Patient-Provider Interventions to Improve Transition to Adult Care in SCD

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DESCRIPTION (provided by applicant): Mortality rates for young adults with sickle cell disease (SCD) are alarming ranging from 6 to 20 percent within 10 years of transitioning to the adult healthcare system 21-22. The Specific Aims of this K07 award are to: (1a) design, optimize, and pilot a self-management intervention for providers (i.e. evidence-based care strategies including motivational interviewing, behavioral change counseling, etc.) that will enhance patient interactions, education and motivation; (1b) design, optimize and pilot a chronic disease self-management intervention for SCD patients age 16-24 (critical ages when patients are transitioning or newly transitioned to adult care) to improve health outcomes (e.g. treatment adherence, pain interference, fatigue, etc.); and (2) to design, refine, and launch an SCD-specific patient-parent portal that integrates with the current electronic health record, MyChart portion of EPIC, and facilitates patient-provider and provider-provider coordination, and 3) prepare the Candidate to be a leader in SCD health services and implementation research. The Candidate's programmatic line of research is in innovation in chronic disease care including transforming the healthcare delivery system for patients with SCD. The candidates' immediate career goal is to establish herself as an independent investigator developing and piloting clinical support tools (i.e. patient- provider self-management interventions and a web-based patient/parent portal) to aid patients with SCD in the transition to the adult healthcare system. The Career Development Plan includes in depth mentorship, formal coursework, and seminars in leadership in 4 focus areas: 1) knowledge of clinical epidemiology to improve understanding of clinical factors related to increased morbidity in SCD; 2) health services and implementation research skills; 3) advanced methods for research methods and biostatistics; and 4) training in the responsible conduct of research. Cincinnati Children's provides an ideal setting for this award because of the strong institutional support for health services and outcomes research, nationally recognized Comprehensive Sickle Cell, Clinical Effectiveness and Health Policy, and Treatment Adherence and Self-Management Centers, advanced electronic health information systems, and a commitment of the Institution to "change the outcomes" for SCD patients transitioning to adult care.