News at CHOP: Fall 2023

Neighborhood Opportunity Linked to Pediatric Primary Care Outcomes

Researchers in Clinical Futures, a CHOP Research Institute Center of Emphasis, found that neighborhood opportunity—which comprises socioeconomic factors, access to education, and healthy environment—is linked to several pediatric primary care outcomes. JAMA Network Open published the study findings by author Stephanie Mayne, PhD, MHS, and fellow researchers.

The cross-sectional observational study used electronic health record data to evaluate clinical factors including up-to- date preventive care, immunization status, presence of obesity, adolescent depression and suicidality, and maternal depression and suicidality, in relation to Childhood Opportunity Index (COI) quintiles. The researchers found that living in higher COI neighborhoods was associated with being up to date on preventive care and immunizations and lower odds of obesity, adolescent and maternal depression, and suicidality.

“Understanding these associations can help health systems identify neighborhoods that need additional support and advocate for and develop partnerships with community groups to promote child well-being,” researchers write. “The findings underscore the importance of improving access to preventive care in low COI communities.”

CHOP Researchers Develop First-of-Its-Kind Prediction Model for Newborn Seizures

Researchers from CHOP’s Neuroscience Center have developed a prediction model that determines which newborn babies are likely to experience seizures in the neonatal intensive care unit (NICU). This model could be incorporated into routine care to help the clinical team decide which babies will need continuous electroencephalography (cEEGs) and which babies can be safely managed in the neonatal care unit without EEG monitoring. The findings were published by Lancet Digital Health.

Approximately 30% of newborn babies with hypoxic-ischemic encephalopathy (HIE) will have seizures. Most seizures can only be detected through EEG monitoring. Newborns with HIE are at an increased risk for neurobehavioral problems and epilepsy later in life, and detecting and treating seizures is important to reduce seizure-induced injury.

To address the complexity in predicting which babies may have seizures, researchers used data from a recently developed EEG reporting form based on common data elements incorporated into the electronic medical record. Prediction models using machine learning methods were developed using data from 1 000-plus patients. The study team has made the model publicly available as an online tool (neopredict.helbiglab.io).

Interpersonal and Structural Stigmas Increase Suicide Risk for Sexual Minority Youth

A new study conducted by researchers from CHOP and the University of Pennsylvania analyzed structural stigma—societal level conditions, cultural norms, and policies affecting opportunities and well-being of the LGBTQ+ community—to better understand how it affects the mental health of lesbian, gay, and bisexual (LGB) youth.

“Our findings provide us with evidence that we need to develop interventions targeted at reducing discrimination to help reduce the risk of youth suicide among those in a sexual minority,” says Ran Barzilay, MD, PhD, psychiatrist in the Lifespan Brain Institute and senior study author. “Additionally, parents, educators, and clinicians working with young adolescents should be aware of the increased mental health burden of LGB youth, especially in areas with higher degrees of structural stigma.”

The study team analyzed data from the Adolescent Brain and Cognitive Development Study, in which more than 11 000 U.S. adolescents were followed between the ages of 10 to 13 years old. Researchers found that 29.5% of those in a “sexual minority” who identified as gay, lesbian, or bisexual faced interpersonal discrimination based on their sexual orientation in the past 12 months, more than 6 times as much as 4.6% of those who identified as heterosexual. Those in the sexual minority group were more than twice as likely to report having thoughts of suicide compared to their heterosexual peers (38.2% vs. 15.1%) and almost 4 times as likely to attempt suicide (9.2% vs. 2.4%).

The study appeared in Journal of the American Academy of Child and Adolescent Psychiatry.

CHOP Researchers Find Strong Adolescent- Parent Relationships Lead to Better Long-Term Health Outcomes in Young Adults

Using data from the National Longitudinal Study of Adolescent to Adult Health, researchers from CHOP have found that adolescents who report strong relationships with their parents have better long-term outcomes in general health, mental health, and sexual health while also reducing substance use in young adulthood. Study findings were published in JAMA Network Open.\

Prior studies with similar conclusions have often been limited by small sample sizes, short-term outcomes, differing measures for parent-adolescent relationship characteristics, lack of diversity, and a focus only on relationships with mothers rather than relationships with mothers and fathers.

The researchers looked at data from more than 10 000 participants and found that participants who reported higher levels of mother-adolescent and father- adolescent warmth, communication, time together, academic expectations, relationship or communication satisfaction, and inductive discipline reported significantly higher levels of general health in young adulthood, senior study author Carol A. Ford, MD, says.