The Hassenfeld Child Health Innovation Institute’s Core Research and Evaluation Unit provides the necessary research and evaluation infrastructure at Brown University, Hasbro Children’s Hospital, and Women & Infants Hospital as well as at other supporting research institutions that is needed in order to support work on a broad range of health initiatives within the Institute as well as with outside collaborators.
The Core Research and Evaluation Unit consists of six core faculty members, identified as Hassenfeld Faculty Scholars. They are:
Elizabeth Chen, MA, PhD (Bioinformatics)
William G. Fairbrother, MA, PhD (Genomics)
Annie Gjelsvik, PhD (Epidemiology)
Adam Sullivan, PhD (Biostatistics)
Erika Werner, MD, MS (Maternal Health and Clinical Research)
Patrick M. Vivier, MD, PhD (Child Health and Health Services Research)
In addition to this multidisciplinary faculty team, the Hassenfeld Core Research and Evaluation Unit includes a robust and experienced research staff. Their activities span Hasbro Children’s Hospital, Women & Infants Hospital, the Alpert Medical School, the School of Public Health, the broader university, and additional partners. The initial focus of the Core Research and Evaluation Unit is in two complementary areas: Geographic Information Systems (GIS)/Informatics and the development of a birth cohort study.
Geographic Information Systems (GIS) / Informatics
Rhode Island’s geography, population, healthcare infrastructure, and administrative size position the state exceedingly well to transform child health. This unique statewide concentration of resources has been used to address specific child health issues with great success. For example, childhood lead poisoning has been mapped down to small geographic units in the state, demonstrating unacceptable health disparities due to poverty and related factors such as old housing.
This research, undertaken in collaboration with the University-wide Spatial Structures in the Social Sciences (S4) at Brown University has not only resulted in high-profile national research publications aimed at understanding the origins of poverty-based health disparities, but has also guided successful lead remediation programs in Rhode Island. This work has been part of a long‑term focus that has evaluated provider lead screening practices and also the impact of new legislation for healthy housing.
The Hassenfeld Child Health Innovation Institute will build on this model of mapping child health issues for the purpose of local impact and national research implications, expanding the focus to a broad range of child health issues.
Hasbro Children’s Hospital is Rhode Island’s only children’s hospital and is the home to the only pediatric emergency department in the state. It provides the majority of inpatient, emergency department, and specialty care for children in the state. The extent to which pediatric care is concentrated in this one hospital, coupled with the hospital’s recent adoption of a unified electronic medical record system (EMR), offers unprecedented opportunities for statewide research and evaluation projects, as well as real time monitoring for innovative health interventions. Institute researchers will also be able to access data from other affiliated hospitals in the Lifespan system including Bradley Hospital, Miriam Hospital and Newport Hospital.
The Hassenfeld Core Research and Evaluation Unit will geocode, map, and analyze hospital and other health data for research and evaluation, as well as for innovative health programs. This will include mapping all emergency department visits and inpatient stays, to first identify “hot spots” (Gawande, 2011) in Rhode Island where children disproportionately suffer from health issues, and then help shape interventions to address these disparities.
In addition to mining hospital data systems, core researchers will also build the capacity for enrolling families in research and intervention projects at Hasbro Children’s Hospital and affiliated sites.
Similar research and evaluation efforts will be undertaken with data from Women & Infants Hospital, the birthplace for almost three quarters of Rhode Island children. This will include mapping and analyzing hospital data to understand critical issues related to maternal health, prenatal care, prematurity, and other neonatal health issues. We also hope to be able to access data from other Care New England Hospitals including Memorial Hospital and Butler Hospital as they move to the Epic EMR system.
Hospital information systems will not be the only data source for program planning, evaluation, and research. As was the case with the lead poisoning research, researchers will leverage a broad range of data sources including partnerships with the RI Department of Health and their rich data sources, as well as long standing collaborations with the state Medicaid program. The institute will explore developing provider-based networks, spanning maternal and child health, that can participate in data-driven innovations. The goal is to be able to address the broad range of health issues that affect children using all available data and engaging all potential partners.
The Core Research and Evaluation Unit will undertake a comprehensive statewide assessment of the health of children to explore the most urgent targets for health interventions and to serve as a baseline for assessing new health innovation programs. A sophisticated survey research team at the School of Public Health will undertake a broad range of statewide studies of children of all ages. The Institute will also benefit from the active participation of Brown’s new Center for Biomedical Informatics as well as the Medical School’s biobank. Similar to the lead poisoning research, researchers will expand the spatial analysis and data team that will conduct statewide analyses addressing a range of health issues using data from a broad range of sources.
Prospective Birth Cohort
We will develop capacity to engage Rhode Island families at the time of birth and earlier during pregnancy. Planning is currently underway to launch a birth cohort study that will include enrolling families, collecting key information about prenatal exposures, initial health status assessments of the newborn, and annual follow up assessments. The prospective birth cohort study will provide critical information on early determinants of child health and will provide a framework for assessing the impact of innovative approaches to improve the health of families. A Prospective Birth Cohort Scientific Committee has been formed to provide input on the design and implementation of the prospective birth cohort study. The members of the committee are:
- Kristine Campagna
- Will Fairbrother
- Alison Field
- James Padbury
- David Savitz
- Patrick Vivier (Co-Chair)
- Erika Werner (Co-Chair)
The committee will work with faculty from the Institute’s current initiatives, along with experts from throughout Brown University, affiliated hospitals and community partners.
In addition to undertaking the comprehensive assessments described above, the Institute has assembled teams of experts to implement and assess innovative new approaches to address critical child health issues.
The first three initiatives launched by the Hassenfeld Institute are:
- Autism, a Precision Medicine Approach
- Childhood Asthma Research Innovation Program
- Healthy Weight, Nutrition, and Physical Fitness Initiative
However, over time, as the expertise of the faculty and clinicians affiliated with the Institute deepens and broadens, new health challenges will be tackled. As an ongoing process, leadership within the Core Research and Evaluation Unit will continue to engage research faculty, clinicians and community members to provide input and ongoing feedback. This discussion will be used to stimulate innovation teams to implement pilot studies and develop action plans for additional critical health issues that will be the focus of future Institute initiatives and collaborations.