Project Summary / Abstract – Administrative Supplement Request The purpose of this K23 administrative supplement is to support the return to full productivity of Jennifer K. Walter, MD, PhD, MS, following 12 weeks of parental leave due to the adoption of her infant son. Dr. Walter’s long-term goal is to become an independent physician-investigator testing interventions in the field of cardiac disease and pediatric palliative care. The parent K23 award has supported her training, mentorship, and research experience towards her ability to compete for R01 grants supporting intervention studies in this area. Pediatric advanced heart disease is a leading cause of non-accidental death for children. The children that die do so in the cardiac intensive care unit (CICU), where many parents report being unprepared for the death and as a result, are unable to make goal-concordant decisions. Thus, there is a critical need to create evidence- based interventions that support teams and families in effectively communicating about treatment goals. To achieve this objective, Dr. Walter has identified a cohort of parents of patients with advanced heart disease and clinicians regularly attending interprofessional team meetings in the CICU who will participate in family meetings. With this cohort, the Aims of the parent K23 award are to: (1) Use co-design methods working with parents of CICU patients and interprofessional team members to custom adapt an intervention called CICU Teams and Loved Ones Communicating (CICU TALC) to improve CICU family meetings; Assess the acceptability (2a) and feasibility (2b) of CICU TALC on parent, patient, and team outcomes with 20 clinicians and 46 parents of CICU children; and (2c) Test the impact of CICU TALC on team and parent behavior in family meetings. To date, Dr. Walter has completed the co-design of the intervention and data collection for Aim 1 and pre-implementation data collection for aim 2b. Necessitated by the COVID-19 pandemic, she redesigned the training of clinicians on the intervention for a virtual environment. Once the intervention implementation is complete, Dr Walter will be poised to collect post-intervention data from family meetings and parental surveys to complete the evaluation of the feasibility of the study (Aim 2b) and the impact of the intervention on clinician and family outcomes (Aim 2c). The proposed administrative supplement will support qualitative methods team members with expertise in subject interviews, qualitative analysis, data management, and quantitative coding of transcripts. These funds for qualitative methods experts to assist in the assessment of the acceptability of the intervention and data management and coding of the family meetings will enable Dr. Walter to focus on those tasks necessary to maintain scientific productivity, such as completing data analyses, writing scientific manuscripts, disseminating findings to scientific audiences, and drafting an R01 application.