Introduction

This fact sheet summarizes new

initiatives from the Agency for

Healthcare Research and Quality

(AHRQ) in child and adolescent health

care, focusing on improving the quality,

safety, efficiency, and effectiveness of

health care. In fiscal year (FY) 2006,

AHRQ committed more than 

$7 million of total support over the lives

of these projects for new intramural and

extramural research, including grants

and contracts. Of this amount, 

$3 million was committed in FY 2006,

with the remainder to be expended in

the out years.

Improving Quality and

Increasing Safety

Projects funded under AHRQ’s RFA

for Improving Patient Safety Through

Simulation Research. This program

supports grants that will advance the

knowledge of how simulation can improve

patient safety across disciplines, settings,

and populations; analyze the impact of

different types of simulation; and inform

providers, patients, health educators,

payers, policymakers, the public, and

AHRQ about successful simulation

initiatives.

• In Situ Teamwork Training and

Detection of Safety Threats in

High-Risk Settings. Principal

Investigator: Mary Patterson,

Cincinnati Children’s Hospital

Medical Center, Cincinnati, OH.

Grant No. U18 HS16615

(09/30/06-09/29/08). This study

will identify the causes of medical

errors and use multidisciplinary

simulation-based teamwork training

to decrease the numbers of and

mitigate the effects of medical errors

in high-risk clinical settings. The

effectiveness of this training will be

evaluated by assessing teamwork

Research on Child and

Adolescent Health Care

New Starts-Fiscal Year 2006

FACT SHEET

Agency for Healthcare Research and Quality

AHRQ’s mission is to improve the quality,

safety, efficiency, and effectiveness of health

care by:

• Using evidence to improve health care.

• Improving health care outcomes through

research.

• Transforming research into practice.

Advancing Excellence in Health Care • www.ahrq.gov

Agency for Healthcare Research and Quality

* Projects that include children or children’s health care issues but do not focus exclusively on

children are marked with an asterisk (*).
behaviors, errors, and time to

intervention. Minorities will be

included in this study.

• Improving Patient Safety with

Just-In-Time Pediatric Simulation

Training. Principal Investigator:

Vinay Nadkarni, Children’s Hospital

of Philadelphia, Philadelphia, PA.

Grant No. U18 HS16678

(09/30/06-09/29/08). This

prospective study will randomize

“sharp end” providers who manage

airway emergencies in the pediatric

ICU to either no overtraining vs. 20

minutes of either low-fidelity or

high-fidelity simulation overtraining.

Women and minorities will be

included in this study. 

Projects funded under AHRQ’s

Program Announcement (PA) for

Practice-Based Research Networks

(PBRNs) and Translating Research

Into Practice (TRIP). These programs

build on earlier RFAs from AHRQ (TRIP

I and II; Quality Improvement Strategies

in Health Care; Partnerships for Quality)

and NIH, and focus on approaches for

translating research evidence into practice

in ways that are effective in communitybased primary care settings. • Treatment of Children with

Obesity in Primary Care. Principal

Investigator: Ellen Wald, University

of Wisconsin, Madison, WI. Grant No. R21 HS14862 (11/01/05-

10/31/07). This prospective,

randomized, controlled clinical trial

will take place in 5 of 22 practices

comprising the Pediatric PitNet, a

PBRN servicing 130,000 children

and including 142 pr

oviders. The

study will assess the effectiveness of

teaching primary care providers to

use specific communication

strategies with parents of overweight

children to help them take steps

with their child toward healthy

behavior changes. This study will

also offer core components of an

efficacious, family-based behavioral

weight management program within

the pediatric primary care setting to

determine whether participating

children will change behaviors

regarding dietary intake and physical

activity to achieve clinically

meaningful weight loss. Racial and

ethnic minority children between

the ages of 9 and 12, with at least

one parent, will be included in this

study.

• Electronic Health Record (EHR)

Decision Support To Improve

Outpatient Asthma Care. Principal Investigator: Louis Bell, Children’s Hospital of Philadelphia,

Philadelphia, PA. Grant No. R21

HS14873 (01/02/06-12/31/07).

This intervention study will

determine whether an active clinical

decision support (CDS) intervention

imbedded in an EHR improves

adherence to National Asthma

Education and Prevention Program

(NAEPP) guidelines in the primary

care setting. The intervention will

offer a validated educational

curriculum to the primary care

providers that stresses the evidencebased components of effective

asthma care management and

provides an asthma control and

symptom assessment tool. The

study is intended to ensur

e

portability to other institutions and

EHR systems. This research will

include urban and suburban

children ages 6-18 years who make a

clinic visit to one of the 10 primary

care pediatric sites during the study

period and meet the criteria for

persistent asthma.

