Research on Child and

Adolescent Health 

New Starts—Fiscal Year 2003

FACT SHEET

U.S. Department of Health 

and Human Services

Public Health Service

Agency for Healthcare Research and Quality

AHRQ is the lead Federal agency charged with

supporting and conducting research that will

improve the quality, safety, efficiency, and

effectiveness of health care for all Americans. 

This fact sheet summarizes AHRQ

initiatives in child and adolescent health

care focusing on improving the quality,

safety, efficiency and effectiveness of

health care. In Fiscal Year 2003,

AHRQ announced support for $9.9

million over the life of new intramural

and extramural research projects,

including grants, contracts, and interagency agreements. 

Improving Quality and

Increasing Safety 

Project Funded under Program

Announcement (PA) for AHRQ’s

Small Research Grant Program. This

program provides support for new

investigators or researchers new to health

care services issues, and encourages

preliminary, exploratory, or innovative

research in new or previously unexamined

areas.

• Racial Differences in PhysicianPatient Communication. Principal

Investigator: Thomas Campbell,

University of Rochester, Rochester,

NY. Grant No. R03 HS13223

(09/30/2003-09/29/2004). This

study will examine differences in the

tone of voice of physicians when

they talk with white compared to

black adolescents. Previously

collected audiotapes of interviews

occurring during a preventive health

visit will be analyzed. Forty

interviews between a white primary

care physician and black adolescents

will be randomly selected and

individually matched to two

interviews between the same

physician and 2 white adolescents,

creating 80 matched black/white

pairs for analysis. Identifying

clinically significant differences in

physicians’ nonverbal

communication with black patients

compared to white patients will help

to understand and address racial

disparities in the quality of health

care communication. 

Project Funded under AHRQ’s PA for

Health Services Research. This PA

supports projects focusing on a wide range

of topics under AHRQ’s priority program

areas including: (1) supporting

improvements in health outcomes, (2)

improving quality and patient safety, and

(3) identifying strategies to improve access

and foster appropriate use and reduce

unnecessary expenditures. 

*Project includes children or children’s health care

issues, but does not focus exclusively on children.
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• *Validation of an Innovative

Approach to Error Reduction.

Principal Investigator: David

Blumenthal, Massachusetts

General Hospital, Boston, MA.

Grant No. R01 HS13099

(09/30/2003-09/29/2005). This

project will validate and improve

a previously developed

instrument that directly

identifies error-prone clinical

processes and systemic factors

contributing to errors in a

network of hospital emergency

departments. Investigators will

conduct personal interviews,

focus groups and literature

reviews to produce a revised

instrument that will be

cognitively and psychometrically

tested, and then administered to

approximately 6,800 personnel

in a network of 85 emergency

departments. This study will

include services rendered to

children. Blacks, Hispanics, and

other personnel and patients will

participate in this study. 

Projects funded under the Request

for Applications (RFA): Safe

Practices Implementation

Challenge Grants. This RFA sought

projects to assess patient safety risks to

patients, and devise ways to prevent

and implement safe practices that

show evidence of eliminating hazards

to patient safety when providing care. • Risk Analysis of Pediatric

Chemotherapy Processes. Principal Investigator: Jerry Shenep, St. Jude Children’s

Hospital, Memphis, TN. Grant

No. UCl HS14295

(09/30/2003-09/29/2004). The

aims of this study are to: (1)

conduct a formal risk analysis

using a failure mode and effects

analysis; (2) evaluate and

document risks associated with

each step of a complex

chemotherapy medication

process for possible failure points

before and after testing of a

commercially available highly

integrated computerized

physician order entry (CPOE)

system at a leading children’s

cancer center; and (3) evaluate

and test approaches to eliminate

identified risks. Before

implementing CPOE system in

complex treatment areas such as

pediatric oncology, all aspects of

the medications process require

careful analysis to ensure that the

risk of error actually will be reduced. 

