Implementation Science + Health Equity Advancement Laboratory (I+HEAL)
I+HEAL's mission is the promotion of health equity and justice to center the values and needs of historically marginalized communities. Health justice is achieved through dismantling the effects of oppression in the form of 'isms and phobias to achieve sustainable and equitable policies so that everyone has access to quality healthcare and social services such as education, housing, and food.
I-HEAL uses implementation and dissemination science frameworks to examine current health inequities in relation to structural disenfranchisement and intersectionality. We take these frameworks a step further by integrating equity frameworks, produced by communities on the periphery, into mainstream healthcare frameworks.
Pediatric Health and Wellbeing
Universal Implementation of a Substance Use Service in a Pediatric Hospital for Youth with Chronic Medical Conditions
Adolescents with chronic medical conditions (CMC) use alcohol and marijuana at levels equal to or greater than their peers without CMC and are more likely to initiate substance use (SU) at 14 years or younger. When using substances, adolescents with CMC are at elevated risk for adverse consequences to their medical conditions. Although there has been recent progress to integrate SU services into pediatric emergency departments for 8the general adolescent population, there has been almost no implementation of standardized SU services into pediatric hospitals for adolescents with CMC.
The purpose of this project is to identify the implementation determinants for an evidence-based SU service called Screening, Brief Intervention, and Referral to Treatment for Adolescents (SBIRT-A), within inpatient units at Lurie Children's Hospital for adolescents with CMC. This study combines implementation science frameworks such as the Consolidated Framework for Implementation Research 2.0 (CFIR 2.0) and the Health Equity Implementation (HEI) framework to adapt and integrate SBIRT-A into the healthcare system at Lurie Children's Hospital for adolescents with CMC receiving inpatient care.
Implementation of an Evidence-Based Substance Use Program in School-Based Health Centers for Students with Chronic Medical Conditions and their Caregivers
Over the past several decades, School-Based Health Centers( SBHCs) are health clinics embedded in elementary, middle, and high schools, offering a range of primary, preventative, and acute medical and behavioral health services. The goal of SBHCs are to identify, prevent, and treat any risks to students' health and academic performance by providing comprehensive care in a convenient location. SBHCs provide access to quality healthcare and improve health outcomes for children, adolescents, and families while decreasing healthcare costs. Many young people, especially those experiencing oppression and marginalization access mental and physical health services solely in educational settings. Moreover, mental health concerns such as substance use (SU) are the focus of a large proportion of visits in SBHCs and having access to a SBHC increases the likelihood of youth receiving mental health services for these concerns.
SBIRT-A is a public health approach for identifying and intervening on adolescent SU. The standard SBIRT-A approach has typically focused almost exclusively on adolescents by including only the youth in screening and intervention procedures. Yet, family SU, especially within the nuclear family unit is associated with increased risk for adolescent substance use. Also, studies have demonstrated that effective caregiver management strategies and higher levels of support from caregivers are associated with a reduced risk for adolescent SU.
Thus, the primary goal in this study, is the identification of determinants of implementation of SBIRT-A+caregivers (SBIRT-AC) for youth with chronic medical conditions receiving care in SBHCs. The research team will also focus on the selection and prioritization of implementation strategies to affect organizational change within schools in areas of high community need.
Faith Summersett Williams, PhD, is a behavioral scientist at Ann & Robert H. Lurie Children’s Hospital of Chicago and an Assistant Professor of Research in Pediatrics at Northwestern University Feinberg School of Medicine. Dr. Summersett Williams is dedicated to establishing a universal standard of equitable healthcare for communities on the periphery. Her interest in studying and addressing substance use in youth, especially among those with chronic medical conditions, came about due to her deep awareness of the role substance use often plays as a driver of poor and inequitable health outcomes. Dr. Summersett Williams also has research and clinical experience in medical ethics with the goal of prioritizing underrepresented issues within bioethics such as health justice. Her hope is that her work informs health care policies and practices to improve the quality of care delivered to youth and families.