# Promoting Safe Transitions from Hospital to Home for Children with Medical Complexity: A Health Literacy-Informed and Family-Centered Approach

> **NIH NIH K23** · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · 2022 · $168,798

## Abstract

PROJECT SUMMARY/ABSTRACT
Children with medical complexity (CMC), or those with multiple chronic conditions, progressive conditions, or
technology dependence, are at high risk for post-hospitalization morbidity. Despite representing 1% of children
in the US, CMC account for 1/3 of pediatric hospital expenditures; 30-day readmission rates are ~20%. Research
on post-discharge morbidity (e.g., adverse drug events, infections, unanticipated visits) has focused on adults.
Few studies have assessed strategies to reduce post-discharge morbidity in CMC. Such strategies must account
for 1) factors distinct to children (e.g., liquid medications, recognizing symptoms in children who cannot express
what is wrong) and 2) specific needs of CMC (e.g., medical equipment, knowing which of many providers to
contact, managing multiple chronic medications, complex family/household dynamics). Inadequate provider-
parent communication and low parent health literacy contribute to poor comprehension of and adherence to
discharge instructions, increasing risk for post-discharge morbidity. Despite recommendations from multiple
national organizations for evidence-based, health literacy-informed interventions to improve communication
processes, to date, a health literacy-informed approach to address post-hospitalization morbidity for CMC has
not been used while also incorporating principals of family dynamics.
The primary objective of this application is to support Dr. Glick’s goal of becoming an independent investigator
with the aim of improving 1) parent comprehension of/adherence to discharge instructions and 2) post-discharge
outcomes for CMC. This goal will be achieved through training from an expert multidisciplinary mentorship team
and formal coursework. He will gain advanced skills in 1) qualitative/mixed method research, 2) family dynamics,
3) user-centered design, and 4) implementation science/design and evaluation of complex interventions. Dr.
Glick will accomplish his goals at NYU School of Medicine through the following 3 aims:
In Aim 1, Dr. Glick will use qualitative methods to examine barriers/facilitators for a) parents in comprehension
of/adherence to discharge instructions and b) pediatricians in providing optimal discharge education for CMC.
In Aim 2, Dr. Glick will use Aim 1 findings, multiple rounds of usability testing, multi-disciplinary workgroups, a
national sample of discharge instructions for CMC, and an existing tool designed to improve parent adherence
to discharge instructions for common pediatric diagnoses to inform the design of his new tool for CMC.
In Aim 3, Dr. Glick will utilize a randomized controlled trial to examine this tool’s efficacy in improving parent
comprehension of and adherence to discharge instructions and reducing post-hospitalization morbidity for CMC.
Successful completion of this project will lead to an R01 application to test the efficacy of the intervention, now
linked to the electronic health record, in improving parent...

## Key facts

- **NIH application ID:** 10378647
- **Project number:** 5K23HD102553-02
- **Recipient organization:** NEW YORK UNIVERSITY SCHOOL OF MEDICINE
- **Principal Investigator:** Alexander Glick
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $168,798
- **Award type:** 5
- **Project period:** 2021-04-01 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10378647

## Citation

> US National Institutes of Health, RePORTER application 10378647, Promoting Safe Transitions from Hospital to Home for Children with Medical Complexity: A Health Literacy-Informed and Family-Centered Approach (5K23HD102553-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10378647. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*