California

Child Health Extramural Research by State and Country

California

Principal Investigator: Asarnow, Joan
Title: Youth Partners in Care: Depression and Quality Improvement
Institution: University of California, Los Angeles, CA
E-mail: jasarnow@mednet.ucla.edu
Project Dates: 08/01/98-07/31/03
Project No.: R01 HS09908
Summary: This study is a randomized control trial of an intervention for treatment of adolescent and young adult depression within managed primary care settings. Intervention effects will be assessed, compared to usual care, quality of care, satisfaction with care, clinical symptoms and daily functioning, service use and cost, and parental psychological distress. Depression in youth interferes with functioning during a critical developmental period and is associated with adverse outcomes, such as suicide, risk for drug and alcohol problems, and adult depression.

Principal Investigator: Baraff, Larry
Title: Commercial Telephone Triage vs. Physician On-Call Advice
Institution: University of California, Los Angeles, CA
E-mail: lbaraff@ucla.edu
Project Dates: 09/30/99-09/29/00
Project No.: R01 HS10604
Summary: This study will compare the telephone triage of a commercial service versus a traditional physician on-call in a prospective, randomized trial of pediatric patients, who represent the majority of calls for medical advice.

Principal Investigator: Bergner, Greg
Title: El Dorado County Safety Net Technology Project/ACCESS El Dorado*
Institution: Marshall Medical, Placerville, CA
E-mail: bergner@sbcglobal.net
Project Dates: 09/30/05-09/28/08
Project No.: UC1 HS016129
Summary: This project will focus on creating health information technology connections through a new patient-centered program called Care Connections; create a county-wide technology infrastructure; implement basic electronic health record capabilities; and implement electronic prescription writing. This study will include low-income/uninsured adults and children, minority groups (Latino/Native American) and individuals with special health care needs not currently available in the rural service area.

Principal Investigator: Clarke, Gregory
Title: HMO Collaborative Care Treatment for Depressed Youth
Institution: Kaiser FDN Research Institute, Oakland, CA
E-mail: greg.clarke@kp.org
Project Dates: 06/01/99-05/31/03
Project No.: R01 HS10535
Summary: This study will examine the effectiveness of cognitive-behavioral therapy when used as an adjunct to antidepressant medication therapy to treat adolescents ages 12-18 who experience depression for the first time.

Principal Investigator: Dudley, Adams
Title: How Public Reporting and Pay-For-Performance Policies Impact Safety Net Hospitals*
Institution: Regents of the University of California, San Francisco, CA
E-mail: adudley@itsa.ucsf.edu
Project Dates: 09/30/05-09/29/07
Project No.: R03 HS16117
Summary: The aims of this project are to (1) understand the Medicare and Medicaid regulations and policies pertaining to public reporting (PR) and pay-for-performance (P4P) and how they limit involvement of safety net hospitals (SNH); (2) assess whether SNHs are participating in PR and P4P and determine the factors that influence SNH executives' decisions to participate in PR and P4P; (3) identify potential changes to current PR and P4P approaches that might make these initiatives more applicable and feasible to SNHs. Additionally, the project aims to (4) determine whether the barriers to rural SNH participation in PR and P4P differ from those faced by urban SNHs; and (5) evaluate the feasibility and acceptability to other stakeholders of the SNH executive proposals for changing PR and P4P. This study will include CA city/county acute care hospitals with more than 50 percent Medicaid or uninsured patients, as well as rural hospitals.

Principal Investigator: Gonzales, Ralph
Title: Minimizing Antibiotic Resistance in Colorado (MARC)
Institution: Regents of the University of California, San Francisco, CA
E-mail: solatn@medicine.ucsf.edu
Project Dates: 07/01/01-06/30/05
Project No.: R01 HS13001
Summary: The aim of this study is to examine the processes and outcomes of care focusing on various intervention strategies to improve ambulatory antibiotic prescribing practices. For example, the program will measure and assess changes in antibiotic prescription rates for pharyngitis in children and bronchitis in adults, using MCO and Medicaid data from physician practices.

