modifiable data elements that prone misclassification bias—as proxies for...
Abstract Poverty‐exposed children with cancer are more likely to experience adverse outcomes. Supplemental Nutrition Assistance Program (SNAP) benefits improve food insecurity and child health outcomes, could be used mitigate disparities. We conducted a secondary analysis of parent‐reported data collected in frontline pediatric leukemia trial (NCT03020030) assess SNAP eligibility (proxied by other means‐tested program participation) participation. At diagnosis, 105/287 families (37%) were...
10009 Background: Children with cancer living in poverty are more likely to relapse and die, even when treated uniformly on clinical trials. No evidence-based interventions targeting as a risk factor for disparate outcomes exist pediatric oncology. We previously developed refined the Pediatric Cancer Resource Equity (PediCARE) intervention—a centrally-delivered, household material hardship (HMH)-targeted intervention that provides transportation groceries low-income oncology families. report...
Disparities in relapse and survival from high-risk neuroblastoma (HRNBL) persist among children historically marginalized groups even highly standardized clinical trial settings. Research other cancers has identified differential treatment toxicity as one potential underlying mechanism. Whether racial ethnic disparities treatment-associated exist HRNBL is poorly understood.
Black and Hispanic children with leukemia experience inferior survival compared to non-Hispanic White (NHW) children. Identifying modifiable social determinants of health can inform intervention targets address inequities. We characterized the frequency income poverty household material hardship (HMH) by race/ethnicity in a clinical trial cohort de novo acute lymphoblastic leukemia. Compared NHW families, families reported more frequent HMH (19% vs. 47% 68% respectively); low-income (27% 52%...