2
Projects funded under RFA for

AHRQ’s Small Research Grant

Program. This program provides support

to new investigators or researchers who

will conduct exploratory/pilot projects or

feasibility studies. 

• The Feasibility of Assessing the

Prevalence of Rickets. Principal

Investigator: James Taylor, University

of Washington, Seattle, WA. Grant

No. R03 HS16029 (05/01/06-

10/31/07). The Puget Sound

Pediatric Research Network

(PSPRN) will conduct a preliminary

study to determine the feasibility of

a larger project that will examine the

prevalence of rickets in breastfed

infants and toddlers not receiving

supplemental vitamin D. Minority

children will be included in this

study.

• Parents and Health Care

Professionals Working Together To

Improve Adolescent Health.

Principal Investigator: Carol Ford,

University of North Carolina at

Chapel Hill, Chapel Hill, NC.

Grant No. R03 HS16021

(06/01/06-05/31/07). The North

Carolina Adolescent Research

Consortium for Health is an

emerging network focused on

improving adolescent health and

health care through collaborative

research. In this study, focus groups

will be conducted with parents of

adolescents to increase researchers’

understanding of parents’

perceptions of adolescent health, the

amount of discordance between

perceptions of “ideal” and “actual”

adolescent health during early,

middle, and late adolescence, and

perceived roles of parents and health

care professionals in addressing areas

of discordance. Health content areas

include general health, obesity

prevention, detection of

asymptomatic sexually transmitted

infections, and prevention of

alcohol-related injuries. Minorities,

women, and adolescents will be

included in this study.

Investigator-Initiated

Research

Research project grants. AHRQ

supports projects that focus on a wide

range of topics that address the Agency’s

mission of improving quality, patient

safety, efficiency, and effectiveness of

health care.

Small grants. AHRQ’s small research

grant program provides support for new

investigators or researchers new to

health care service issues and encourages

preliminary, exploratory, or innovative

research in new or previously

unexamined areas.

Dissertation awards. AHRQ’s

dissertation grant program supports

research undertaken as part of an

academic doctorate that focuses on areas

relevant to health services research, with

emphasis placed on methodological and

research topics that address AHRQ’s

mission.

Career development awards. AHRQ

provides an array of intramural and

extramural predoctoral and postdoctoral

educational and career development

grants and opportunities in health

services research. 

Research infrastructure development

awards. AHRQ supports two research

initiatives designed to build and

strengthen the Nation’s research

infrastructure, and support the planning

and development of health services

research (HSR) in traditionally

minority-serving institutions and

institutions in States that do not receive

significant HSR funding. They are (1)

the Minority Research Infrastructure

Support Program (M-RISP) and (2) the

Building Research Infrastructure and

Capacity (BRIC) Program, respectively. 

Conference grants. AHRQ supports

both large and small conferences that

further its mission. The types of

conferences eligible for support include:

research development; study design and

methodology; research dissemination;

and research training, infrastructure,

and career development. 

Grants awarded in child health during

fiscal year 2006 under these

mechanisms are listed below.

Research Project Grant

• Perinatal Regionalization and

Quality of Care. Principal

Investigator: Scott Lorch, Children’s

Hospital of Philadelphia,

Philadelphia, PA. Grant No. R01

HS15696 (09/30/06-09/29/09).

This study will (1) evaluate

differences in the quality of neonatal

care between hospitals; (2)

determine the effect of perinatal deregionalization on rates of mortality,

failure-to-rescue, complications, and

21-day readmission in very lowbirth-weight (VLBW) infants; and

(3) develop a predictive model that

explains neonatal outcomes as a

function of the quality of neonatal

care and regionalization policy in a

given geographical area. This project

will use population data from 1992

to 2002 in three States (California,

New York, and Pennsylvania) that

have an estimated 12,800 VLBW

births per year. Racial and ethnic

minority infants will be included in

this study.

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Small Grants

• Poisoning Incidence and

Emergency Department

Use/Misuse in Young Children.

Principal Investigator: Barbara

Polivka, Ohio State University,

Columbus, OH. Grant No. R03

HS15713 (02/15/06-05/15/07).

This study will examine poison

exposures where the poison control

center (PCC) was contacted for

advice and subsequently followed,

versus those that were not followed,

versus emergency department/urgent

care (ED/UC) in lieu of initial PCC

contact. This retrospective review of

electronic records will link data from

the PCC, the hospital ED/UC, and

the institutional national electronic

injury surveillance system. This

study will develop a comprehensive

age-specific poisoning incidence rate,

determine rates of non-PCC

compliance, and identify patterns in

non-PCC use. Electronic record

reviews will be limited to children

younger than 6 years old from a

Midwestern urban area. Records of

racial/ethnic minority children will

be included in this study. 