Principal Investigator: Guendelman, Sylvia
Title: Healthcare Access for Children of the Working Poor
Institution: The Regents of the University of California, Berkeley, CA
E-mail: sylviag@uclink.berkeley.edu
Project Dates: 09/30/02-09/29/03
Project No.: R03 HS13411
Summary: This study will analyze data from the California Health Interview Survey to (1) compare access and utilization of healthcare among working poor children with children in other socioeconomic strata; (2) explore the differences in access and utilization of healthcare between immigrants and native born children of the working poor; and (3) assess the extent to which expansions in health coverage for working poor parents can improve access and use of health services for their children.

Principal Investigator: Harrington, Charlene
Title: Meeting the Nation's Needs for Personal Assistance Services Conference—April, 2007 (Washington, DC)*
Institution: University of California, San Francisco, CA
E-mail: charlene.harrington@ucsf.edu
Project Dates: 09/30/06-09/29/07
Project No.: R13 HS016608
Summary: This conference has two purposes: (1) summarize, synthesize, and disseminate current research findings on personal assistance services (PAS) to researchers, policy makers, 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. Moreover, it 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.

Principal Investigator: Holbrook, Troy
Title: Study of Functional Outcome After Trauma in Adolescents
Institution: University of California, San Diego, La Jolla, CA
E-mail: tholbrook@ucsd.edu
Project Dates: 09/30/98-09/29/03
Project No.: R01 HS09707
Summary: This project is determining the degree of disability, quality of life, and psychological well-being after trauma in adolescents aged 12-17 years. This study is also examining risk factors for functional limitation after major trauma in adolescents. The Quality of Well-being Scale (Child Questionnaire), and the Functional Disability Score will be used in this study.

Principal Investigator: Hsu, John
Title: Impact of Health Information Technology (HIT) on Clinical Care
Institution: Kaiser Foundation Research Institute, Oakland, CA
E-mail: jth@dor.kaiser.org
Project Dates:09/30/04-09/29/07
Project No.: R01 HS015280
Summary: This study has two aims. The first will be to determine the quality and safety impact of ambulatory HIT on resource use for patients with five chronic diseases (asthma, coronary artery disease, congestive health failure, diabetes mellitus, and hypertension), by evaluating measures of drug use, laboratory monitoring, and physiologic disease control. The second project aim will be to determine the impact of ambulatory HIT on resource use for patients with these chronic diseases by estimating the rates of office visits, ED visits, and hospitalizations. A large number of children with asthma and fewer with diabetes mellitus will be included in this study as well as women and minorities.

Principal Investigator: Hsu, John
Title: Safety and Financial Ramifications of ED Copayments
Institution: Kaiser Foundation Research Institute, Oakland, CA
E-mail: jth@dor.kaiser.org
Project Dates:07/01/01-06/30/03
Project No.: R01 HS11434
Summary: The aim of this study is to evaluate the effects of the size of copayment for emergency department use on patient outcomes and treatment costs within the Kaiser Permanente-Northern California health system using a quasi-experimental pre-post design with concurrent controls.

Principal Investigator: Hunkeler, Enid
Title:Antidepressant Medications and Suicidal Behavior in Children and Adolescents
Institution: Kaiser Permanente, Oakland, CA
E-mail: enid.hunkeler@kp.org
Project Dates: 8/1/05-2/1/06
Project No.: 290-00-0015
Summary: This contract will focus on a scientifically sound and feasible plan to analyze one or more existing large databases of community-treated children and adolescents (generally defined as subjects under age 19) in an effort to address as many questions as possible within the 6-month duration of this task. Questions to be explored include, but are not limited to: (1) linkages, if any, between completed suicides and antidepressant use in youth that may suggest causality; (2) evidence of any increased rates of suicidal attempts, emergency room visits, and/or hospitalizations for suicidal behavior among youths treated with antidepressants; (3) associations, if any, between specific antidepressants and suicidal behavior. Additional questions to be addressed include: (4) gender differences between antidepressant use and suicidal behavior; and (5) evidence of linkages between antidepressants and aggression to others.