• *Blood Product Transfusions

and Safe Practices Implementation. Principal

Investigator: Loreen Herwaldt,

University of Iowa, Iowa City,

IA. Grant No. UC1 HS14312

(09/30/2003-09/29/2005). In

this study, handheld wireless

barcode devices attached to

blood products and patients will

be scanned and the resulting

information will be fed

automatically into a new online

“check” application that will

provide immediate notification

of any mismatches. The project

will compare the proportion of

mislabeled blood specimens,

mislabeled blood products, and

misidentified patients before and

after the implementation.

Children and minorities will be

included in this study in the

same numbers and proportions
they represent in the patient

population. 

• *The PeaceHealth Communitywide Electronic Shared

Medication List. Principal

Investigator: Ronald Stock, Sacred

Heart General Hospital, Eugene,

OR. Grant No. UC1 HS14315

(09/30/2003-09/29/2005). This

project will improve medication

safety in the outpatient arena by

generating a single, reconciled

community-wide electronic

medication list and patient care

plan. This study will create an

electronic “patch” for existing

inpatient and outpatient

electronic medical records that

will enable all members of the

care team to know exactly what

medications each patient is

currently on, what medications

have been discontinued, and

patient medication allergies. The

basic plan will be available 24

hours a day, 7 days a week for all

care team members, including

patients and their caregivers,

physicians, clinics, hospitals, and

others participating in the care of

patients. Clinicians will be

trained to use the tools when the

web-based medication list and

plan are in place. Children,

including racial and ethnic

minorities will participate in this

study. 

• *Statewide Efforts to Improve

Care in Intensive Care Unit.

Principal Investigator: Peter

Pronovost, Johns Hopkins

University, Baltimore, MD.

Grant No. UC1 HS14246

(09/30/2003-09/29/2005). The

aims of this project are to

implement and evaluate the: (1)

impact of the Comprehensive

Unit-based Safety Program that

includes the ICU Safety

Reporting System; (2) effect of an

intervention to improve

communication and staffing in

ICUs; (3) effect of an intervention

to reduce/eliminate catheterrelated blood stream infections in

ICUs; (4) effect of an intervention

to improve the care of ventilated

IC patients; and (5) effect of an

intervention to reduce ICU

mortality. Investigators will

partner with the Michigan

Hospital Association, whose has

over 130 Michigan hospitals, to

implement a safety program and

other interventions in a cohort of

hospitals. Children will be

included in this study as several of

the ICUs admit exclusively

pediatric patients. Participating

patients will represent a diverse

population of children, women

and minorities, including African

Americans. 

Project funded under the RFA:

Building the Evidence to Promote

Bioterrorism and Other Public

Health Emergency Preparedness in

Health Care Systems. This RFA

sought projects to examine and promote

the health care system’s readiness for a

bioterrorist event or other public health

emergencies through the development of

new evidence, tools and models. 

• *Discharge Criteria for Creation

of Hospital Surge Capacity.

Principal Investigator: Gabor

Kelen, Johns Hopkins University,

Baltimore, MD. Grant No. U01

HS14353 (09/30/2003-

09/29/2005). This study will

develop a simple discharge

planning tool for use during a

biothreat or other public health

disasters; test and refine the

developed tool by simulation with

real patient data; conduct a

simulated disaster drill and

compare patients designated for a

safe discharge; and determine the

ease of use and accuracy of

application of the tool in the

hands of treating physicians. This

generalizable, validated method to

pre-designate hospitalized patients

for safe early discharge will have

wide applicability in the Nation’s

hospitals for the rapid creation of

surge capacity in the event of a

biothreat or a critical event. Data

will be collected on patients of all

ages, including children,

minorities and women. 

Capacity Building 

Projects funded under the RFA:

Building Research Infrastructure

and Capacity Program (BRIC):

Phase II. This limited competitive

program provides additional support for

the refinement, expansion, and

implementation of plans developed

among grantees supported in Phase I.

• Mississippi Building Research

Infrastructure Capacity

(MSBRIC): Phase II. Principal

Investigator: Linda Southward,

Mississippi State University, MS.