• *Opioid Prescribing Patterns in

the United States. Principal

Investigator: Mark Pletcher,

University of California-San

Francisco, San Francisco, CA. Grant

No. R03 HS16238. (03/01/06-

02/28/08). This study will analyze

(1) how many ambulatory care visits

result in an opioid prescription every

year in the United States; (2) how

patient behavior (presenting with

pain) and physician behavior

(prescribing with pain) contribute to

trends in opioid prescribing; (3) how

choice of analgesic has changed over

time (non-opioids vs. opioids, shortvs. long-acting opioids, high abuse

potential and brand name

formulation); and (4) how opioid

prescribing differs by clinical setting,

physician type, and geographic

area/U.S. State. The analysis uses

1993-2002 data from the National

Ambulatory Medical Care Survey

and the National Hospital

Ambulatory Medical Care Survey.

Youths age 12 to 17 years old and

young adults of racial and ethnic

minority populations (Hispanic,

American Indian/Alaska Native,

Asian, and African American), will

be included in this study. 

Dissertation Awards

• Human-Computer Interaction

(HCI) Evaluation of Medication

Management Use of Health

Information Technologies (HITs)

in Pediatric Care. Principal

Investigator: Kevin Moloney,

Georgia Tech Research Corporation,

Atlanta, GA. Grant No. R36 HS

15682 (01/01/06-12/31/06). In

collaboration with Children’s

Healthcare of Atlanta (CHOA), this

dissertation research project will

examine user-, device-, and contextbased factors that affect user

interaction with traditional and

mobile computing technologies

while performing medication

management tasks in pediatric care.

Minority undergraduate and

graduate students from the Georgia

Institute of Technology and minority

healthcare staff (physicians, nurses,

and pharmacy clinicians) from

CHOA using HITs as part of their

daily work will be included in this

study. 

• Racial and Ethnic Variation in

Adolescent Obesity: A Multilevel

Study of Neighborhoods and

Schools. Principal Investigator: Lisa

Nicholson, Ohio State University,

Columbus, OH. Grant No. R36

HS16568 (09/01/06-06/30/07).

This study will use longitudinal data

from the National Longitudinal

Study of Adolescent Health (ADDHealth), Waves I and III, to examine

variation in young adult obesity, as

predicted by adolescent

neighborhood environments and

school facilities, with a specific focus

on poor neighborhoods and schools,

Blacks, and Hispanics. This study

will determine the (1) effect of

race/ethnicity on the risk of obesity;

(2) extent to which neighborhood

disadvantage helps to explain racial

and ethnic variation in obesity; and

(3) extent to which disadvantaged

schools explain racial and ethnic

variations in obesity. This study will

also explore the interactive effect of

race and ethnicity with

neighborhood disadvantage and

school disadvantage. 

• The Economics of Mother’s Milk

Feedings in the Neonatal Intensive

Care Unit. Principal Investigator:

Briana Jegier, Saint Louis University,

Saint Louis, MO. Grant No. R36

HS16012 (09/01/06-06/30/07).

This study will measure the doses of

mothers’ milk recorded daily for the

entire hospital stay. This study will

also estimate the maternal cost of

producing mothers’ milk for verylow-birth-weight (VLBW) infants in

the neonatal intensive care unit

(NICU), as well as quantify the

impact of increasing doses and the

exposure period of mothers’ milk on

hospital financial outcomes,

specifically charges and length of

stay. The study population is a

cohort of 1,000 VLBW infants

admitted to a NICU from 1997 to

2003, including racial and ethnic

minority infants, low-income

infants, and infants with special

health care needs. 

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Career Development Awards • Prescribing Errors in Ambulatory

Pediatric Care. Principal

Investigator: William Basco, Medical

University of South Carolina,

Charleston, SC. Grant No. K08

HS15679 (06/01/06-05/30/10).

The aims of this Mentored Clinical

Scientist Development Award are to

(1) validate a method for imputing

weights for determining overdose

and underdose for pediatric

medications; (2) define and

determine the frequency of

ambulatory pediatric prescribing

errors; (3) identify provider and

patient characteristics associated with

pediatric prescribing errors; (4)

evaluate whether electronic medical

records that include a prescribing

module reduce the rate of pediatric

prescribing errors among trainees;

and (5) determine the relative

contributions of prescriber and

pharmacy to pediatric ambulatory

prescribing errors. This study will

use prescription data from SC Medicaid enrollees ages 0-18 years

old, including Hispanic and AfricanAmerican children and youth of

both genders.

