Piloting an Innovative System-Level Intervention for Pediatric Patients with Inflammatory Bowel Disease and Social Risk

Objective: The purpose of this study is to describe the implementation of the Novel Interventions in Children's Healthcare (NICH) program for youth with inflammatory bowel disease (IBD) and high social risk. Method: This study examined the implementation of NICH with four adolescents of racial and ethnic diversity with high social risk and IBD, using a retrospective pretest-posttest design. Chart reviews captured descriptions of the course of treatment and healthcare utilization data for one year prior to and one year post NICH service initiation, including the presence and frequency of hospital admissions, ED visits, and the number of days spent in the hospital. Demographic information and medical appointment attendance data were also collected. Results: EHR records indicated that NICH services were tailored to account for factors specific to IBD as well as youth and family culture. All four youths demonstrated improvements in health, and most youths evidenced reductions in acute care use and associated costs, increased engagement in recommended preventative care, and improved disease management. Conclusions: NICH is a promising intervention for youth with IBD who are experiencing disease management difficulties due to social factors and represents an alternative approach to care for this population. Implications for Impact StatementThis case series examines how an alternative program to office-based services (Novel Interventions in Children's Healthcare: NICH) could be feasibly used for youth with IBD and high social risk. Youth generally evidenced fewer acute complications and improved outpatient medical attendance, reported improved quality of life, and demonstrated reduced healthcare costs one year following NICH enrollment. Findings indicated NICH is a promising service for youth with IBD and specifically for youth with IBD from underserved and underrepresented populations.