Grant No. R24 HS11849

(09/30/2003-09/29/2006). The

aims of this project are to: (1)

build upon the research

infrastructure and collaborations

established during Phase I, with a

particular focus upon engaging

child care centers as research

venues; (2) develop a systematic

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research agenda identifying best

practices for prevention of dental

disease among very young

children; and (3) develop

strategies to use the MSBRIC

childcare centers as a model by

which results may be replicated

among other high-risk

populations and similar sites in

other underserved and/or rural

areas. Both male and female

minority children are included in

this study. 

• *LSU Health Services Research

Program. Principal Investigator:

Frederick Cerise, Louisiana State

University Health Sciences

Center-New Orleans, New

Orleans, LA. Grant No. R24

HS11834 (09/30/2003-

09/29/2006). The aims of this

study are to: (1) build upon

infrastructure and center

development to strengthen and

sustain the LSU Health Services

to approximately 1 million people

in Louisiana during phase I; (2)

continue efforts to maintain,

build and expand collaborative

linkages with partnerships

between the LSU School of

Public Health, Tulane University,

Harvard Pediatric Research

Program, Pennington Research

Center, and LSU A&M for a

successful health services research

network; and (3) focus on

developing specific “research

themes” to improve care and

outcomes for building a

sustainable health services research

infrastructure for the Louisiana

population, including children.

The majority of patients in the

study are low-income, uninsured

or Medicaid, and AfricanAmerican.

Small Research Grants for Primary

Care Practice-Based Research

Networks (PBRNs) RFA. These

projects will conduct exploratory/pilot

or feasibility studies in primary care

PBRNs that are likely to lead to larger

scale undertakings by the network.

• Smoking Cessation in Pediatric

Practice: Phase I. Principal

Investigator: Jonathan Klein,

University of Rochester,

Rochester, NY. Grant No. R03

HS14418 (09/30/2003-

09/29/2004). This study will

conduct: (1) pilot procedures for

recruitment and randomization of

Pediatrics Research in Office

Settings (PROS) practices; (2)

field trial/pilot PROS practitioner

cessation counseling and practices’

enrollment of adolescent patients;

and, (3) assess the feasibility of

pediatric clinician referral of

adolescent patients to internetbased adjuncts for smoking

cessation. This study will develop

methods for future larger scale

studies and will provide an

understanding of the process of

implementing adolescent smoking

cessation in primary care practice.

This study will include Hispanic

and black children and youth 14-

19 years of age. 

• Piloting Tools to Improve

Nutritional Health in Primary

Care. Principal Investigator:

Adolfo Ariza, Children’s Memorial

Hospital, Chicago, IL. Grant No.

R03 HS14431 (09/30/2003-

12/31/2004). This pilot study

will test and refine the

implementation of a

computerized system to aid health

providers in the interpretation of

child growth and the routine

delivery of nutritional counseling

in two diverse Pediatric Practice

Research Groups. The project

will: (1) determine changes

affected by the program in the

rates of identification of

overweight or at risk for

overweight children, in the

provision of counseling on

healthy behaviors, and in patient

flow; (2) assess practice use of and

reactions to the new systems; (3)

obtain feedback leading to

improvements in the proposed

changes to common practice

processes and the software; and

(4) examine the cost of

implementing this system. This

study will provide sufficient data

to support wide-spread evaluation

of the program across an array of

diverse practice settings.

Participants included in this study

are expected to be Hispanic and

African-American children. 

• *Trial to Reduce Antibiotic Use

in a Primary Care PBRN.

Principal Investigator: David

Bates, Brigham and Women’s

Hospital, Boston, MA. Grant

No. R03 HS14420 (09/30/2003-

09/29/2005). This pilot study

will design and implement an

electronic medical record-based

template for the care of patients

with upper respiratory tract

infections (URIs) in primary care

practices, using the URI Smart

Set. The URI Smart Set will

include easy documentation in

the form of checkboxes for

symptoms and physical findings;

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patients’ problems, allergies, and

medications; decision-support

for the treatment of sinusitis,

pharyngitis, and acute

bronchitis; printable patient

handouts about URIs, self-care,

antibiotics; and access to relevant

medical literature. This project

will also test the implementation

of the URI Smart Set in a

randomized, controlled trial

within 18 practices. Minority

women and children are fully

represented in this study in the

proportion of their presence in

the 18 outpatient practices in the

Brigham and Women Primary

Care Clinics. 