• Does Parental Health Insurance

Loss Affect Children’s Access to

Care? Principal Investigator:

Jennifer Devoe, Oregon Health &

Science University, Portland, OR.

Grant No. K08 HS16181

(07/01/06-06/30/11). The aims of

this Mentored Clinical Scientist

Development Award are to (1)

explore the potential barriers to

children’s health insurance and access

to healthcare using a cross-sectional

secondary analysis of the Medical

Expenditure Panel Survey, and

primary collection and analysis of

the Oregon Children’s Access to

Healthcare Study; and (2) conduct a

longitudinal analysis of data from

three survey waves of the Oregon

Health Plan Prospective Cohort

Study to determine how parental loss

of health insurance is associated with

changes in children’s health

insurance status over time. Women,

racial/ethnic minority populations,

and individuals with chronic

conditions will be included in this

study. 

• Disparities in Quality of

Healthcare Affect Utilization.

Principal Investigator: David

Brousseau, Medical College of

Wisconsin, Milwaukee, WI. Grant No. K08 HS15482 (03/02/06-

02/28/11). This Mentored Clinical

Scientist Development Award will

determine the impact of disparities

in perception of primary care quality

on healthcare utilization patterns for

both a nationally representative

population (from the Medical

Expenditure Panel Survey) and a

low-income, high-risk pediatric

population (the Wisconsin Medicaid

administrative database). The

researcher will also define the

parental perspective on non-urgent

use of the emergency department

(ED), and determine the effect of

the parent/provider relationship on

non-urgent ED utilization using

focused interviews with parents who

brought their children to the ED

with non-urgent conditions. Finally,

the project will also define the

primary care provider perspective on

non-urgent utilization of the ED

and determine provider responses to

the views expressed by parents from

their practice. Low-income, innercity, and minority (Hispanic or

Latino, American Indian/Alaska

Native, Asian, Native Hawaiian or

other Pacific Islander, and African

5
American) children and parents will

be included in the study. 

• Entry Into Adult Care for Youth

with Chronic Conditions.

Principal Investigator: Peter Scal,

University of Minnesota Twin Cities,

Minneapolis, MN. Grant No. K08

HS15511 (09/01/06-08/31/09).

This Mentored Clinical Scientist

Development Award will compare

(1) delays in care and unmet needs

and their determinants between

adolescents (ages 14-17 years) and

young adults (ages 18-24 years) with

chronic conditions using data from

the National Health Interview

Survey; and (2) factors associated

with access to health care, specifically

primary care services, between

adolescents and young adults with

chronic conditions using data from

the Medical Expenditures Panel

Survey (MEPS). Using MEPS, the researcher will also compare the

health care utilization and

expenditures of adolescents with

young adults with chronic

conditions, and evaluate the effect of

loss of insurance coverage on health

care access, utilization, and

expenditures. Women, children,

racial, and ethnic minority

populations (Hispanic or Latino,

American-Indian/Alaska Native,

Asian, Native Hawaiian or other Pacific Islander, and Black or African

American) will be included in this

study. 

• Racial Stereotypes and the

Recognition of Child Abuse. Principal Investigator: Antoinette

Laskey, Indiana University-Purdue University, Indianapolis, IN. Grant No. K08 HS16564 (09/30/06-

09/29/11). This Mentored Clinical

Scientist Development Award will be

used to develop and implement a

Web-based tool to study the

influence of race on the diagnosis of

abusive head trauma and physicians’

recall of clinical information in cases

of potential abusive head trauma.

This researcher will also develop an

educational intervention to decrease

the effect of physicians’ unconscious

stereotypes on the decision to

evaluate for abusive head trauma;

and pilot test the educational

intervention for reducing the role of

unconscious racial stereotypes in the

recognition of abusive head trauma.

The study population in this

research will be physicians, including

Black pediatricians.

• *Evaluating e-Prescribing in a

Community-based, Integrated Health System. Principal

Investigator: Emily Devine,

University of Washington, Seattle,

WA. Grant No. K08 HS14739

(08/01/06-07/31/11). This Mentored Clinical Scientist Development Award will be used to

conduct an impact evaluation of the

implementation of medication safety

clinical decision support (CDS)

alerts on medication errors and

adverse drug events (ADEs)

associated with generic and

therapeutic drug duplications,

appropriate drug-laboratory

monitoring, appropriate prescribing

in patients, drug-drug interactions,

and appropriate prescribing in

pregnancy. Using a longitudinal

study design, this project will

determine the incidence of serious

medication errors and ADEs prior

to, and after implementing CDS

alerts in these specific categories.

