2017 Community Benefit Report CHAI_160088756_2018-11_2017 Community Benefit Repo | Page 18

2017 COMMUNITY BENEFIT REPORT
Research Through
New Eyes Reducing Costs, Improving Outcomes
Partnership engages family leaders in healthy weight research While emergency services are necessary in some cases, many
families could avoid a trip to the emergency department (ED) by
scheduling an appointment with their medical home provider or by
having a conversation with a provider over the phone. The reasons
that families use the ED are complex—lack of transportation, job-
related responsibilities of caregivers and insufficient information
around ED use are just a few. And data demonstrates that families
covered by public health insurance programs like Medicaid use the
ED with a much greater frequency.
Research shows that Hispanic children in Colorado, particularly those who come from low-
income families, are at a higher risk for becoming overweight or obese, with weight issues
often beginning early in a child’s life. While most obesity prevention efforts focus on children
ages five and older, research has shown that changing behaviors later in a child’s life is
challenging because patterns are already well established.
Children’s Hospital Colorado and its community partners are working together to research
culturally relevant interventions that would help prevent health disparities among low-
income Hispanic children in their first few years of life. And over the past three years,
Children’s Colorado has served as the lead organization for this Familias Saludables
partnership, which is funded by the Patient-Centered Outcomes Resource Institute Pipeline-
to-Proposal (PCORI) award.
The Familias Saludables partnership brings together hospital staff and faculty from
the University of Colorado to conduct regular meetings and focus groups with Hispanic
caregivers, where they discuss the challenges low-income Hispanic parents face when
establishing and maintaining a healthy weight for their young children.
Including families in research — a new approach
Pipeline-to-Proposal Awards enable individuals and groups that are not typically involved in
clinical research to develop community-led funding proposals focused on patient-centered
comparative effectiveness research.
“Our engagement work with families is incredibly important. Research stemming from this
work will, as a result, be more innovative, and hopefully more relevant to the concerns of
the Hispanic community,” said Darcy Thompson, MD, associate professor of pediatrics and
research lead.
For the past two years, about 15 caregivers from the Denver metro area have participated in
the research group. They meet with hospital staff and faculty to provide input on everything
from what are considered credible sources for information and guidance, to who in the family
should receive education about healthy habits for their child. Discussions have also focused
on what’s culturally appropriate and what kind of words resonate with the community.
For example, the family leaders identified that the term “obese” doesn’t register with the
Hispanic community when referring to an infant or young child, and that a term like “healthy
weight” is more appropriate.
“Many times, research is never translated into practice, or if it is, it’s not as successful as it
was in the study,” says Maria Valenzuela, Children’s Colorado’s family engagement leader for
the study. “That’s because we haven’t traditionally involved the people we want to impact,
and that’s what the Familias Saludables partnership is doing.”
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CHILDREN’S HOSPITAL COLORADO
Research aims to reduce emergency department utilization
“There’s a whole host of reasons why kids on Medicaid use the ED
more often—sometimes they don’t have a primary care provider
they can rely on or can’t see them in a timely fashion, and often
it’s a lack of understanding of how to use our healthcare system,”
said Children’s Hospital Colorado’s pediatrician Steven Poole,
MD. “That’s why Children’s Colorado identified ED and urgent
care utilization as a critical opportunity for improving patient
outcomes and reducing healthcare costs.”
In 2016, Children’s Colorado partnered with the Colorado
Children’s Healthcare Access Program (CCHAP) to develop an
innovative program aimed at reducing improper ED and urgent
care utilization among children on Medicaid, increasing the use
of a medical home by these patients and enhancing access to
community-based supports and services for families.
Narrowing the scope
Two pediatric medical home practices in the Denver metro area
that have experienced a pattern of high ED and urgent care
utilization among their publicly insured patients were identified
to participate in the research. CCHAP and Children’s Colorado
work directly with these practices to assist them in developing a
number of interventions.
One of these interventions includes calling families the day after
their child enters the ED to help parents understand alternative
ways of getting advice in handling their child’s illness, and making
appointments while on the phone for future preventive care.
Alternative interventions encourage parents to call their child’s
doctor or the Children’s Colorado call center for advice or use
other resources like the existing Childrens MD pediatric mobile
app to help parents and caregivers understand the appropriate
source of care based on their child’s symptoms.
The project also identifies families within these practices that could
benefit from enhanced education on using the healthcare system,
and connects families who are high ED utilizers or who are otherwise
identified as high risk to a Community Health Navigator, who assists
them in addressing socioeconomic barriers to good health.
“Our intent is that we can identify the most effective
interventions, then work with Colorado Medicaid to reimburse
practices for actually implementing these interventions,” Dr.
Poole says. “Ultimately, our goal is that, in the long-term, we’ll
contribute to improved health outcomes among these families.”
Children in Colorado on Medicaid come to ED almost
5X
As often as kids on commercial insurance
If we can find a way to help the families of kids
who are on Medicaid use the ED at the same level as
commercially insured kids, we’d save Colorado
$90 MILLION A YEAR
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