# Comparing Family Decision Making Engagement in Telehealth versus In-person Primary Care for Children with Chronic Conditions

> **NIH AHRQ R01** · CINCINNATI CHILDRENS HOSP MED CTR · 2022 · $399,999

## Abstract

PROJECT SUMMARY/ABSTRACT
The COVID-19 pandemic led to unprecedented changes to healthcare delivery during the spring of 2020,
including the rapid and wide implementation of telehealth. This expansion included areas in which telehealth
had not previously been broadly applied, such as pediatric primary care. By its very nature, telehealth changes
the communication and structure of the healthcare interaction, perhaps especially in pediatrics where both the
parent and patient need to be engaged in the visit. Such changes may directly affect shared decision making,
an essential component of high-quality care and a strategy to improve outcomes. Children with asthma and
attention deficit hyperactivity disorder, the most common chronic conditions in pediatric primary care, are
especially vulnerable to changes in health care delivery. These conditions are highly prevalent among urban,
underserved children and while some barriers to care are alleviated by telehealth new ones may emerge.
Understanding the impact of telehealth on an underserved, inner-city, primary care population is critical to
prevent worsening disparities. Our long-term goal is to improve pediatric primary care by ensuring delivery of
chronic disease care that meets families’ goals and improves children’s health and well-being. The overall
objective of this proposal is to compare the decision-making processes and outcomes between telehealth and
in-person pediatric primary care for children with chronic conditions. This proposal consists of three distinct
aims that build upon one another by triangulating perceived and observed decision-making, parents’ and
adolescent patients’ perceptions, and quantitative and qualitative data to achieve breadth and depth of
understanding about shared decision making in pediatric primary care. In Aims 1 and 2 we will evaluate the
quality of pediatric primary care delivered via telehealth compared to in-person care. Aim 1 will use rigorous
survey methods to understand families’ perceptions of decision making that occurs during either a telehealth or
in-person pediatric primary care visit. This will be coupled with chart review to understand the contribution of
telehealth or in-person care to clinical outcomes. Aim 2 will build upon the first by video-recording healthcare
visits so the extent of observed shared decision making can be assessed both quantitatively and qualitatively.
Finally, in aim 3 we will use qualitative interviews to “feed forward” the data from aims 1 and 2 to parents,
adolescents and healthcare providers to gain a more in-depth understanding regarding experiences of decision
making in telehealth compared to in-person care. The expected outcome of this proposal is an understanding
of the impact of telehealth delivery in pediatric primary care on decision making processes for children with
chronic conditions. These results will have a positive impact on care delivery by facilitating the development of
targeted approaches to supporting shar...

## Key facts

- **NIH application ID:** 10560396
- **Project number:** 1R01HS029152-01
- **Recipient organization:** CINCINNATI CHILDRENS HOSP MED CTR
- **Principal Investigator:** Ellen A Lipstein
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2022
- **Award amount:** $399,999
- **Award type:** 1
- **Project period:** 2022-09-30 → 2025-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10560396

## Citation

> US National Institutes of Health, RePORTER application 10560396, Comparing Family Decision Making Engagement in Telehealth versus In-person Primary Care for Children with Chronic Conditions (1R01HS029152-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10560396. Licensed CC0.

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