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Child & Adolescent Health Study Examples

Study Examples | Key Publications | Intro

Current Group Health Center for Health Studies (CHS) studies in child and adolescent health include:

• Anxiety Disorders in Adolescents with Asthma
• Outcomes Assessment of Pediatric Asthma
• Improving Household Firearm Storage Practices in Alaska Native Villages
• Antibiotic Use in Children
• Assessing Medical Need Among Children in Managed Care: Pediatric Rx

Anxiety Disorders in Adolescents with Asthma

• Principal Investigator: Wayne J. Katon, MD, University of Washington Department of Psychiatry and Behavioral Sciences
• Group Health Co-investigator: Paula Lozano, MD, MPH

Already the most common chronic illness of childhood and adolescence, asthma is becoming even more common. Previous research found panic disorder and other anxiety disorders more prevalent among children and adults with asthma than in their peers. But this research, done in hospitals, with few patients, did not measure the effect of anxiety and depressive disorders on asthma outcomes. By contrast, this epidemiologic study is estimating the prevalence of panic disorder and other anxiety and affective disorders in a population-based sample of 1,300 adolescents with asthma who are enrolled at Group Health. It is comparing adolescents who have asthma and either panic disorder or one or more anxiety and depressive disorders to those who have only asthma. The goal is to measure the impact of these co-morbidities on asthma's personal, familial, and societal impacts, such as symptom burden, functional status, quality of life, medical costs, and the quality of asthma self-management.

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Outcomes Assessment of Pediatric Asthma

• Principal Investigator: Kevin Weiss, MD, MPH, Northwestern University Feinberg School of Medicine
• Group Health Co-investigator: Paula Lozano, MD, MPH

This study's goal is to develop outcome measures for childhood asthma using data from three health systems. It also aims to refine lessons learned from a randomized controlled trial in 638 children with asthma, comparing two interventions based in primary care: intensive provider education and organizational change. The researchers are developing ways to translate these research findings into practice by encouraging health systems to adopt effective interventions for childhood asthma. The Agency for Healthcare Research and Quality (AHRQ) and the National Heart, Lung, and Blood Institute (NHLBI) are funding CHS with $1.2 million over five years for its part in this multicenter study.

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Improving Household Firearm Storage Practices in Alaska Native Villages

• Principal Investigator: David C. Grossman, MD, MPH

Suicide rates are more than 10 times higher for Alaska Native youth than for adolescents in the entire United States. More than six in 10 of these suicides are completed with firearms, which are common in Alaska (with at least one firearm present in six of 10 Alaskan homes, and an estimated nine of 10 homes in remote Alaskan villages). In a pilot study, these researchers showed that installing gun safes in the homes of village residents substantially improved storage practices there. This study will estimate the prevalence of firearm ownership and of specific firearm storage practices among residents of the Bristol Bay and Yukon-Kuskokwin regions of southwest Alaska. The researchers will help plan and execute a randomized trial of an intervention to improve firearm storage practices among residents of selected villages. This work is supported by a three-year, $450,000 grant.

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Antibiotic Use in Children

• Principal Investigator: Jonathan A. Finkelstein, MD, MPH, Harvard Medical School
• Group Health Co-investigator: Robert L. Davis, MD, MPH

The rate of antibiotic resistant organisms is on the rise in the United States. Understanding prescribing patterns and use in children is an important step toward curbing unnecessary antibiotic use. The defined populations of managed care organizations are uniquely suited to analyze these issues. This part of the HMO Research Network's CERT research is discovering more about antibiotic use in children. Each health plan in the HMO Research Network has contributed data from a sample of 25,000 children—aged 3 months to 18 years—who were enrolled in their plans over five years. Researchers gather information from the automated databases, including claims for dispensed medications and physician visits. Once analyzed, this information can be used to guide future medical-practice decisions and as a basis for further investigation. AHRQ is awarding CHS $200,000 over three years for its participation in this project.

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Assessing Medical Need among Children in Managed Care: Pediatric Rx

• Principal Investigator: Paul A. Fishman, PhD

This study is the first to examine comprehensively how well risk assessment models identify the medical needs of children in managed care plans, regardless of their insurance source. It is also the first pediatric risk assessment to explore opportunities to use all the information available in health plans' automated data systems. The working hypothesis is that current risk models are not sensitive enough to identify the medical needs of children as a group—or among children with special needs. Unless these models can accurately reflect children's medical needs for risk adjustment purposes, health plans may have financial incentives to avoid enrolling children and families with children, particularly children with special needs. AHRQ funds this study at $1.1 million for three years.

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Study Examples | Key Publications | Intro