Social & Contextual Impact on Children Undergoing Liver Transplantation

Description

The social determinants of health have a large impact on health. For example, neighborhood socioeconomic deprivation is associated with increased risk of medication non-adherence, graft failure, and death in children after liver transplant. In order to address these socioeconomic inequities in outcomes, a more granular understanding of how the social determinants of health impact outcomes is needed. In this observational prospective cohort, caregivers of children undergoing liver transplantation will complete surveys and undergo in-depth, qualitative interviews. The survey will assess comprehensively for the social determinants of health (e.g. material economic hardship, health literacy, social connectedness, primary care quality, etc). The qualitative interviews will identify barriers and facilitators that socioeconomically deprived children/families have to obtaining the ideal outcome and identify health system opportunities to integrate social needs and medical care. Data will be linked to an existing prospective cohort study (The Society for Pediatric Liver Transplant registry) to assess the impact of social risk on outcomes after transplant. Healthcare providers who take care of children undergoing liver transplant will also be included in the qualitative interviews. The goal of including this group in the study is to determine the health systems barriers and facilitators to social needs screening and intervention.

Conditions

Liver Transplantation, Liver Diseases

Study Overview

Study Details

Study overview

The social determinants of health have a large impact on health. For example, neighborhood socioeconomic deprivation is associated with increased risk of medication non-adherence, graft failure, and death in children after liver transplant. In order to address these socioeconomic inequities in outcomes, a more granular understanding of how the social determinants of health impact outcomes is needed. In this observational prospective cohort, caregivers of children undergoing liver transplantation will complete surveys and undergo in-depth, qualitative interviews. The survey will assess comprehensively for the social determinants of health (e.g. material economic hardship, health literacy, social connectedness, primary care quality, etc). The qualitative interviews will identify barriers and facilitators that socioeconomically deprived children/families have to obtaining the ideal outcome and identify health system opportunities to integrate social needs and medical care. Data will be linked to an existing prospective cohort study (The Society for Pediatric Liver Transplant registry) to assess the impact of social risk on outcomes after transplant. Healthcare providers who take care of children undergoing liver transplant will also be included in the qualitative interviews. The goal of including this group in the study is to determine the health systems barriers and facilitators to social needs screening and intervention.

Social & Contextual Impact on Children Undergoing Liver Transplantation

Social & Contextual Impact on Children Undergoing Liver Transplantation

Condition
Liver Transplantation
Intervention / Treatment

-

Contacts and Locations

Los Angeles

Children's Hospital Los Angeles, Los Angeles, California, United States, 90027

Palo Alto

Lucile Packard Children's Hospital, Palo Alto, California, United States, 94304

San Francisco

University of California San Francisco, San Francisco, California, United States, 94158

Atlanta

Children's Healthcare of Atlanta, Atlanta, Georgia, United States, 30329

Cincinnati

Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States, 45229

Pittsburgh

UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, United States, 15224

Dallas

Children's Medical Center Dallas, Dallas, Texas, United States, 75235

Seattle

Seattle Children's Hospital, Seattle, Washington, United States, 98105

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * Children \<18 years of age at the time of transplant
  • * Undergoing liver transplantation
  • * Guardian's consent, child assent (in accordance with each institution's IRB policies)
  • * Consents to enrollment in SPLIT
  • * Caregiver unwilling or unable to complete the survey
  • * Child is a ward of the state (e.g., foster care) since present circumstances may not be reflective of child's past or future circumstances
  • * Non-English, non-Spanish speakers
  • * Non-US residents
  • * Declined participation in SPLIT
  • * Participants who have completed the questionnaire OR
  • * Medical team member involved in the care of children undergoing liver transplant (e.g., physician, nurse, social worker)

Ages Eligible for Study

to 70 Years

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

University of California, San Francisco,

Sharad Wadhwani, MD, MPH, PRINCIPAL_INVESTIGATOR, University of California, San Francisco

Study Record Dates

2024-12