The representation of children

should closely approximate that of

the pediatric population cared for at

pediatric clinics included in the

work. This study will include racial

and ethnic minority populations. 

6
Research Infrastructure

Development Awards 

Grant funded under the Minority

Research Infrastructure Support

Program (M-RISP) • *San Antonio Health Services

Research (HSR) Program.

Principal Investigator: Raymond

Garza, University of Texas, San

Antonio, San Antonio, TX. Grant

No. R24 HS14064 (02//01/06-

01/31/09). A study in this HSR

capacity building program entitled

“Enhancing Health-Conscious

Attitudes and Behaviors among

Hispanic Youth” will address major

health issues that involve Hispanic

children and youth. This project

will focus on reducing the risk of

chronic disease and promoting

healthy attitudes and behaviors

among preadolescent and adolescent

Mexican-American children. Targeted behaviors include cigarette

smoking, alcohol use, eating habits

related to obesity and diabetes risk,

and physical activity. 

Grant funded under the Building

Research Infrastructure and

Capacity (BRIC) Program • *Arkansas Consortium for Health

Services Research. Principal

Investigator: Bradley Martin,

University of Arkansas Medical

Sciences, Little Rock, AR. Grant

No. P20 HS15878 (06/01/06-

05/31/08). This project will expand

and strengthen the capacity for

health services research (HSR)

within the State of Arkansas (AR)

through creation of the AR

Consortium for HSR. The

consortium will (1) develop and

maintain research-quality databases

from several underutilized State data

sources including AR BlueCross/

BlueShield enrollment and claims

files, AR Medicaid enrollment and

claims files, and AR hospital

discharge data system; (2) develop

multidisciplinary research

mentorship, communication, and

skill-building opportunities for

health services researchers across the

State; and (3) develop and

administer an intramural HSR “seed

grant” program that provides

dedicated programming time and a

limited amount of funding to allow

researchers to conduct pilot studies

using consortium data resources.

The initial research project proposed

for the consortium focusing on

disparities in access to antipsychotic

drug therapies will include a

significant analytic component

devoted specifically to disparities

among children. Racial and ethnic

minorities will be included in this

research. 

Conference Grants • Increasing the Impact of Maternal

and Neonatal Health Systematic

Reviews (2006-New Orleans).

Principal Investigator: Frederique

Jacquerioz, Tulane University School

of Public Health and Tropical Medicine, New Orleans, LA. Grant No. R13 HS16273 (07/01/06-

06/30/07). The goal of this

conference, to be held in March

2007, is to assess the barriers to

conducting and implementing the

results of systematic reviews in order

to increase the impact of systematic

reviews in maternal and neonatal

health. The conference has three

objectives: (1) to identify the needs

for administrative and technical

support to revie

wers for the

preparation of systematic reviews,

including the development of

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protocols and the identification of

relevant topics on maternal and

neonatal issues for the Americas; (2)

to identify new ways to encourage

and assist current reviewers in

updating their reviews on a regular

basis; and (3) to identify the best

strategies to widely diffuse existing

evidence from systematic reviews to

health care professionals,

stakeholders, policymakers, and

health researchers and to encourage

the use of evidence-based practices

in the Americas.

• Child Health Services Research

(CHSR) Meeting (June 24, 2006-

Seattle, WA). Principal Investigator:

Jennifer Muldoon, AcademyHealth,

Washington, DC. Grant No. R13

HS16292 (05/12/06-05/11/07).

The purpose of this eighth annual

CHSR meeting was to bring

together researchers, managers, and

policy and clinical decisionmakers in

child health services to learn firsthand from colleagues about the

latest research, policy challenges,

methods, and resources for the field.

This conference provided a forum

for the child health services

community to (1) disseminate the

results of child health services

research; (2) inform policy and

clinical decisionmaking on child

health services; (3) build researchers’

skills with new methods and data

sources for child health services

research; and (4) create networking

opportunities for those interested in

child health services. This meeting

was the principal dissemination

opportunity for health services

research on a priority population—

children. 

• Promoting Quality of Care for

Publicly Insured Children.

(August 17–18, 2006-Washington,

D.C.) Principal Investigator:

Charles Homer, National Initiative

for Children’s Healthcare Quality,

Cambridge, MA. Grant No. R13

HS16360 (07/21/06-02/20/07).