Projects funded under the PA:

Minority Research Infrastructure Support Program (MRISP). These

projects will strengthen the research

environments of minority institutions

and develop or expand existing

capacities for conducting research in

all areas of health services. • Puerto Rico Health Services

Research Institute. Principal Investigator: Roberto TorresZeno, University of Puerto Rico Medical Sciences, San Juan, Puerto Rico. Grant No. R24

HS14060 (09/30/2003-

09/29/2006). Three pilot

studies will be conducted to: (1)

compare health care utilization

patterns between children with

asthma enrolled in the Puerto

Rico government’s managed care

plan and those enrolled in

private health insurance plans

under the same health insurance

company; (2) assess

psychometric properties of two

measures of health care systems

factors: one measure is related to

organizational climate and the

other measure is related to

quality of the therapeutic

relationship—potential

indicators of performance of

mental health services for

children and adolescents; and (3)

investigate the impact of Puerto

Rico’s health care reform on

infant mortality, birth weight,

and the utilization and adequacy

of prenatal care. This project

will provide comprehensive

comparative studies comparing

the health of Puerto Ricans on

the island with Puerto Ricans’

health in the U.S. Hispanic or

Latino infants, children and

adolescents will be participants

in this study.

•

Health Research Enhancement

at Morgan State University. Principal Investigator: Ruhul

Amin, Morgan State University,

Baltimore, MD. Grant No.

R24 HS11638 (09/30/2003-

09/29/2006). This project will

focus on issues

disproportionately affecting

African-Americans in inner-city

Baltimore and its surrounding

areas, including teenage

pregnancy, maternal and child

health, school health, reproductive health, nutritional

status, breast-feeding, infant and

child mortality, and pre- and

post-natal care among teen and

disadvantaged mothers. Pilot

studies to be conducted include:

(1) breast-feeding promotion

among inner-city minority

populations; (2) Baltimore City’s

healthy start program; and (3)

school-based comprehensive

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program for pregnant

adolescents. This project seeks

to improve community-based or

school-based comprehensive

preventive health care for

medically underserved urban

populations. 

Training Grants • SCHIP, Medicaid and Special

Needs Children’s Experience.

Principal Investigator: Susan

Milner, Johns Hopkins

University, Baltimore, MD.

Grant No. R03 HS13998

(09/30/2003-09/29/2004). This

dissertation project will examine

differences in caregiver reported

evaluations and experiences with

health care between SCHIP and

Medicaid children enrolled in

HealthChoice, Maryland’s

combined Medicaid/SCHIP

managed care program.

Differences will be explored in

both a random sample of

children enrolled in state Medicaid HMOs and in a

cohort of children with special

health care needs. The

HealthChoice’s study population

includes African-American,

Asian and Latino participants. 

•

Medicaid MCO’s and

Suboptimal Pediatric Care.

Principal Investigator: William

Cooper, Vanderbilt University,

Nashville, TN. Grant No. K02

HS13076 (08/15/2003-

07/31/2006). The aim of this Independent Scientist Award is

to examine the effect of

Medicaid managed care

organizations (MCOs) on access

to specific recommended care for

children with asthma, as

individual MCOs may have

conflicting incentives for

authorizing care or providing

resources for care. The study

will compare MCO’s with

respect to suboptimal use of

preventive medications for

asthma among approximately

24,000 black, Hispanic and

other children with moderate to

severe asthma in Washington

State and Tennessee. The study

will be conducted using a

Medicaid research database,

linked with vital records and

U.S. Census data in Washington

State and Tennessee. 

