Network Studies










Interested in Collaborating with CORNET?

Consider submitting a research proposal. We look forward to hearing from you!

Network Studies


Studies in Development

iPOP-UP: improving Pediatric Obesity Practice Using Prompts Dissemination & Implementation study
PI: Mona Sharifi, MD, MPH
Objective: Implement a previously-demonstrated packaged of EHR-based clinical decision support and patient education materials to improve obesity care and children's BMI at EPIC-using CORNET sites using a stepped wedge study design to evaluate.

CORNET ACEs
Cross-sectional observational study that will survey continuity clinics about social determinants of health across 3 domains:

  • Patient screening practices
  • Resident education practices
  • Resource infrastructure

CORNET Card Studies

  • Electronic Medical Records
  • Resident Adverse Childhood Experiences (ACEs)

Strengthening the CORNET-Family Voices collaboration: working towards better access to mental/behavioral health services for children and youth
PI: Susan Feigelman, MD
Collaborators: Parent Partners
Objective: Comparative effectiveness study of the benefits of the addition of a parent navigator on different levels of behavioral and mental health (BMH) co-located services.

IMAPP: Improving Mental Health Access with Parent Partners
PI: Iman Sharif, MD, MPH
Collaborators: Parent Partners
Objective: Understand the degree to which embedding a parent partner in a primary care practice can improve the outcomes of BMH referrals in pediatrics.

Ongoing Studies

LitNet Reach Out and Read Survey. This study will look at what pediatric residency programs are doing around resident training and Reach Out and Read. This study will consist of a survey filled out by your residents, continuity faculty, and your site's Reach Out and Read Champion. Participating programs that reach 80% completion of their surveys will receive 100 free books through Reach Out and Read. Programs that achieve 100% completion of surveys will have their site names put in a hat and two will be randomly selected to receive a pizza party for their residents.

If your site would like to participate, please contact Holly Tyrrell directly at hollyce@academicpeds.org for enrollment.

National Immunization Partnership with the APA (NIPA). As a part of this grant, the APA is working with CORNET and the National Improvement Partnership Network (NIPN) to implement a large-scale practice-based quality improvement (QI) program to prioritize HPV vaccination at every adolescent visit.

Wave 1: 14 CORNET sites, 38 NIPN practices
Wave 2: 15 CORNET sites, 60 NIPN practices
Wave 3: 12 CORNET sites, 64 NIPN practices
Wave 4: 7 CORNET sites, 54 NIPN practices

To learn more about this initiative, please visit the NIPA Virtual Toolkit

WE CARE:
Principal Investigator: Arvin Garg, MD
Collaborator: Pediatric Research in Office Settings (PROS)
Objective: Address poverty-related issues and unmet basic social needs of families through the following implementation strategies: 1) On-site training program, 2) off-site web-based program

Understanding Clinicians' Needs Related to Healthcare for LGB Adolescents:
Principal Investigator: Lindsay Taliaferro, PhD, MPH
Collaborators: Tiernan Middleton, BS, & Meagan Acevedo, BS

Dr. Taliaferro and her colleagues are conducting semi-structured interviews to better understand physicians' and residents' knowledge, attitudes, behaviors, and training needs related to working with sexual minority youth. The interview may occur via telephone or Skype, or at a convenient location in the Orlando area.

Any primary care physician or medical resident who provides healthcare services to adolescents or young adults interested in participating should email Middleton.Tiernan@knights.ucf.edu. Participants' responses will remain confidential, and participants will receive a $35 Amazon.com gift card.

UCF Institutional Review Board approval SBE-17-13070

Completed Studies

Current Practices for Identifying and Addressing Social Determinants of Health in Continuity Clinic. The objective of this survey was to describe current practices in systematic screening for Social Determinants of Health (SDH) in pediatric resident clinics enrolled in the Continuity Research Network (CORNET) and examine correlations among screening and clinic characteristics. Findings reflect that screening for SDH in CORNET clinics is common but has not been universally implemented. Screening practices are variable and reflect the complex nature of screening, including the heterogeneity of the patient populations, the clinic staff composition, and the SDH encountered.

CORNET CARD STUDY #1: DO YOU SEE WHAT I SEE, AND CAN I DO WHAT YOU DO? [Caring for Children with Special Health Care Needs (CSHCN)]. Card Study #1 gathered data on the kinds of patients seen at resident continuity practices. The project team tested the hypotheses that 1) Patients seen by pediatric residents and faculty are of the same level of complexity; 2) Patients seen by senior residents are as likely as patients seen by faculty to see a provider with high self-efficacy (SE) in managing their care; 3) Patients seeing their own primary care provider (PCP) are more likely to see a provider with high SE for managing their care. CSHCN were seen mostly by attendings; more exposure may be needed for residents to develop SE in caring for CSHCN. This first CORNET CARD Study provides fertile data for further analyses. Residents were invited to participate as co-investigators with questions they would like to pose to the dataset, with resident education or QI projects that stem from the results, or with follow-up studies exploring parental confidence in care received.

Preventive Services Improvement Project - State Spread (PreSIPS2). PreSIPS2 was one component of many ongoing efforts to enhance Bright Futures implementation at the state, community, practice, and family levels. With participation from AAP National, AAP chapters, CORNET academic programs, and national and state partners, PreSIPS2 was a 17-month quality improvement (QI) state-based learning collaborative designed to create sustainable state to local improvement infrastructure to achieve awareness and improvement in the preventive health outcomes of children based on Bright Futures. Four CORNET practices participated in the project.