The purpose of this conference was

to improve the quality of care for

children served by public programs

by promoting the translation of

recent research into practice and

policy. The objectives of this

dissemination conference were (1)

summarize what is known from

research and state experience about

key aspects of the quality agenda,

namely, quality measurement and

improvement, health information

technology, and pay for

performance; (2) engage research

users and stakeholders in a

discussion of the next steps and

strategies necessary to accelerate the

diffusion and adoption of this

research into policy and practice; (3)

identify key research questions that

remain unanswered; and (4)

disseminate the results of this event

broadly to stakeholders in the public

and the private sectors as well as

researchers. This conference included

a specific emphasis on low-income

children, racial/ethnic minority

children, and children with special

health care needs. 

• Asthma Education Conference for

Tribal Health Officers Serving the

Aberdeen Area (September 2006-

Rapid City, SD). Principal

Investigator: David Osterberg,

University of Iowa, Iowa City, IA.

Grant No. R13 HS16435

(06/01/06-05/31/07). The goal of

this conference was to advance the

state of knowledge of asthma among

tribal health representatives and

directors, Indian Health Service staff,

emergency medical workers, nurses,

and pediatricians working with 18

tribes in the region served by the

Northern Plains Tribal Epidemiology

Center so that they may transform

this knowledge into better medical

services and heightened

understanding of this condition in

their communities. This regional

conference focused on childhood

asthma among Native Americans in

the Northern Plains region and was

designed to inform representatives of

the Northern Plains tribal health

agencies about the current state of

research and treatment of asthma, its

potential environmental health

triggers, prevention strategies, and

environmental improvement

measures. The conference addressed

exposures to everyday types of

indoor and outdoor contaminants,

including, but not limited to

environmental tobacco smoke,

allergens and endotoxins; molds and

insects; biological contaminants

(e.g., dust mites); chemical

contaminants (e.g., pesticides and

formaldehyde); exhaust from woodburning stoves; and motor vehicle

exhaust. 

• Child Abuse Recognition,

Research, Education Translation

(CARRET) Conference

(September 14–15, 2006-Elk

Grove Village, IL). Principal

Investigator: Alison Baker,

American Academy of Pediatrics, Elk

Grove Village, IL. Grant No. R13

HS16359 (04/01/06-03/31/07).

The purpose of this conference was

to bring together a multidisciplinary

group of 35-40 professionals who

treat, manage, and advocate for

children who have been maltreated

to discuss the results of a recently

completed study, entitled “Child

8
Abuse Recognition Experience

Study,” and other studies that have

examined health care provider

decisionmaking regarding possible

child abuse. The conference had

three goals: (1) to understand the

roles and relationships between

healthcare professionals, investigative

agencies, and the legal system; (2) to

develop strategies to enhance

physicians’ capabilities and

confidence in reporting suspected

child abuse and neglect; and (3) to

enhance working relationships

among multidisciplinary participants

who will work toward

implementation of strategies

developed during this conference

including dissemination of its

results. 

• Conference To Improve Outcomes

in Pediatric Trauma Care (2007-

Seattle, WA). Principal Investigator:

Frederick Rivara, University of

Washington, Seattle, WA. Grant

No. R13 HS16431 (06/01/06-

05/31/07). This conference will

bring together experts and

researchers from a variety of fields to

develop a research agenda to address

the limitations of prior studies of

and provide definitive answers to the

national questions on pediatric

trauma care. Experts from across the

country in a wide variety of

specialties will review the current

state of knowledge about pediatric

trauma care and develop an

innovative, collaborative research

agenda for improvement. The

agenda will be disseminated through

a supplement to a peer-reviewed

journal, presentations, and Web

sites. “White papers” on the various

aspects of key topics will be

presented at the meeting. This

conference will allow policymakers

to better understand the strength, or

lack, of evidence for current trauma

policy and how research might be

used to guide future policy.

• Improving Child Health: The

Role of Policymakers in

Prevention and Treatment of Birth

Defects and Developmental

Disabilities (August 2007-Boston,

MA; July 2008-New Orleans, LA;

and July 2009-Philadelphia, PA).

Principal Investigator: Alissa

Johnson, National Conference of

State Legislatures, Washington, D.C.

Grant No. R13 HD54282

(10/1/06-09/30/09). The objectives

of this multi-year conference are to

(1) identify the range of policy

approaches utilized by State and

Federal policymakers to address the

prevention and treatment of birth

defects and developmental

disabilities; (2) foster information

sharing about new strategies to

prevent and treat birth defects and

developmental disabilities through

public programs; and (3) develop

new pathways for the translation of

scientific research and technology

into public health programs by

informing policymakers about

research activities. This conference is

intended to better the lives of

children through improved quality

and access to birth defects and

developmental disabilities prevention

and treatment. AHRQ is cofunding this conference with the

National Institute of Child Health

and Human Development and other

entities.