Principal Investigator: Irwin, Jr., Charles E.
Title: Implementing Adolescent Preventive Guidelines
Institution: University of California, San Francisco School of Medicine, San Francisco, CA
E-mail: cirwin@itsa.ucsf.edu
Project Dates: 09/30/00-09/31/03
Project No.: U18 HS11095
Summary: Study providers will attend training sessions and bimonthly booster sessions and receive feedback on adolescent patients' receipt of clinical preventive services in 6 topic areas. Providers will receive tools including an adolescent health screening questionnaire and a customized charting form that includes reminder prompts and a format for documenting that services were provided.

Principal Investigator: Kaji, Amy
Title: Hospital Disaster Plans: Structure, Training and Function*
Institution: Harbor-UCLA Research and Education Institute, Torrance, CA
E-mail: akaji@emedharbor.edu
Project Dates: 01/01/04-12/31/04
Project No.: F32 HS13985
Summary: 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. Disadvantaged groups including children, women and minorities will be included in this study. Many of the hospitals are approved for the emergency care of pediatric patients in the Los Angeles Emergency Department.

Principal Investigator: Kirk, Adele
Title: The Relationship between Education and Health: Is it Causal?
Institution: University of California, Los Angeles, Santa Monica, CA
E-mail: amkirk@ucla.edu
Project Dates: 09/01/05-05/31/06
Project No.: R36 HS15988
Summary: The purpose of this dissertation award is to employ a data-rich longitudinal dataset and instrumental variables methods to investigate the nature of the observed relationship between education and health. Specifically, the aims of this study will (1) explore the determinants of educational attainment in youth to evaluate the effect of youth health on educational attainment; (2) examine the extent to which estimates of education's effect on health behaviors and health status are robust to the exclusion on frequently omitted variables; and (3) estimate the causal effect of education using instrumental variables methods. This study will include racial and ethnic minority populations living in rural and urban areas of Los Angeles.

Principal Investigator: Kuo, Alice
Title: Assessment of School Readiness in Pediatric Office Visits
Institution: UCLA Center for Healthier Children, Families, and Communities, Los Angeles, CA
E-mail: akuo24@ucla.edu
Project Dates: 04/01/01-06/30/02
Project No.: HRSA-240-97-0043
Summary: The purpose of this project is to perform an analysis of the current practices in pediatric office visits focusing on the school readiness assessment from the National Survey of Early Childhood Health.

Principal Investigator: Kupperman, Miriam
Title: Evaluating A Decision Tool For Prenatal Testing
Institution: University of California, San Francisco, CA
E-mail: miriam_kupperman@quickmail.ucsf.edu
Project Dates: 9/30/99-9/29/02
Project No.: R18 HS10214
Summary: This randomized controlled trial will pilot-test, refine, and evaluate a computerized tool for assisting pregnant women and their partners. The study will measure the effect of the tool on knowledge about prenatal testing and its outcomes, satisfaction with decisionmaking, and use of prenatal diagnostic tests.

Principal Investigator: Kushel, Margot
Title: Improving Health Care Outcomes Among the Homeless*
Institution: Regents of the University of California, San Francisco, CA
E-mail: kushel@itsa.ucsf.edu
Project Dates: 03/01/02-02/28/07
Project No.: K08 HS11415
Summary: The aims of this Mentored Clinical Scientist Development Award are to: (1) examine the effects of different levels of community services (including housing, health care, overall services) for homeless people on hospitalization and emergency department rates of homeless adults and children; (2) examine the cost-effectiveness of case-management as a strategy for improving health outcomes among HIV infected homeless persons; and (3) examine the health care utilization and public costs of a cohort of homeless persons under different policy options: supportive housing and usual care.