•

Improving Safety of Pediatric

Sedation. Principal Investigator:

Jenifer Lightdale, Children’s Hospital, Boston, MA. Grant No. K08 HS13675

(06/01/2003-05/31/2007). This Mentored Clinical Scientist Development Award will (1)

assess intolerance, other adverse

events and medical errors during

sedation of children for

gastrointestinal (GI) endoscopy;

(2) utilize regression modeling to

develop prediction rules to

improve the safety of sedation

for children undergoing the

procedure; and (3) tailor existing

taxonomies to classify medical

errors associated with IV

sedation for GI endoscopy.

Primary and secondary outcomes

data, including measures of

intolerance, other adverse events

and errors related to sedation,

will be collected in a large

prospective, observational

pediatric cohort study.

Researchers will seek to include

minorities in this pediatric study. 

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• Improve Safety of Blood

Product Transfusions in

Children. Principal Investigator:

Anthony Slonim, Children’s

National Medical Center,

Washington, D.C. Grant No.

K08 HS14009 (09/30/2003-

08/31/2006). This Mentored

Clinical Scientist Development

Award will perform a probabilistic

risk assessment (PRA) of blood

product transfusion practices in

children so that opportunities to

reduce errors and improve safety

for other low frequency, highimpact processes can be identified.

The PRA is a tool that is a hybrid

between process analysis and

decision support methods used in

high-risk industries. Using

AHRQ’s Healthcare Cost and

Utilization Project, and the

Pediatric Health Information

System databases, this study will

determine the proportion of

discharges through which blood

product transfusions are

administered during

hospitalization and describe

patient characteristics associated

with transfusions. American

Indians, Asians, Blacks and other

children will be participants in

this study. 

• Improving Obesity Care in

Pediatric Offices. Principal

Investigator: Sarah Barlow, St.

Louis University, St. Louis, MO.

Grant No. K08 HS13901

(09/01/2003-8/31/2008). The

aims of this Mentored Clinical

Scientist Development Award are

to (1) describe the current

frequency of evaluation of obesity

in African-American children ages

6 to 17 according to their

pediatricians; (2) assess

experiences and attitudes of

pediatricians in diagnosing and

discussing this condition, with

particular attention to the

interpersonal barriers to labeling a

child overweight; (3) assess

experiences and attitudes of

adolescents, and of parents of

elementary school age children in

discussing obesity with the

pediatrician to learn what

approaches are acceptable, and

what alienate or motivate them;

and (4) test the effect on

pediatricians’ self-efficacy of an

intervention that teaches

pediatricians how to address

obesity to create an alliance with

patients and families and motivate

them to make changes. 

• Fellowship in Health Services

Research. Principal Investigator:

Paul Darden, Medical University

of South Carolina, Charleston,

SC. Grant No. T32 HS13851

(07/01/2003-06/30/2008). The

aims of this Institutional TrainingPost Doctoral Award are to (1)

prepare clinicians in pharmacy,

nursing and medicine such as

pediatrics to conduct health

services research in a practical

setting focusing on changing

healthcare systems and

understanding differences in

organizational cultures, and (2)

stimulate improvement in the

healthcare system’s responsiveness

to diverse groups of patients,

including minority, poor and

other underserved patients. 

• Child Health Services Research

Training Program. Principal

Investigator: Donald Goldmann,

Children’s Hospital, Boston, MA.

Grant No. T32 HS00063

(09/30/2003-06/30/2008). The

aim of this Institutional TrainingPost Doctoral Award is to address

the well-documented critical gaps

in child health services research

and fundamentally improve the

capacity of the U.S. health care

system to meet the needs of

children and families, including

socio-economically disadvantaged

and minority populations. 

• *Hospital Disaster Plans:

Structure, Training and

Function. Principal Investigator:

Amy Kaji, Harbor-UCLA

Research and Education Institute,

Torrance, CA. Grant No. F32

HS13985 (01/01/2004-

12/31/2004). The aims of this

Predoctoral Fellowship Award are

to: 

(1) obtain disaster plans from 40

hospitals; (2) conduct a site survey

at each hospital to validate the

written plans and identify

methods of implementation; (3)

identify outcome measures

currently in use to assess hospital

preparedness and performance

during drills; (4) define specific

measurable characteristics that

vary between plans and likely

impact on overall preparedness;

and (5) develop a taxonomy for

hospital-based disaster

management plans, based on

identified practice variation.

