Past Awardees
J.Kyle Hawa, PhD
YES or No? A Pilot Study Evaluating the Fit of the Youth Empowerment Support (YES) Platform in Pediatric Primary Care
J. Kyle Haws, PhD, Instructor Fellow in the ACCORDS Primary Care Research Fellowship, Department of Psychiatry, Division of Child and Adolescent Psychiatry
Youth mental health needs are at an all-time high, yet access to mental healthcare remains a significant challenge. Pediatric primary care offers a unique opportunity to address this gap through scalable digital solutions like the Youth Empowerment and Support (YES) platform. This pilot study will use mixed methods, including surveys, qualitative interviews with providers, youth, and caregivers, and co-creation workshops to identify barriers, facilitators, and adaptations for integrating YES into clinical workflows. Findings will guide the adaptation and testing of YES in diverse clinical settings and generate pilot data for a career development award proposal. By improving access to evidence-based care, this work will advance equitable, scalable solutions for addressing youth mental health needs.
Melanie Stall, MD
Shareholder-driven co-design and piloting of Spanish educational videos about clinical trials
Melanie Stall, MD, Assistant Professor, Department of Pediatrics, Section of Hematology/Oncology/Bone Marrow Transplant, Fellow in the ACCORDS Surgical/Subspecialists Clinical Outcomes Research (SCORE) Fellowship
One in twelve Americans self-report speaking English less than “very well,” representing a vulnerable population of people who may struggle to understand or communicate their needs in English. Families of children with cancer who speak languages other than English (LOE) are particularly at risk for experiencing disparities, including decreased clinical trial enrollment which in turn affects outcomes. Compared to English-speaking parents, those who speak LOE have a significantly decreased understanding of key aspects of informed consent, yet research is limited on interventions to improve parental informed consent comprehension, decision-making self-efficacy, and clinical trial enrollment in minority children with cancer. This pilot study will engage parents, medical interpreters, and multidisciplinary clinicians to co-design educational videos about clinical trials in Spanish and test their use as a tool to improve clinical trial enrollment in the setting of a language barrier. The project will inform a future career development award application that expands the number of available languages and investigates the impact of multilingual educational videos on clinical trial enrollment.
Deanna Swain PhD
Improving Access to Evidence-Based Treatments for Caregivers of Autistic Youth: Preliminary Outcomes of Self-Guided Mobile ApplicationDeanna Swain PhD, Assistant Professor, Developmental Pediatrics
The prevalence of autism has surged by 317% since 2000, now affecting 1 in 36 individuals in the United States. This dramatic increase, coupled with a shortage of specialized providers and multi-year waitlists, has significantly limited access to effective interventions, such as caregiver-mediated interventions (CMI). CMI equips caregivers with evidence-based strategies, helping them implement interventions with high fidelity, leading to better outcomes like reduced caregiver stress and fewer child disruptive behaviors—one of the most common reasons families seek care. The gaps and delays in accessing effective clinical services underscore the urgent need for innovative solutions to improve access to CMI for families of children with autism and co-occurring challenging behaviors. Digital health tools, such as mobile-based interventions, offer a promising, cost-effective, and flexible alternative. However, low initial and sustained engagement rates hinder their scalability. This study seeks to: 1) examine engagement patterns with a digital health tool for families waiting for in-person autism services, and 2) analyze how engagement with the app impacts outcomes like caregiver confidence and child disruptive behavior. The findings will serve as the foundation for a career development award aimed at co-designing an engagement toolkit with caregivers of autistic youth, to be used in ambulatory settings, with the goal of expanding access to effective care.
Anna Abrams, MD
Law Enforcement Involvement During Pediatric Emergency Department Encounters and Related Clinical Outcomes
Anna Abrams,MD, Assistant Professor, Department of Pediatrics, Section of Emergency Medicine
Clinical experience suggests that the presence of law enforcement officers (LEOs) at the time of emergency department (ED) encounters can significantly affect the care patients receive and, potentially, patient outcomes. The prevalence of LEOs in the emergency department and associated patient and encounter characteristics is unknown, and pediatrics perspective and context are lacking. This pilot study developed a novel electronic health record (EHR)-based algorithm to retrospectively identify and quantify the presence of LEOs during pediatric ED encounters and explored pediatric clinician perspectives about and experiences with LEO presence in the pediatric ED via in depth interviews. Dr. Abrams leveraged these pilot data in applying for next step funding and was awarded a 2.25-year AHRQ PEDSnet Scholars award to continue building on this work by testing the model at other sites and interviewing pediatric patients and families.
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David M. Higgins, MD, MPH, MS
Understanding the Role of Clinical Support Staff in Team-Based Vaccine Recommendations within Pediatric Primary Care
David M. Higgins, MD, MPH, MS, Fellow in the ACCORDS Primary Care Research Fellowship, Department of Pediatrics, Section of General Academic Pediatrics
Vaccines remain one of the most effective means of protecting children from numerous vaccine-preventable diseases, but many parents have concerns about their safety or effectiveness. Physicians have historically been the primary source of education and advice regarding vaccines, but research in many fields suggest that a team-based approach to preventive health care delivery may be superior to relying solely on the physician. This project aimed to explore the roles, barriers, and facilitators for all pediatric primary care team members to participate in delivering high-quality vaccine communication. The goal was to inform future interventions that engage not just clinicians but also medical assistants and front office staff in team-based vaccine promotion. Over the course of the grant, we conducted 174 direct observations of medical assistants (MAs) and front office staff and 24 semi-structured interviews of MAs and clinicians at two pediatric practices in the Denver metro area. Major accomplishments include identifying unique communication roles for non-clinician staff, characterizing barriers to team-wide vaccine messaging, and developing a preliminary framework for a team-based vaccine communication training intervention. Post-funding, the relationships built and knowledge gained will support sustained engagement with partners, with potential for long-term impact on pediatric vaccine delivery models. These data formed the basis for a Career Development Award submission that will be submitted in June to support 75% of Dr. Higgins’ time for research.
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Monica Perez-Jolles, PhD
Using process mapping to optimize the integration of child psychosocial screenings in primary care, and increase family linkages to behavioral and safety net services
Monica Perez-Jolles, PhD, Associate Professor, Department of Pediatrics, Section of General Academic Pediatrics
The high prevalence of mental health problems and social factors that negatively impact children’s health make it crucial to screen for psychosocial problems during well child visits. Even if screening occurs, however, the linkages to community services to address identified problems is frequently inadequate due to lack of effective systems to support this linkage. The CARELOOP Pilot was a collaborative effort between Denver Health, ACCORDS, and three Community-Based Organizations (CBOs) with the objective of understanding the pathways from psychosocial screenings at clinics to service referrals and strengthening the connection between clinics, caregivers and community partners in the primary care setting. Through four process service mapping sessions, valuable lessons were learned about the importance of communication and coordination across all groups.It became clear that uniformity in workflows and the accessibility of resources are critical for improving service delivery. The sessions also highlighted the need for more integrated follow-up systems and clearer pathways to reach referral services. Lastly, involving all parties in a streamlined, well-communicated process helped foster trust and better outcomes for families and communities. These pilot data led to R01 level funding for Dr. Perez-Jolles from the Agency for Healthcare Research and Quality (AHRQ).
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