Principal Investigator: Lara, Marielena
Title: Improving Outcomes in US Latino Children
Institution: University of California, Los Angeles, CA
E-mail: lara@rand.org
Project Dates: 07/01/00-06/30/02
Project No.: K08 HS00008
Summary: The long-term purpose of this Mentored Clinical Scientist Development Award is to support and facilitate Dr. Lara's development as a health services researcher whose work will improve health outcomes and quality of life in Latino children with asthma through evidence-based health care and community interventions.

Principal Investigator: Lee, Simon
Title: Ethnography of the Social Ethics of Catholic Healthcare*
Institution: University of California, San Francisco, CA
E-mail: simonleel@earthlink.net
Project Dates: 09/30/02-12/31/03
Project No.: R03 HS13111
Summary: This Dissertation research project will investigate the role of Catholic religious values in the design of healthcare policy and service delivery intended for underserved and other vulnerable populations.

Principal Investigator: Lynch, Anne M.
Title: Outcomes in Spontaneous and Latrogenic Multiple Pregnancy
Institution: Kaiser Foundation Research Institute, Oakland, CA
E-mail: annemlynch@hotmail.com
Project Dates: 09/30/00-12/31/01
Project No.: R03 HS10700
Summary: This retrospective cohort study will examine health care utilization and maternal, neonatal, and infant health outcomes associated with assisted reproductive interventions versus spontaneous conception. The study uses administrative data from a large managed care organization.

Principal Investigator: Lynch, Sean
Title: Translating Cultures of Care: Integrating Behavioral Health Services in Pediatric Practice
Institution: University of California, Los Angeles, School of Public Policy and Social Research, Department of Social Welfare, Los Angeles, CA
Project Dates: 09/30/08-06/30/09
Project No.: R36-HS017749
Summary: Over the last 10 years, pediatricians' use of psychiatric medications to treat children has increased significantly, prompting concern that these children are being over-medicated. One of the disconnects in this situation is the general lack, at this time, of collaboration and communication between the health system (the pediatrician) and the mental health system (the social worker). This doctoral dissertation research will study communication between these two groups of health care providers in the delivery of mental health services in primary care. The promotion of children's emotional well-being and the treatment of mental health disorders, this investigator argues, can be achieved through the integration of mental health consultation by the social worker as part of children's primary care. A greater public awareness of children's behavioral health issues could help to prevent milder disorders from worsening and improve children's mental health outcomes over their lifetime.

Principal Investigator: Manber, Rachel
Title: Acupuncture Treatment of Depression During Pregnancy
Institution: Stanford University, Stanford, CA
E-mail: rmanber@stanford.edu
Project Dates: 9/30/98-9/29/01
Project No.: R01 HS09988
Summary: The primary objective is to determine if the efficacy of acute (short term) acupuncture treatment for depression during pregnancy is substantial enough to warrant a large-scale clinical trial. The specific aims are: (1) to evaluate the efficacy (and effect size) of acupuncture treatment for major depression during pregnancy at the end of the acute phase, relative to the two control conditions; (2) to evaluate the efficacy (and effect size) of the combined acute/ continuation specific acupuncture on the incidence of depression during the post partum period, relative to the two control conditions; and (3) to evaluate the clinical significance of acupuncture treatment for major depression by assessing the differential impact of the treatment conditions on infant outcomes measures.

Principal Investigator: Mangione-Smith, Rita
Title: Doctor-Parent Communication and Antibiotic Over-Prescribing
Institution: University of California, Los Angeles, CA
E-mail: ritams@ucla.edu
Project Dates: 09/30/02-09/29/07
Project No.: K02 HS13299
Summary: The aim of this Independent Scientist Award is to examine the doctor-parent communication as a determinant of both inappropriate antibiotic prescribing and parent satisfaction with care, and then develop a communication-based intervention to decrease antibiotic over-prescribing in pediatric outpatient settings to improve the quality of patient care.