Many of the hospitals are

approved for emergency care of

pediatric patients in the Los

Angeles Emergency Departments.

Disadvantaged groups including

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children, women and minorities

will be included in this study. 

• *Communication Errors during

Antibiotic Management Calls.

Principal Investigator: Darren

Linkin, University of

Pennsylvania, Philadelphia, PA.

Grant No. F32 HS13982

(07/01/2003-06/30/2005). The

aim of this Predoctoral Fellowship

Award is to perform a

retrospective cohort study to

determine the effect of inaccurate

communication of patient data

(from physicians caring for

patients to the antimicrobial

management program [AMP]

practitioners) on inappropriate

antimicrobial recommendations.

The quality of patient data

recorded by the AMP

practitioners will be judged

compared to the patient medical

record. The results of this study

will be applied in a future

intervention study, using clinical

outcomes as an endpoint.

Researchers expect a small

proportion of the study patients

to be children. Asian Americans

and African-Americans will be

participants enrolled in this

research. 

Improving Efficiency and

Effectiveness 

Project Funded under the PA:

Patient-Centered Care:

Customizing Care to Meet Patients’

Needs. This PA supports redesign and

evaluation of new care processes that

lead to greater patient empowerment,

improved patient-provider interaction,

easier navigation through healthcare

systems, and improved access, quality,

and outcomes.

• Childhood Chronic Illness:

Enhancing Family Capabilities.

Principal Investigator: Gail

Kieckhefer, Children’s Hospital

and Regional Medical Center,

Seattle, WA. Grant No. R01

HS013384 (09/30/2003-

09/29/2007). The purpose of

this study is to strengthen abilities

of parents to manage the

complexities of their child’s

chronic illness by improving their

own and ultimately their child’s

health. Researchers will be testing

a parent psycho-educational

program for impact on parental

self-efficacy to manage their

child’s chronic illness; ability to

involve their child in

developmentally appropriate

shared management; coping with

behavior, emotional health, and

perceived family quality of life. A

seven-session program (2 hours

per week) will be developed and

provided to parents of children

who have a chronic illness and are

between 3 and 11 years of age.

The diverse population for this

research will include American

Indians/Alaska Natives, Asians,

Native Hawaiians or other Pacific

Islanders, and African-Americans. 

Project Funded under PA for

AHRQ’s Small Research Grant

Program. This program provides

support for new investigators or

researchers new to health care services

issues, and encourages preliminary,

exploratory, or innovative research in

new or previously unexamined areas.

• Specialized Therapies by

Children: Correlates of Use.

Principal Investigator: Karen

Kuhlthau, Massachusetts General

Hospital, Boston, MA. Grant

No. R03 HS13757 (08/06/2003-

07/31/2004). In this study, four

data sources including the

National Health Interview Survey

on Disability, the Medical

Expenditure Panel Survey, the 5

percent sample of Medi-Cal

eligibility and encounter data, the

California’s fee-for-service

Medicaid plan, and a cohort of

children in Harvard Vanguard

Health Associates will be used to

(1) describe patterns of use and

expenditures for specialized

therapies for Hispanic, black,

Native or American Indian, Asian

or Pacific Islander, and other

children with and without chronic

conditions, (2) determine

correlates of specialized therapy

use among children including

predisposing, enabling, and need

characteristics, and (3) understand

how use of providers affects use. 

Training Grants 

• Health Policies and Pathways to

Mental Health Services for

Children. Principal Investigator:

Ramesh Raghavan, University of

California-Los Angeles, Los

Angeles, CA. Grant No. R03

HS13611 (04/15/2003-

01/14/2004). This dissertation

project will examine the impact of

Medicaid managed care and

Medicaid eligibility policy on

access to mental health services

for children in foster care.

Specifically, it will examine the

effects of three Medicaid managed

care policies: enrollment into

Medicaid managed care,

behavioral health carve-outs under

Medicaid managed care, and

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varying models of Medicaid

managed care service delivery.

