2018 Annual Meeting

Applying Epidemiology Across the Lifespan to Improve Health Care,
Inform Health Policy and Enhance Population Health




Concurrent Session 3b

Location: University of Cincinnati, Medical Sciences Building (MSB), Room 5051

Health Transitions into Adulthood (Growing up with chronic diseases of the childhood)

Chair: Brad Pollock, PhD, MPH, FACE, Professor and Chairman, Rolkin Chair in Public Health Sciences, Associate Dean for Public Health Sciences, School of Medicine, University of California at Davis

Description: Using epidemiology to inform health policies for adults living with chronic medical conditions originating in childhood, we will discuss childhood cancer, sickle cell disease and autism, each having unique health care transition issues.

Abstract: Children and adolescents with chronic diseases or survivors who are at risk for long-term sequelae or relapse face many health challenges as they transition to adulthood. Health care transition has become the standard of care for patients living with chronic medical conditions originating in childhood. Epidemiology can inform health policies by better defining the population at risk as well as establishing the evidence base to support specific surveillance and interventions approaches aimed at improving long-term outcome. We discuss childhood cancer, sickle cell disease and autism; each having unique health care transition issues.



Brad Pollock, PhD, MPH, FACE, University of California at Davis, “The challenges of childhood cancer survivors”

Abstract: As the survival of children with cancer has significantly increased over the last 40 years, determining how best to manage the health care transition for young adult survivors of childhood and adolescent cancer is of increasing concern. Epidemiological research has allowed us to better characterize the spectrum and severity of long-term sequelae as well as help identify host and disease characteristics associated with poor outcome. Application of this knowledge can be used to design more effective and cost-efficient medical surveillance approaches. However, the evidence-base justifying many medical practices for this population is still deficient. Over the last 20 years, research has broadened to better characterize the social, behavioral and financial impacts of childhood and adolescent cancer as survivors transition into adulthood. Applied epidemiology is central to the development of clinical practice guidelines which increasingly rely on observational big data from electronic health records and administrative datasets, patient-reported outcome (PRO) data, and evidence from study designs other than the traditional individually-randomized intervention trials. An epidemiological approach can inform policies to improve health care delivery during the transition with magnified impacts in older adulthood.

Brief Biography:

Brad Pollock, PhD, MPH, FACE, is Professor and Chair of the Department of Public Health Sciences and Associate Dean for Public Health Sciences at the UC Davis School of Medicine. He is the former Founding Chair of the Department of Epidemiology and Biostatistics at UT Health San Antonio. He co-directs the Population Sciences & Health Disparities research program of the UC Davis Comprehensive Cancer Center. Dr. Pollock serves as PI of the Children’s Oncology Group NCI Community Oncology Research Program (NCORP) Research Base and Co-Chair of the NCI Cancer Care Delivery Research Steering Committee. He also serves as the Co-Chair of the Methods & Processes Domain Task Force for the national Clinical Translational Science Award Consortium. His research focus is in child and adolescent cancer, cancer control and cancer care delivery research.


Lori Crosby, PsyD, Professor of Pediatrics, Innovations Co- Director, Cincinnati Children’s Hospital Medical Center, “Transition to Adult Care in Sickle Cell Disease”

Abstract: Sickle cell disease (SCD) is a group of inherited blood disorders affecting red blood cells which can impede blood flow to tissues and organs and associated with significant medical complications including vaso-occlusive pain, anemia, stroke, and injury to vital organs (e.g. heart, lung, kidney, bones). Medical advances have resulted in children with sickle cell disease living into adulthood necessitating a transition to the adult health care system. Data suggests that patients with SCD are at risk for increased morbidity and mortality during this time. In addition, young adult patients are often taking on more responsibility for managing their SCD without support from caregivers, which increases their risk for gaps in care. This presentation will review predictors and indicators of successful transition, special considerations, and evidence-based interventions/recommendations. It will end with a discussion of current research efforts and ways that epidemiological research can contribute to the prevention of poor health outcomes during the transition process.

Brief Biography:

Lori E. Crosby, PsyD, is a Professor in the Division of Behavioral Medicine and Clinical Psychology at Cincinnati Children’s Hospital Medical Center (CCHMC) and Department of Pediatrics at the University of Cincinnati College of Medicine. Dr. Crosby is also Co-Director of the Cincinnati Center for Clinical and Translational Science (CTSA), Community Engagement Core, INNOVATIONS in Community Research and Program Evaluation, and directs a research program in pediatric sickle cell disease. In 2012, Dr. Crosby was elected as Fellow of the American Psychological Association (APA) Division 54 in light of her significant contributions to the field of pediatric psychology. Dr. Crosby has expertise in self-management, treatment adherence, healthcare transition, recruitment and retention of minorities in research and integrating design thinking into research. Her work in community engagement for individuals affected by sickle cell disease was featured in a Special Issue on Pediatric Health in the Community for the Journal of Prevention and Intervention in the Community. She has given over 100 presentations at regional or national meetings and authored or co-authored over 50 peer-reviewed articles, book chapters, or community-focused reports. Dr. Crosby has been a Co-Investigator or Consultant on more than 18 federally-funded grants. In 2011, she received a K07 grant from the National Heart, Lung, and Blood Institute (NHLBI) to develop patient-provider tools to enhance the transition to adult care for young adults with SCD. She just completed an R21 from the Eunice Kennedy Shriver National Institute on Child Health and Human Development (NICHD) piloting a self-management intervention for adolescents with sickle cell disease. In December 2017, she was awarded a contract from the Patient Centered Outcomes Research Institute (PCORI) to disseminate a hydroxyurea shared decision-making intervention.


Alice Kuo, MD, PhD, UCLA “Health Care Transition for Children with Autism”

Abstract: Autism is a spectrum of neurodevelopmental disorders characterized by social communication difficulties, restricted interests and/or repetitive behaviors, and challenges with social interactions. Current prevalence estimates by the Centers for Disease Control and Prevention (CDC) are 1 in 59 children, and 1 in 37 boys. Although most of the focus of treatment for autism has been on early or preschool intervention (0–5 years), nearly all of these children survive into adulthood. Very little research dollars have been allocated to study the life course of autism or the experiences of autism in young adulthood. The sparse data available suggest that adults with autism fare worse than adults with other developmental disabilities such as Down syndrome, with the vast majority unable to live independently or have full-time employment. Adults with autism also have greater morbidity from cardiovascular disease and cancer and shorter life spans, presumably due to challenges with health care access. Epidemiological research is needed to better characterize the health status of adults with autism and identify the health needs of this population.   

Brief Biography:

Alice Kuo, MD, PhD, is Chief and Professor of Internal Medicine and Pediatrics at the David Geffen School of Medicine at UCLA, and of Health Policy and Management in the UCLA Fielding School of Public Health. Her research interests are mainly in early childhood, and she has published in the areas of developmental screening and services, early literacy practices, cognitive and language development in young minority children, hearing screening in early childhood, services for children with autism, and mental health services for children. She has co-edited two books, Child Health: A Population Perspective (2015) by Oxford University Press and Care of Adults with Chronic Childhood Conditions (2016) by Springer. Dr. Kuo currently directs the Health Care Transitions Research Network and the University of California Leadership Education in Neurodevelopmental Disabilities program, both funded by the federal Maternal and Child Health Bureau. She is also currently President of the Southern California chapter of the American Academy of Pediatrics.

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