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In the News: Overcoming Food Avoidance, Career Development Award, Genomics Research Network Expands, Asthma Medication Adherence

Published on
Nov 1, 2019
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By droseyb [at] email.chop.edu (Barbara Drosey)

This week’s roundup of research news includes positive results from a clinic that applies cognitive-behavioral therapy to food avoidance, a multiyear grant to expand the Genomics Research Innovation Network, and efforts to improve medication adherence among children with asthma through a combination of technology and incentives. In addition, join us in congratulating research fellow Kshitiz Singh on his Career Development Award from the American Society of Cell and Gene Therapy.

Clinic Helps Parents Encourage Kids to Eat Varied Foods

Do you have an excessively picky eater in the house? Help may be on the way. In a study published in Cognitive and Behavioral Practice, pediatric researchers from Children’s Hospital of Philadelphia and the University of Pennsylvania describe a group cognitive-behavioral therapy program that provided parents with specific techniques to improve their children’s mealtime behaviors and expand the range of foods they would eat. 

The study demonstrated the acceptability, feasibility, and positive outcomes of the Picky Eaters Clinic, a group-based intervention intended to train parents of children with avoidant/restrictive food intake disorder (ARFID).

“In the clinic, parents are taught to act as behavioral therapists who promote long-term improvements in food acceptance and positive mealtime behaviors,” said Katherine Dahlsgaard, PhD, ABPP, study leader and clinical director of the Anxiety Behaviors Clinic at CHOP.

Seven clinic sessions occurred over a six-month period that included in-person meetings as well as time for families to practice learned behavior strategies at home. At a reunion session held three months later, parents shared their results, and researchers administered post-treatment feeding measures and a parent satisfaction survey.

“I occasionally receive emails from the parents, telling me that their children are trying everything or eating in restaurants with no problem,” Dr. Dahlsgaard said. “But I'm interested to research this systematically and report on the long-term outcomes for all the families.”  

Read the CHOP press release for more information.

Research Fellow Kshitiz Singh Receives Career Development Award

Kshitiz Singh, MBBS, MMST, a CHOP research fellow is among six awardees of a $50,000 Career Development Award. The American Society of Gene and Cell Therapy (ASGCT) Career Development Awards support independent transformative pilot studies in gene and cell therapy conducted by ASGCT members, particularly for ideas that would be challenging to fund with normal funding mechanisms. 

Dr. Singh is working with an animal model to investigate the development of non-viral mechanisms of targeting lung epithelial cells for prenatal gene editing. Congenital genetic defects, including genetic lung diseases, often result in substantial morbidity and mortality shortly after birth, or in chronic debilitating illness. 

“Advances in gene therapy and gene editing approaches have provided hope for a cure for these diseases at their molecular roots,” Dr. Singh said. “However, lung-specific delivery of gene editing molecules is still challenging. This award from ASGCT is significant for developing clinically relevant platforms for lung-targeted gene editing.”

This group of awardees is ASGCT’s second class of Career Development Award recipients, a program in which ASGCT recognizes members who are transitioning toward independence in their careers.

Genomics Research Network Expands With New NIH Grant

A research collaboration sharing genomic data among CHOP and two other leading pediatric hospitals received a multiyear federal grant to broaden the network and extend it to other institutions, with the ultimate goal of accelerating scientific discoveries and advancing precision medicine treatments of genetic diseases in children.

The National Center for Advancing Translational Sciences (NCATS), part of the National Institutes of Health, awarded more than $8.5 million over five years to the Genomics Research Innovation Network (GRIN). CHOP co-founded GRIN in 2015 with Boston Children’s Hospital and Cincinnati Children’s Hospital.

Even major hospitals may treat only a few patients with a specific rare condition, so collaborative research networks are crucial to pooling data so researchers may discover a condition’s underlying genetic causes and translate that knowledge into improved clinical care.

“Genomics is impacting all aspects of healthcare and research in pediatrics,” said Ian Krantz, MD, geneticist and director of the Roberts Individualized Medical Genetics Center at CHOP, one of GRIN’s co-founders and a co-investigator on the new grant. “In order to optimize the utility of this information for breakthroughs in care and discovering new cures, we need a new model to share data collaboratively across institutions. GRIN has stepped up to do this, and this award is a validation of this approach to transforming precision medicine.”

Read more on Cornerstone and in CHOP’s press release. 

Improving Medication Adherence for Children With Asthma

When taken as prescribed, inhaled corticosteroid (ICS) medications effectively improve asthma control and reduce morbidity, as well as reduce the number of days children experience symptoms, emergency department visits, and hospitalizations. Yet adherence is low among certain high-risk populations such as urban racial/ethnic minority children. 

Chén Kenyon, MD, MSHP, pediatric hospitalist, faculty member at PolicyLab and the Center for Pediatric Clinical Effectiveness at CHOP, and an assistant professor of Pediatrics at the University of Pennsylvania, is leading a study “Tailored Adherence Incentives for Childhood Asthma Medications” to better examine the potential of technology and incentives for families dealing with high-risk asthma.

Dr. Kenyon’s research team completed a series of studies to develop an intervention to improve asthma medication adherence. Their latest pilot incorporated gain-framed incentives for kids, which allows them to earn a reward for performing a particular behavior. In this case, the desired behavior of taking their asthma medication could earn children up to $1 a day for achieving 30 days of adherence. 

Using an electronic sensor on the child’s asthma inhaler and a mobile app on their caregiver’s smartphone, families received medication reminders and weekly feedback about the child’s adherence and incentives accumulated. During the intervention month, average medication adherence was 80 percent; however, in the following month when families did not receive reminders, feedback, and incentives, adherence dropped to 30 percent. These findings demonstrate the feasibility of this pilot incentive-based intervention in engaging caregivers and children with high-risk asthma in regular medication use, and indicate room for improvement in medication adherence. 

The next phase of the project will continue to apply behavioral economics principles to promote medication habits and include a randomized control trial. Building on the pilot study, the project aims to determine if a combination of technology and incentives works to enhance ICS adherence and decrease emergency department and hospital use in high-risk children. 

Read Dr. Kenyon’s blog post for the whole story.

ICYMI

Catch up on our headlines from our last edition of In the News:

  • Subtle MtDNA Mutations Alter Expression of Nuclear Genes
  • Carousel Ball Raises $3.5 Million for Cardiac Center
  • CHOP Researchers Awarded High-Risk, High-Reward Grants
  • Genetics Researchers Identify Neurodevelopmental Syndrome
  • Rhonda Boyd, PhD, Discusses Expanding Research to Address Suicide

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