National Partnership for Adolescent Immunization (NPAI). This project focused on enhancing adolescent immunization delivery through the implementation of quality improvement activities in primary care practices and pediatric resident training programs. During the learning collaborative stages of this project, participating practices were asked to choose one of two strategies to improve their HPV vaccine immunization rates. The two strategies included a point of care prompt (either nurse or EMR) or standing orders. The selected strategy was implemented in each participating practice for 12 months, during which faculty/resident/staff champions participated in monthly learning collaborative conference calls. Thirteen practices participated, with five choosing standing orders as their strategy and eight utilizing prompts. Findings were presented in two platforms and two posters at PAS 2016, in addition to a workshop on involving pediatric residents in QI in continuity clinics, using adolescent immunizations as a template. Three manuscripts are currently underway.

Initial results from the Bright Futures Oral Health study funded by the Maternal and Child Health Bureau (Hank Bernstein, PI) were presented at the 2011 Denver PAS meeting. Twenty-seven pediatric training programs (143 residents) participated. This RCT was very successful in showing that residents improved in confidence and knowledge about BF concepts, and were able to incorporate preventive health strategies into their practices. Two manuscripts are underway. This was a very intensive and important CORNET study. Thanks to everyone who participated!

Secondary Sexual Characteristics in Boys Study (SSCIB). Seven CORNET practices, including 10 CORNET faculties, collaborated with the PROS network in this study that examined the onset of secondary sexual characteristics in boys. Marcia Giddens, DrPh, PA served as the PI. CORNET contributed data on 300 minority and underserved boys, increasing the generalizability of study results. Results have been presented at the last two PAS meetings.

The Survey of Pediatric Asthma Care Education in Residency (SPACER) study was completed in 2009. This study, with Sande Okelo, MD as PI, and Terry Hetzler and Cindy Ferrell as CORNET co-investigators, was a cross-sectional survey to assess asthma management and incorporation of national practice guidelines by pediatric residents. Ten pediatric training programs participated and surveys were obtained from 369 residents. Two PAS abstracts were presented in 2009 and 2010 and a manuscript is under revision. Future analysis will compare resident responses to those of practitioners from a similar study Dr. Okelo conducted within the American Academy of Pediatrics and practicing pediatricians.

Health Care of Pediatric Residents and their Families. This cross-sectional study funded by East Carolina University was led by Kristina Simeonsson, MD and John Olsson, MD and examined pediatric residents' perceived access to health care for themselves and their families, self-prescribing practices, whether colleagues provide care and the care their families receive. Nineteen pediatric training programs participated, with 834 residents providing data. Results were presented in two posters at the PAS meeting. Manuscript preparation has begun. The results from this study will help to inform the Residency Review Committee (RRC) and the Accreditation Council for Graduate Medical Education (ACGME).

How is Continuity Defined in Continuity Clinics? Paul Darden, MD, MPH was the principal investigator for this CORNET-APA Continuity SIG collaboration which surveyed pediatric continuity directors to determine how they measure and define continuity, an important concept to the Residency Review Committee. Results from 170 programs (over 75% of all pediatric training programs nationally) were presented at the 2011 Denver PAS.

Bright Futures, Preventive Services Improvement Project (PreSIP). Paula Duncan, MD, the PI on this project, obtained funding from HRSA and MCHB for a collaborative project based in four CORNET sites and several practices participating in the QUINN program. The goal is to determine if Bright Futures can be easily implemented in a busy clinical setting, targeting children birth to 3 years. The methodology is a quality improvement project to develop and test specific changes, using rapid cycle change strategies. Results from the project are now in the analysis phase.

Adolescent Immunizations within Medical Homes Initiative (AIMHI). This 3-phase study, funded by the Centers for Disease Control, is a quality improvement study to increase adolescent immunization rates, and a collaboration between CORNET and the Rochester practice-based network (GR-PBRN). Peter Szilagyi, MD, MPH is PI. Phase 1 was a survey of 47 CORNET practitioners that determined potential interventions, barriers, strategies and critical components of interventions to enhance immunization of adolescents. Results were presented at the 2011 PAS meeting. The second phase has consisted of a series of focus group discussions using a modified Delphi technique. Participants have discussed the most feasible and sustainable strategy to enhance adolescent immunizations. Use of an EMR and nurse prompts were the most promising tools. In Phase 3, 12 CORNET sites participated in a trial of 3 different strategies in order to measure the effectiveness of the selected strategies in increasing adolescent vaccination rates and impact on utilization of services in the medical homes.

Pediatric Residency Integrated Survey: Mental Health in Primary Care (PRISM-PC). The PI for this 2-phase study is Maya Bunik, MD, MPSH. The first phase, funded by University of Colorado, was a cross-sectional survey of continuity directors focusing on mental health patient access, resident education of mental health issues, and whether practices have integrated mental health models at their sites. Surveys were completed by 54 programs and results were presented at the 2011 PAS meeting. Funding is being secured for the second phase, which will be a comparative study examining patient and resident educational outcomes among different mental health integration models.


 

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