• *Improving ICU Care and Safety

through Evidence-Based Tools

(June 16, 2006-Baltimore, MD).

Principal Investigator: Lisa

Lubomski, Johns Hopkins

University, Baltimore, MD. Grant

No. R13 HS16216 (03/01/06-

02/28/10). This conference will be

held annually over a 4-year period.

The goal of this first conference was

to disseminate tools and results from

the AHRQ-sponsored project—

Statewide Efforts To Improve Safety

in Intensive Care Units (UC1

HS14246: Keystone ICU project).

This conference addressed the

following: (1) evidence-based tools

to improve care and patient

outcomes used during the Keystone

ICU project; (2) results of

improvements in patient outcomes

from the use of project-developed

tools; and (3) implementing the

tools in the ICU to improve patient

care and outcomes in other clinical

settings. The conference focused on

issues pertinent to all patient

populations, including the elderly,

women, children, racial and ethnic

minority groups, low-income

groups, rural populations, and

persons with special health care

needs. 

• *Medication Error Reporting

Systems: Challenges, Lessons,

Future Direction (November

2006-Rockville, MD). Principal

Investigator: Diane Cousins, U.S.

Pharmacopeia, Rockville, MD.

Grant No. R13 HS16515

(09/01/06-06/01/07). The purpose

of this conference is to determine

how hospitals have utilized

medication error data to improve

patient safety. The conference will

convene participants from 20

hospitals that have participated in

the MEDMARX medication error

reporting program for at least 5

years, as well as other participants.

Conference discussions will address

safety issues for all patients,

including minorities, women,

children, and the elderly. 

9
• *Meeting the Nation’s Needs for

Personal Assistance Services

Conference (April 2007-

Washington, DC). Principal

Investigator: Charlene Harrington,

University of California San

Francisco, San Francisco, CA. Grant

No. R13 HS16608 (09/30/06-

09/29/07). This conference has two

purposes: (1) summarize, synthesize,

and disseminate current research

findings on personal assistance

services (PAS) to researchers,

policymakers, advocates, and other

stakeholder groups; and (2) develop

a future research agenda for the

study of PAS. The conference will

focus on access, quality, and costs of

PAS delivered in the home, the

community, and the workplace as

well as PAS workforce trends and

future research needs. The

conference will address the needs of

individuals with disabilities,

individuals from low- income

groups, both genders, racial and

ethnic minority groups and

subgroups, and children who need

and/or use PAS. 

• *1st National Summit on Primary

Care Emergency Preparedness

(February 2007-New York, NY).

Principal Investigator: Melissa

Corrado, Primary Care

Development Corporation, New York, NY. Grant No. R13

HS16593 (09/30/06-09/29/07).

The goal of this summit is to

increase the emergency preparedness

level of primary care sites and

facilitate their integration into local

and regional emergency response

planning. The conference will serve

as a national forum to (1) discuss the

preparedness level of primary care

(PC) centers across the Nation; (2)

share best practices and innovative

strategies to impr

o

ve the

preparedness level and response

capabilities; (3) convene stakeholders

to identify roles; and (4) set the

agenda for preparedness on the local,

State, and national levels. The

participants include PC providers,

hospital emergency planners, schoolbased emergency planners,

ambulatory care network

administrators, and others. 

The Center for Education Research

on Therapeutics. This demonstration

program is a national initiative designed

to conduct research and provide education

that advances the optimal use of

therapeutics (i.e., drugs, medical devices,

and biological products). • *Center for Education and Research on Mental Health

Therapeutics. Principal

Investigator: Stephen Crystal,

Rutgers State University of New

Jersey, New Brunswick, NJ. Grant

No. U18 HS16097 (04/14/06-

03/31/11). The first project of this

study, “Use and Monitoring of

Antidepressant Therapy among

Youths,” will describe rates,

predictors, and trends in

antidepressant use associated with

treatment initiation among children

and adolescents in multistate

Medicaid and SCHIP populations.

This study will also examine

monitoring patterns following

initiation of selective serotonin reuptake inhibitors (SSRIs),

including frequency and timing of

professional visits, provider specialty,

receipt or non receipt of mental

health specialty services. and

procedure codes for type of visits

(psychotherapy, diagnosis and

evaluation, medication

management). 

10
The second project, “Assessing

Quality of Antipsychotic Treatment

of Medicaid Youth,” will examine

variations in patterns of

antipsychotic use for youth across

eight states, including provider,

beneficiary characteristics and

diagnoses associated with treatment,

treatment duration, and use of

multiple medications. The project

will also estimate how closely

practice conforms to selected

Treatment Recommendations for

Atypical Aggressive Youth (TRAAY)

guidelines, and identify physician

and patient characteristics associated

with low-conformance. 