The study will also examine the

effects of state policies that make

foster children categorically

eligible for Medicaid on three

measures of access to mental

health services: mental health

provider visits, number of such

visits, and use of

psychopharmacological

medication for children in foster

care. 

• Access to Pediatric

Subspecialty Care in the USA.

Principal Investigator: Michelle Mayer, University of North

Carolina at Chapel Hill, Chapel

Hill, NC. Grant No. K02

HS13309 (09/01/2003-

08/31/2007). The aims of this

Independent Scientist Award are

to: (1) depict the practice

location of pediatric and adult

subspecialists; (2) explore the relationship between county

characteristics and access to

pediatric subspecialty care; (3)

ascertain the extent to which

adult subspecialists expand access

to care for children with

rheumatic diseases; (4) describe

the practice patterns of

subspecialists, their comfort with

treating a variety of pediatric

conditions, and the practice,

provider, and market

characteristics that influence

their decisions to treat pediatric

patients; and (5) determine the

independent effects of selected

training, personal, and practice

characteristics on the likelihood

that an adult subspecialist treats

pediatric patients. Women and

minorities will participate in this

study. 

• *Latina Immigrants, Bridge

Persons, and Preventive

Health. Principal Investigator:

Melanie Wasserman, University

of North Carolina at Chapel

Hill, Chapel Hill, NC. Grant

No. R03 HS13864

(09/01/2003-08/31/2004). This

dissertation research study will

(1) test the theory that bridge

persons, including advocacy

organizations, churches, and

service agencies, promote the use

of preventive maternal and child

health services by Latina

immigrant women ages 15-35;

(2) test the viability of the

church-based frame for smallarea sampling; and (3) conduct

literature reviews of interventions

to promote the utilization of

preventive health services by

Latina women and their young

children. 

Contracts

AHRQ supports the Ambulatory

Pediatric Association’s Young

Investigator Grant Program. This

program builds the field of health

services research with focus on heath

care delivery in general pediatrics. • Characteristics of Smoking

Parents: Insights to Engage

Pediatricians and Improve

Tobacco Interventions to

Parents. Principal Investigator: Susanne Tanski, University of

Rochester, Rochester, NY.

Contract No. 03R000173

(04/28/2003-12/31/2004). This

study aims to better define the

roles of pediatricians in

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improving the quality and

quantity of counseling and other

intervention practices around

issues of tobacco use. Data from

the National Health Interview

Survey will be used to determine

the demographic, health and

healthcare utilization

characteristics of smoking

parents and their children,

compared to parents who do not

smoke and their children. 

• Caregiver Continuity and

Impact on Health Care

Utilization for Children in

Foster Care. Principal

Investigator: Sandra Jee,

University of Michigan Health

System, Ann Arbor, MI.

Contract No. 03R000173

(04/28/2003-12/31/2004). The

National Survey of Child and

Adolescent Well-Being General

Use Dataset will be used to (1)

conduct a cross-sectional analysis

to determine the sociodemographic characteristics of a

foster child and their caregiver in

longstanding relationships, and

(2) determine whether foster

children who have higher

caregiver continuity will have

lower utilization of health

services for acute and emergency

visits than children with lower

caregiver continuity. 

• The Unmet Medical Needs:

Risk Factors for Their Presence

and Their Effect on Pediatric

Emergency Department

Utilization. Principal

Investigator: David Brousseau,

Medical College of Wisconsin,

Milwaukee, WI. Contract No.

03R000173 (04/28/2003-

12/31/2004). This study will

examine the relationship

between parental satisfaction

with primary care and

emergency department

utilization with a validated

measure to assess the level of

parental satisfaction from

AHRQ’s Medical Expenditure

Panel Survey database,. 

• Racial Disparities: Is it the

Content of Care? Principal

Investigator: Patricia McBurney,

Medical University of South

Carolina, Charleston, SC.

