Addressing Disparities Across Systems: Initial Implementation of Novel Interventions in Children’s Healthcare (NICH) Global Implementation Research and Applications
Date
08/15/2025Abstract
Children with complex and/or chronic medical conditions that experience psychosocial challenges are often at risk for repeated, and sometimes avoidable, hospitalizations. While some behavioral interventions address the presenting problems associated with complex and chronic medical conditions, most interventions do not meet the needs of youth from marginalized communities, who experience health inequities due to systematic and historical oppression. In addition, developers of evidence-based interventions often struggle to disseminate their programs outside of their home institution. The Novel Interventions in Children’s Healthcare (NICH) program is an intensive intervention that involves delivering evidence-based interventions (e.g., family-based problem-solving, case management, care coordination, behavioral skills training) in the homes and communities of youth with chronic and/or complex medical condition. This intervention, originating in Oregon, has shown promising outcomes in terms of decreases in hospitalizations and associated costs. However, less is known about the transportability of the intervention to external sites. This paper explores the process of implementing NICH in two external healthcare systems in the Bay Area. Results show that, with training and supervision, interventionists were able to deliver the intervention with fidelity. We explore findings related to tracking the different phases of the implementation process and present qualitative findings from interviews conducted with key personnel at each of the intervention sites to better understand implementation successes and challenges.
Author List
Mackenzie Z. Norman, Kristen A. Torres, Lisa Saldana, Kimberly Spiro, Diana Naranjo, Jenise C. Wong, Alison Reed, Rachel Bensen, Samantha Barry-Menkhaus, Michael A. Harris & David V. WagnerAuthor
Mackenzie Z. Norman PhD, MA Assistant Professor in the Pediatrics department at Medical College of WisconsinView Online
