Pilot Grant Program Helps Launch Projects Focused on Changing Practice and Policy

Clinical Futures and PolicyLab jointly administer the Pilot Grant Program to fund pilot studies focused on clinical effectiveness and policy.

shafere1 [at] chop.edu (By Emily Shafer)

Editor's Note: Faculty and instructors from all Children's Hospital of Philadelphia (CHOP) departments and divisions are encouraged to apply for the Joint Pilot Grant Program offered by PolicyLab and Clinical Futures, which are CHOP Research Institute Centers of Emphasis. Applications for fall 2023 are due Oct. 2. Read on to learn about the Spring 2023 awardees.

Pediatric clinicians and policymakers for children's health rely on research evidence to inform practices and decision-making. Two Centers of Emphasis at Children's Hospital of Philadelphia (CHOP), PolicyLab and Clinical Futures, set the foundation for this important research with their Pilot Grant Program.

They jointly award pilot grants in the spring and fall that promote and support CHOP investigators with funding to conduct feasibility studies that focus on clinical effectiveness or policy-oriented health services to achieve the best outcomes for children and adolescents. These small-scale preliminary studies often pave the way for investigators to determine the best approach to conduct a future, full-scale project that attracts external funding support.

The spring 2023 awardees are pursuing projects that challenge and seek to shift current research or clinical practice paradigms by utilizing novel theoretical concepts, approaches or methodologies, instrumentation, or interventions.

The Experiences of School Nurses in Caring for Sexual and Gender Minority Youth

Investigators: April J. Ancheta, PhD, RN; Nadia L. Dowshen, MD, MSHP; Catherine C. McDonald, PhD, RN; Dalmacio Dennis Flores, PhD, ACRN.

Previous research has shown that sexual and gender minority (SGM) youth seek school nurse services more often than heterosexual, cisgender peers; however, the role of school nurses in addressing health disparities for SGM youth remains largely undefined. The researchers will uncover school nurses' knowledge about state and local policies that affect their care provision for SGM youth.

"We hope our findings will help shape future professional development courses for school health services and nursing schools about building inclusive environments and providing quality care for SGM youth," said Dr. Ancheta, postdoctoral research fellow in the Craig-Dalsimer Division of Adolescent Medicine.

GLP1a Therapy and Effects on Bone Health and Energetic Behavior Profiles in Children With Obesity

Investigators: David Weber, MD, MSCE; Jonathan Mitchell, PhD; Jessica Decker, PhD; Rachana Shah, MD

Two glucagon like peptide-1 agonists (GLP1a) are approved by the U.S. Food and Drug Administration to promote weight loss in children. The American Academy of Pediatrics' (AAP) recommendation that children 12 and older with obesity be offered weight loss pharmacotherapy is controversial, as the potential risks and benefits of GLP1a therapy in children is unknown.

"One concern is that rapid weight loss may detrimentally affect bone density and muscle mass," said Dr. Weber, director of the CHOP Center for Bone Health. "But on the other hand, weight loss may have a positive effect on physical activity and sleep, which could mitigate losses in bone and muscle mass."

Researchers are evaluating 15 children receiving GLP1a therapy to determine how the therapy affects bone density and strength, body composition, and energetic behaviors including physical activity, diet, and sleep. The study team aims to use the pilot data obtained from this study to support the types of larger natural history and interventional studies that will be necessary to answer these important clinical questions.

Understanding the Geography and Role of Crisis Pregnancy Centers in Rural Maternal Healthcare Deserts in Pennsylvania

Investigators: Jennifer Whittaker, PhD; Xi Wang, PhD; Rebecka Rosenquist, MS; Meredith Matone, DrPH, MHS

This project takes a unique approach to understanding an underexplored barrier to maternal and child health in rural Pennsylvania. The researchers will identify Pennsylvania communities where Crisis Pregnancy Centers (CPCs) are available, but comprehensive maternal health services are not. The study team will evaluate the actions of CPCs when clients with a desired pregnancy present for pregnancy care and support.

"As the number of CPCs in Pennsylvania grows and access to comprehensive maternal and infant care continues to shrink in rural communities, this gap in comprehensive health service may further entrench rural health inequities, particularly for those most poorly served by existing healthcare and social service systems," said Dr. Whittaker, senior manager of Qualitative Methods Training and Program Development in PolicyLab.

Using Natural Language Processing and Clinical Notes to Assess Clinical Guideline Adherence to HIV Prevention Care in Adolescents and Young Adults

Investigators: Sarah M. Wood, MD, MSHP; Spandana Makeneni, PhD; Charlotte Schluger, BS

The Centers for Disease Control and Prevention, AAP, and U.S. Preventive Services Task Force recommend that all sexually active adolescents be counseled on the existence of HIV pre-exposure prophylaxis (PrEP) medication. Although PrEP is a highly effective intervention that can reduce the risk of HIV infection by more than 90%, it remains underutilized in the adolescent population, despite their high risk for HIV infection.

Researchers will use natural language processing (NLP) methods to extract data from clinical notes to determine PrEP counseling guideline adherence.

"This research lays a critical foundation for future interventions to improve HIV prevention services for youth," said Dr. Wood, attending physician in the Craig-Dalsimer Division of Adolescent Medicine. "In addition, progress made in NLP method development within this study will be extendable to building generalizable NLP models that may be used across health systems and may be applied to clinical issues other than PrEP."