Contract No. 03R000173

(04/28/2003-12/31/2004). In

this study, data from the

National Ambulatory Medical

Care Survey will be used to

conduct a cross-sectional analysis

to examine the content of well

child care, compare proportions

of visits provided to minority to

non-minority patients, and

determine if there are racial

disparities. 

Conferences and Meetings

• Improving Quality in

Medication Management in

School—March 23-24, 2004.

Principal Investigator: Julia Lear,

George Washington University,

Washington, D.C. Grant No.

R13 HS14208 (08/06/2003-

08/05/2004). The focus of this

conference is on improving the

safety of health care for children

in the management of

medication and other treatment

regimes while they are in schools.

The conference will: (1) describe

the issues of patient safety in

medication management in
schools, (2) identify the unique

characteristics of in-school

medication administration,

including the impact of school

board policies, local and state laws

and regulations, (3) develop and

prioritize research topics ready for

further study, and (4) identify

approaches for integrating schoolbased medication management

monitoring and quality

improvement practices with the

larger health care quality

improvements systems. 

• First International Child Health

Services Research Meeting –

September 20, 2003. Principal

Investigator: Wendy Valentine,

AcademyHealth, Washington,

D.C. Contract No. 290-98-0003

(02/28/2003-12/31/2003). This

first-time, one-day affiliate

meeting focused on child health

services research seeking to

advance children’s health services

and health through the

establishment of a strategic focus

for international child health

services research activities. By

bringing together leaders from

diverse countries, the meeting

addressed the current absence of

an emphasis on children in the

international dialogue on health

care quality and health services

improvement. The meeting was

cosponsored by AHRQ and

AcademyHealth; funded in part

by the Nemours Foundation and

the American Board of Pediatrics

Foundation. 

• The Fifth Annual Child Health

Services Research Meeting—

What Works in Child Health

Services Research—June 26,

2003. Principal Investigator:

Wendy Valentine,

AcademyHealth, Washington,

D.C. Grant No. R01 HS 08201

(11/01/2002-06/30/2003). The

meeting gathered researchers and

policy professionals to learn about

new research in child health

services, to discuss critical health

policy issues for children, and to

develop skills in research methods.

Various sessions addressed quality

improvement, patient safety,

children with special health care

needs, oral and dental health,

SCHIP findings for vulnerable

populations, and new frontiers in

child health services research. The

meeting was co-sponsored by

AHRQ and AcademyHealth, with

support from the American

Academy of Pediatrics, The

Commonwealth Fund, HRSA’s

Maternal and Child Health

Bureau, National Association of

Children’s Hospitals and Related

Institutions, Nemours

Foundation, Vanderbilt

Department of Pediatrics and

Vanderbilt Children’s Hospitals

and the Ambulatory Pediatric

Association. 

• *Managing the Risks of

Therapeutic Products-January

12-14, 2003. Principal

Investigator: Judith Kramer, Duke

University, Durham, NC. Grant

No. R13 HS 13929 (01/06/2003-

01/05/2004). The workshop

explored current and future

methods of managing the risks of

FDA approved therapeutic

products against criteria extended

to all populations, including

urban, rural, and low-income

groups; racial and ethnic

minorities; women; children; the

elderly; and those with special

health needs. A research agenda

will be developed to monitor the

effectiveness of these risk

management approaches. 

This workshop is one of five

sessions in the Risk Series. The

workshop was co-sponsored by

The Centers for Education &

Research on Therapeutics/Duke

University, AHRQ, FDA and the

Pharmaceutical Research and

Manufacturers of America. 

For More Information

AHRQ’s Web site at www.ahrq.gov

provides information on the Agency’s

children’s health services agenda, and

detailed information on funding

opportunities. 

Further details on AHRQ’s programs

and priorities in child health services

research are available from:

Denise Dougherty, Ph.D.

Senior Advisor, Child Health

Agency for Healthcare Research and

Quality

540 Gaither Road

Rockville, MD 20850

Phone: 301-427-1868

Fax: 301-427-1347

E-mail: ddougher@ahrq.gov

11
www.ahrq.gov

AHRQ Pub. No. 04-P005

February 2004