Principal Investigator: Mangione-Smith, Rita
Title: Online Commentary Use and Antimicrobial Prescribing
Institution: University of California, Los Angeles, CA
E-mail: ritams@ucla.edu
Project Dates: 07/01/99-09/30/03
Project No.: R01 HS10187
Summary: This study will analyze pediatric acute care encounters to gain a better understanding of how physicians use online commentary in response to both explicit and perceived parental expectations for antimicrobials in the pediatric outpatient setting.

Principal Investigator: Marcin, James
Title: Telemedicine for Children in Rural Emergency Departments
Institution: University of California, Davis, CA
E-mail: jpmarcin@ucdavis.edu
Project Dates: 07/19/02-06/30/07
Project No.: K08 HS131179
Summary: The aim of this Mentored Clinical Scientist Development Award is to determine what impact telemedicine consultations have on the quality and satisfaction of care that critically ill and injured children receive in rural emergency departments.

Principal Investigator: Marcin, James P.
Title: Third Annual Pediatric Telehealth Colloquium
Institution: University of California, Davis, Davis, CA
E-mail: jpmarcin@ucdavis.edu
Project Dates: 07/01/08-12/21/08
Project No.: R13 HS017785-01
Summary: These pediatric clinical telehealth conferences target practitioners providing health care to children in rural and underserved communities. Health care providers, hospital administrators, and health information technology (Health IT) specialists share, disseminate, and train these practitioners in clinical telemedicine programs that have been shown to be successful, thus increasing access to care, reducing disparities in care, and increasing the overall quality of care delivered to children in rural and underserved communities in a financially sustainable framework.

Principal Investigator: Meenan, Richard
Title: Health Expense-Risk Assessment Using Administrative Data
Institution: Kaiser FDN Research Institute, Oakland, CA
E-mail: richard.meenan@kp.org
Project Dates: 07/01/00-06/30/01
Project No.: R03 HS10688
Summary: Collaborators at Kaiser Permanente Center for Health Research have created a large administrative data set from six HMOs to develop prospective health risk-adjustment models for use in adjusting Medicare payments to health plans for enrollee health status(GRAPES). The application proposes a focused research project extending their work to study risk-adjustment models as preliminary population-based screens for enrollees at risk of future high costs. The project will compare the forecasting performance of six different methods: the Global Risk-Assessment Model (GRAM), Adjusted Clinical Groups, Diagnostic Cost Groups, Chronic Disease Scores, a logistic model, and a prior-expense model. The high cost forecasting performance of GRAM will also be evaluated across population sizes, subgroups (e.g., children) and for multiple categories of high-cost status risk. The temporal stability will also be evaluated.

Principal Investigator: Newacheck, Paul
Title: Disparities in Child and Family Health Care Expenditures
Institution: University of California, San Francisco, CA
E-mail: pauln@itsa.ucsf.edu
Project Dates: 07/01/02-06/30/04
Project No.: R01 HS11662
Summary: The aim of this project is to examine the extent to which disparities exist in out-of-pocket health care expenses for children and families, and the role that health insurance plays in reducing or eliminating disparities.

Principal Investigator: Newgard, Craig
Title: Validation of an EMS Triage Rule for Children in MVAS
Institution: Harbor-UCLA Research and Education Institute, Los Angeles, CA
E-mail: newgard@emedharbor.edu
Project Dates: 09/01/00-06/30/02
Project No.: F32 HS00148
Summary: The aim of this project is to measure the sensitivity specificity, positive and negative predictive values of a clinical decision rule for use in the prehospital triage of pediatric trauma patients injured in motor vehicle crashes.

