RESEARCH

Anxiety disorders affect more than 20 percent of youth, often interfering with self-esteem, confidence, family relationships, friendships, or school performance. Although psychological and medication therapies are helpful to many patients, not all patients respond to a given therapy, and those who do frequently respond relapse later. Treatment of a child who has an anxiety disorder begins with the question of which treatment to begin first: psychological or medication therapy. Few studies, however, have compared these two treatments directly, leaving patients, parents, and clinicians without scientific evidence for which treatment is likely to be most helpful. Another question is what to do when the initial treatment is not as helpful as desired: Should the initial single treatment be intensified, or should the other treatment be added to the first, producing a combined psychological and medication therapy? This randomized trial will clarify whether treatment of anxiety should be initiated with medication or cognitive-behavioral therapy and how to proceed if the initial treatment is not as successful as desired.

The goal of this project is to evaluate the long-term health outcomes, including mortality, second cancer and comorbidities among survivors of adolescent and young adult cancer. The magnitude of risk increase of specific late effects associated with specific cancer therapeutic exposure will also be characterized.

Anxiety disorders among youth are extremely common and without effective treatment can lead to depression, substance use, suicide, and deficits in functioning into adulthood. Although pediatric anxiety interventions, such as cognitive behavioral therapy and antidepressant medications, are highly efficacious, many clinicians are under-using these evidence-based treatments. We will develop and test two complementary casemix-adjusted pediatric anxiety outcome quality measures using the GAD-7 instrument: (1) a measure of whether patients are responding to treatment (treatment response) and (2) whether patients’ anxiety remitted (remission), which will provide a critical tool for improving outcomes from anxiety treatment.

The proposal will gather preliminary biomarker data in newborns in response to air pollution and gestational diabetes exposure in-utero

Adolescents and young adults with cancer aged 12-39 account for more than 70,000 new cancer diagnoses in the United States per year, and cancer is their leading disease-related cause of death. This study will evaluate the current state of end-of-life care quality among adolescent and young adult patients and develop a set of quality indicators that capture adolescent and young adult values for care. This work will enable valid assessment of care quality and rigorous evaluation of interventions to improve adolescent and young adult end-of-life care delivery.

This project aims to evaluate adherence to Children’s Oncology Group Long-Term Follow-up Guidelines and population preventive care guidelines among survivors of adolescent and young adult (AYA) cancer.

Existing and proposed mental health quality measures may be biased against health systems, facilities, and clinicians serving more Black and Hispanic patients, measuring the patients they serve rather than the quality of care they provide. This research will use detailed records data from five large health systems to evaluate potential biases in existing and proposed measures and evaluate alternatives to reduce biases.

The aims of this study are (1) to ascertain prevalent diabetes cases in calendar year 2017 among youth age <20 years at diagnosis, using cost-efficient approaches that maximize use of information in the electronic health records (EHRs) and administrative databases, (2) to continue to ascertain newly diagnosed (incident 2015-2020) diabetes cases in youth age <20 years, using cost-efficient approaches that maximize use of EHRs and administrative databases, (3) to determine agreement between the etiological classification of diabetes type using biochemical markers and provider assessment; to describe selected clinical characteristics at diagnosis, and to establish an infrastructure that facilitates the development of more detailed ancillary studies by storing biological samples and preserving contact with potential study participants, and (4) To optimize efficiency of SEARCH surveillance activities through targeted Development and Validation (D&V) Projects designed to utilize electronic health data to operationalize each of the three tiers of surveillance to the extent possible. (1U18 DP006133)

This study is an observational post-marketing safety study required by the United States Food and Drug Administration (FDA). The primary objective of this study is to describe medical events that require emergency room visit or hospitalization in 6 months following MenACWY-CRM vaccination in children 2-23 months of age in a health maintenance organization (HMO) in the United States.

The goal of this study it to evaluate patterns of medical imaging associated with cumulative exposure to radiation (CT, nuclear medicine, fluoroscopy, angiography, and radiography), and subsequent risk of childhood cancers.

This project is part of a series of CDC studies to better understand the association between birth factors such as delivery mode labor or rupture of membrane, and exposure to intrapartum antibiotics and childhood weight gain.

The major goals of this trial are to determine the effectiveness of a school and community-linked physical activity intervention to reduce the decline in physical activity in young women, a cohort who have been followed since middle school.

This project aims to improve the accuracy of computationally identifying high-risk asthma patients, it’s assess potential impact on outcomes and to provide automated prediction result explanations for care management.

Rates of childhood obesity in the U.S. remain at historic highs. Primary care settings lack interventions to address the childhood obesity epidemic that are feasible and sustainable without requiring significant resources. We will test a motivational interviewing-based intervention shown to lower children’s BMI in a real-world clinical setting with the goal of halting and reversing the childhood obesity epidemic.