# Transforming Care Delivery Models for at-Risk Young Adult Patients with Congenital Heart Disease and Amplifying Research Efforts to Improve Health Equity in Pediatric Chronic Disease Care > **NIH NIH R01** · BAYLOR COLLEGE OF MEDICINE · 2024 · $694,198 ## Abstract PROJECT SUMMARY/ABSTRACT Advances in pediatric subspecialty care have improved the health of children who previously died, but now are reaching adulthood, creating a fast-growing population of survivors. One example is congenital heart disease (CHD), the most common birth defect, where now more adults with CHD are living than children. Disparities in subspecialty health outcomes are magnified throughout the lifespan, in part due to failures in transitioning from pediatric to adult providers, and in part due to a dearth of adult providers who understand pediatric chronic conditions. Less than 10% of adults with CHD receive appropriate CHD care, with few adult cardiologists trained to manage long-term CHD issues. Furthermore, scarcity of adult CHD (ACHD) providers makes it especially challenging to access ACHD physicians, particularly for racial and ethnic minorities and those from lower socioeconomic status (SES) and rural environments. Thus, a critical need exists to increase pediatric health equity researchers to recognize and address subspecialty health disparities throughout the lifespan. In this innovative grant, we propose utilizing existing expertise and infrastructure to train a new generation of pediatric health equity researchers caring for high-risk chronic disease populations through a REsearch And Career Health Equity System (REACHES). This system merges experts from Baylor College of Medicine Population Sciences-Shared Research CORE and Texas Children's Hospital Health Policy Center to support trainees and pediatricians whose research, advocacy or QI projects focus on health equity. REACHES directly addresses two NIH NIMHD objectives: 1) to foster innovative collaborations and partnerships, and 2) support the training of a diverse research workforce. Our proposed research exemplifies our REACHES expertise by leveraging existing collaborative relationships and infrastructure with the TX Birth Defects Registry (TBDR), TX A&M Department of Public Service and Administration (PSAA), Geographic Information System (GIS) mapping experts, and the Adult Congenital Heart Association (ACHA) to address health disparities in transitioning ACHD (18-24 yo) patients with moderate to severe CHD in Texas. We plan to 1) identify young ACHD with high-risk sociodemographics (low SES, rural, and minoritized patients) for gaps in care 2) investigate key barriers to ACHD care for patients 3) use barrier data to inform an ACHA patient navigation intervention to increase access to ACHD care, and 4) transform the delivery of ACHD care through operationalizing an adapted hub- and-spoke medical home model for CHD care (MMCC), comprised of an adult cardiologist at the hub with pediatric and ACHD subspecialty consultation, and determine acceptability of the MMCC strategy to deliver remote ACHD care using telemedicine and Project ECHO (a platform facilitating access to specialty expert management and learning). This research directly addresses two NIH NIMHD objectiv... ## Key facts - **NIH application ID:** 10859958 - **Project number:** 1R01MD019298-01 - **Recipient organization:** BAYLOR COLLEGE OF MEDICINE - **Principal Investigator:** Keila Natilde Lopez - **Activity code:** R01 (R01, R21, SBIR, etc.) - **Funding institute:** NIH - **Fiscal year:** 2024 - **Award amount:** $694,198 - **Award type:** 1 - **Project period:** 2024-06-18 → 2029-01-31 ## Primary source NIH RePORTER: https://reporter.nih.gov/project-details/10859958 ## Citation > US National Institutes of Health, RePORTER application 10859958, Transforming Care Delivery Models for at-Risk Young Adult Patients with Congenital Heart Disease and Amplifying Research Efforts to Improve Health Equity in Pediatric Chronic Disease Care (1R01MD019298-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10859958. Licensed CC0. --- *[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*