Principal Investigator: Okumura, Megumi J.
Title: Barriers and Facilitators of Health Care: Transitioning Youth with Special Needs
Institution: University of California, San Francisco, School of Medicine, San Francisco, CA
Project Dates: 09/30/08-09/29/13
Project No.: K08-HS017716
Summary: Dr. Okumura is board-certified both in internal medicine and in pediatrics; in addition, she has completed a Robert Wood Johnson Clinical Scholar Program focusing on health services research. This K08 award will enable Dr. Okumura to conduct research into the study and formulation of interventions addressing the barriers to and facilitators of chronic illness care for children with special health care needs as they transition from the pediatric to adult health care setting. Her research agenda seeks to generate rigorous evidence to improve the quality of health care for adolescents and young adults with complex chronic conditions by means of improved linkages between the patients, health care providers, health care systems, and community organizations.

Principal Investigator: Paddock, Susan
Title: Bayesian Pattern-Mixture Models (PMM) for Quality of Care Data*
Institution: RAND Corporation
Santa Monica, CA
E-mail: paddock@rand.org
Project Dates: 09/30/05-09/29/07
Project No.: R03 HS14805
Summary: The aims of this study are to (1) yield improved estimates of relationships among program structure, treatment process, and client outcomes; (2) improve the ability of health services researchers to provide policy makers with accurate characterizations of quality of care analyses when treatment dropout and study attrition occur; and (3) utilize expert opinion and knowledge about the reasons for treatment dropout and attrition in order to inform the subjective decisions that are required to build the quality of care PMM analyses. This study will include adolescents (African-Americans, Hispanics, Asians and other groups) undergoing substance abuse treatment in 16 Phoenix House Therapeutic community treatment programs.

Principal Investigator: Phibbs, Ciaran S.
Title: Regionalization, Market Forces, and Neonatal Mortality
Institution: Palo Alto Veterans Affairs Medical Center, Menlo Park, CA
E-mail: cphibbs@odd.stanford.edu
Project Dates: 04/01/00-03/31/04
Project No.: R01 HD36914
Summary: This study of neonatal intensive care units (NICU) will use data from California to assess neonatal mortality differences over time, examine the relationship between total (NICU) volume and the volume of newborns in specific high-risk groups, look at the relationship between type of insurance coverage and neonatal mortality over time, and examine how competition and the increased use of market forces to control costs have affected the diffusion of NICUs into community hospitals.

Principal Investigator: Pletcher, Mark
Title: Opiate Prescribing Patterns in the U.S.*
Institution: University of California, San Francisco, CA
E-mail: mpletcher@epi.ucsf.edu
Project Dates:03/01/06-12/31/07
Project No.:R03 HS16238
Summary: This study will analyze (1) how many ambulatory care visits result in an opioid prescription each year in the U.S.; (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 versus opioids, short- versus 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 12-17 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.

Principal Investigator: Raghavan, Ramesh
Title: Health Policies and Pathways to Mental Health Services for Children
Institution: University of California, Los Angeles, CA
E-mail: rraghavan@mednet.ucla.edu
Project Dates: 04/15/03-01/14/04
Project No.: R03 HS13611
Summary: 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 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.

Principal Investigator: Rogowski, Jeannette
Title: Costs of Care for VLBW Infants
Institution: RAND Corporation, Santa Monica, CA
E-mail: jar@rand.org
Project Dates: 09/30/02-09/29/03
Project No.: R03 HS13429
Summary: This descriptive study will use data from 29 hospitals in the Vermont Oxford Network to examine the costs and cost-effectiveness of care for VLBW infants, and investigate how these costs of care vary with the degree of prematurity. The study will include 13,610 infants with birth weights under 1500 grams.

Principal Investigator: Rogowski, Jeanette
Title: Evidence-based Selective Referral in VLBW Infants
Institution: Rand Corporation, Santa Monica, CA
E-mail: jar@rand.org
Project Dates: 09/19/02-08/31/04
Project No.: R01 HS13371
Summary: This study will investigate the validity of volume as an indirect quality indicator for neonatal intensive care by evaluating the association between volume and multiple outcomes for very low birth weight infants, including measures of respiratory, infectious, neurological, gastrointestinal and ophthalmological diseases.