The third project, “Improving Prescriber Practices for

Antidepressants and Atypical

Antipsychotics in Children: The

Texas-New York Medication

Algorithm Project,” will adapt the

TRAAY, originally intended for

inpatient/residential settings, to

outpatient settings. This study will

also integrate and develop “crosswalks” between Texas- and New

York-developed SSRI guidelines, so

that both guidelines address the

complementary roles of primary care

providers and mental health

specialists, and are applicable to both

States. Moreover, this project will

train samples of outpatient

prescribers in Texas and New York to

apply modified TRAAY and SSRI

guidelines; and to evaluate program

impact. Minorities (Hispanic/

Latino, American Indian/Alaska

Native, Asian, Native Hawaiian or

other Pacific Islander, and Black) and

children between 5 and 18 years will

be included in these three projects. 

Contracts • Development of a Resource Guide

to Child-Relevant Measures and

Other Features of AHRQ’s HCUP

Databases including the KID and

Pediatric Quality Indicators,

MEPS Data Sets, and CAHPS

CCC Measurement Tools.

Principal Investigator: Christina

Bethell, The Child and Adolescent

Health Measurement Initiative,

Oregon Health & Science

University, Portland, OR. Contract

No. HHSP233200600562P

(08/01/06-02/28/07). This project

will develop a resource guide that

will facilitate research and

publishable reports relevant to

furthering knowledge on the health

and health care quality of children

and youth. 

Projects funded under the

Ambulatory Pediatric Association

Young Investigator Awards.

AHRQ has supported this initiative of

the Ambulatory Pediatric Association

for several years. This competitive

program provides support to new

investigators in general pediatrics

conducting child health services

research. • Effect of a Clinical Practice Improvement Intervention on

HIV Testing in Sexually Active

Adolescents. Principal

Investigator: Renata Sanders,

Johns Hopkins University

School of Medicine, Baltimore,

MD. Contract No.

HHSP233200600468P

(06/05/06-01/31/07). This

study will (1) measure current

HIV screening practices and the

provider and patient attributes

predictive of screening; (2)

design and implement a quality

improvement (QI) activity to

increase screening by addressing

11
the malleable predictors in a

Plan-Do-Study-Act (PDSA)

framework; and (3) assess the

impact of the QI program on

HIV testing in adolescents ages

12-21 years in a high-prevalence

community. The PDSA model

incorporates planning for

change, executing the plan,

studying the outcomes of the

executed plan, and acting on the

results. 

• Is the Presence of a Mentor

During Adolescence Associated

with Improved Adult

Outcomes in Special

Populations of High-Risk

Youth? Principal Investigator:

Kym Ahrens, University of

Washington, Seattle, WA.

Contract No.

HHSP233200600468P

(06/05/06-01/31/07). This

study will use the National

Longitudinal Study of

Adolescent Health to investigate

whether there are certain populations of high-risk adolescents in

which mentoring relationships

may be particularly beneficial

during the early adulthood years.

The study will focus on four

domains of adolescent and

young adult well-being: education/employment, psychological

well-being, physical health, and

selected problem behaviors. The

high-risk populations include:

adolescents in foster care, pregnant and parenting youth, juvenile offenders, academically atrisk youth, and youth with disabilities. 

• Disparities in Medication

Errors and Adverse Drug

Events in Children. Principal

Investigator: Stephanie Zandieh,

Weill Cornell Medical Center,

New York, NY. Contract No.

HHSP233200600468P

(06/05/06-01/31/07). This

study will determine whether

there are ethnic/racial socioeconomic, linguistic, or educational

disparities in rates of medication

errors, near misses, and preventable adverse drug events (ADEs)

in the pediatric ambulatory care

setting. This study will use a

subset of data that was collected

by a research group at the

Brigham and Women’s Hospital

for a larger study that describes

the epidemiology and prevention

of medication errors and ADEs

in the pediatric ambulatory care

setting. 

For More Information

The AHRQ Web site provides

information on the Agency's agenda in

children's health services research,

including funding opportunities, at

www.ahrq.gov. For further details on

AHRQ's programs in child health,

contact:

Denise Dougherty, Ph.D.

Senior Advisor, Child Health

540 Gaither Road

Rockville, MD 20850

Phone: 301-427-1868

Fax: 302-427-1347

E-mail: ddougher@ahrq.gov

12

www.ahrq.gov 

AHRQ Pub. No. 07-P001

January 2007