Principal Investigator: Rogowski, Jeanette
Title: Measuring the Quality of Care for High Risk Infants
Institution: Rand Corporation, Santa Monica, CA
E-mail: rogowski@rand.org
Project Dates: 9/30/99-9/29/02
Project No.: R01 HS10328
Summary: This project aims to: (1) develop new quality of care measures for very low birth weight (VLBW) infants that overcome the problems of small sample size, bias from patient mix, and the multidimensional nature of quality; and (2) apply these methods to estimate past quality of care and predict future quality.

Principal Investigator: Salisbury, Lois
Title: Partners in Transition: Adolescents and Managed Care Conference
Institution: Children Now, Oakland, CA
E-mail: president@childrennow.org
Project Dates: 09/01/00-08/31/01
Project No.: R13 HS10109
Summary: The purpose of this conference was to engage health plans in a practical, hands-on discussion about why and how to implement a quality initiative devoted to teen health.

Principal Investigator: Seid, Michael
Title: Barriers to Care for Chronically Ill Vulnerable Children
Institution: Children's Hospital Research Center, San Diego, CA
E-mail: mseid@chsd.org
Project Dates: 03/01/02-02/28/03
Project No.: R03 HS13058
Summary: This project will to develop and test a "Barriers to Care Questionnaire" in English and Spanish. The questionnaire will be used to identify and measure modifiable barriers to care that affect the link between vulnerability factors and health care structures, processes, and outcomes for children with special health care needs.

Principal Investigator: Seid, Michael
Title: Measuring Quality of Care for Vulnerable Children
Institution: Children's Hospital Research Center, San Diego, CA
E-mail: mseid@chsd.org
Project Dates: 9/30/99-9/29/01
Project No.: R01 HS10317
Summary: This project aims to use data on structure and process of care to validate an existing pediatric health-related quality-of-life instrument, the PedsQL, as an outcomes measure of quality of care. This field test will be incorporated into an evaluation of HealthLink, a partnership of health care providers and the San Diego school system, which educates an ethnically diverse population.

Principal Investigator: Seid, Michael
Title: Managing the Health Needs of Vulnerable Children: Families' Experience
Institution: Children's Hospital Research Center, San Diego, CA
E-mail: mseid@chsd.org
Project Dates: 09/30/01-09/29/02
Project No.: R03 HS11751
Summary: The aim of this project is to provide qualitative information about managing the health care needs of vulnerable children in San Diego. Data will be gathered using semi-structured interviews focusing on health needs, health care services use, problems in using care, and proposals for health care services improvement. Results will be used to design effective interventions to improve health care delivery to vulnerable children.

Principal Investigator: Selby, Joe V.
Title: Implementation of Otitis Media Practice Guidelines With Priority Populations
Institution: Kaiser Permanente Division of Research, Oakland, CA
E-mail: maggie@lcfresearch.org
Project Dates: 09/00-03/01
Contract Number: 290-00-0015
Summary: This study will evaluate the development and implementation of evidence-based guidelines for acute otitis media patients using a quasi-experimental design. The study, to be conducted at Lovelace Health Systems in Albuquerque, NM, will determine any differences in out comes by ethnicity (Hispanic versus non-Hispanic white) and by socioeconomic status (Medicaid versus non-Medicaid enrollees).

Principal Investigator: Shafer, Mary-Ann
Title: Do Urine Tests Increase Chlamydia Screening in Teens
Institution: University of California, San Francisco, CA
E-mail: shafer@itsa.ucsf.edu
Project Dates: 9/30/99-9/29/02
Project No.: R01 HS010537
Summary: This study will determine whether a systems-level intervention, involving nurse managers, results in an increased rate of urine-based screening in asymptomatic sexually active adolescents in pediatric clinics compared to a traditional physician-based screening program for sexually transmitted diseases.

Principal Investigator: Shapiro, Martin
Title: UCLA/DREW/RAND Program to Address Disparities in Health
Institution: University of California, Los Angeles, CA
E-mail: mshapiro@mednet.ucla.edu
Project Dates: 09/01/00-08/31/05
Project No.: P01 HS10858
Summary: This program project grant includes a project to address racial and ethnic differences in infant mortality using linked birth records, death records and hospital discharge abstract data for all births in California between 1990 and 2000.

Principal Investigator: Stivers, Tanya
Title: Seeking and Denying Antibiotic Treatment in Pediatrics
Institution: University of California, Los Angeles, CA
E-mail: tstivers@ucla.edu
Project Dates: 09/30/99-08/31/00
Project No.: R03 HS10577
Summary: This project will examine physician perceptions of and responses to parental preferences for antibiotic prescriptions, parental statements of concern and formulation of their child's medical problem, and aspects of physicians' information provision and parental behaviors that reveal preferences for antibiotic prescription.

Principal Investigators: Stoto, Michael and Seid, Michael
Title: Evaluation of AHRQ's Children Health Research
Institution: RAND Corporation, Santa Monica, CA
E-mail: michael_stoto@rand.org and michael_seid@rand.org
Project Dates: 09/15/05-07/31/06
Contract No.: 282-00-0005
Summary: The aims of this study include: (1) measuring and assessing to what extent the Agency contributed new knowledge as a result of its children's health research funding (extramural and intramural) and disseminated and/or translated effectively its findings to meet AHRQ's strategic objectives of improving the safety, quality, effectiveness, and efficiency of health care as well as wider DHHS strategic objectives; (2) measuring and assessing to what extent AHRQ's children's healthcare activities (i.e., research findings, meetings, conference support, products, tools, etc.) improved clinical practice and health care outcomes and influenced heath care policies over the past fifteen years. Additional study targets include: (3) measuring and assessing AHRQ's financial and staff support for children's health research, as well as the Agency's internal handling of children's health grants, contracts, and intramural activities research with/among other AHRQ programs, portfolios and activities and other DHHS and federal agency efforts; and, (4) measuring and assessing to what extent the Agency succeeded in involving children's health care stakeholders and/or created partnerships to fund and disseminate key child health activities.

Principal Investigator: Washington, Eugene
Title: Promoting Effective Communication and decisionmaking in Diverse Populations
Institution: University of California, San Francisco, CA
E-mail: wash@obgyn.ucsf.edu
Project Dates: 09/27/00-08/31/05
Project No.: P01 HS10856
Summary: This program project grant includes a study on Ethnic Disparities in Perinatal Outcomes among multi-ethnic uninsured childbearing women enrolled in a staff model managed care organization.

Principal Investigator: West, Neda
Title: El Dorado County Safety Network Technology Project*
Institution: Marshall Medical, Placerville, CA
E-mail: nwest@co.el-dorado.ca.us
Project Dates: 09/30/04-09/29/05
Project No.: P20 HS014908
Summary: This study will integrate the Network's "Access Product," a three-pronged approach to (1) provide outreach and enrollment for children eligible for public insurance; (2) provide access to quality health care services for those children not eligible for public insurance up to 300 percent of the poverty level; and (3) access to healthcare to those families employed by local small businesses unable to provide coverage for their workers. The safety net population included in this study will be indigent, uninsured, and underinsured rural, low-income, minorities, women, and children.

Principal Investigator: Wren, Tishya
Title: Impact of Gait Analysis on Surgical Outcomes
Institution: Children's Hospital of Los Angeles, Los Angeles, CA
E-mail: twren@chla.usc.edu
Project Dates: 04/01/04-03/31/09
Project No.: R01 HS014169
Summary: This project will conduct a randomized controlled trial to assess the effects of preoperative gait analysis on surgical outcomes in ambulatory children ages 3-18 with cerebral palsy. This study will involve a large population of Hispanic children, and a small sample of African-American, Asian, and Native Hawaiian or other Pacific Islander children.

*Project includes children or children's health care issues but does not focus exclusively on children.

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