Division of Adolescent Medicine

Fellowship Research Program Overview

Scholarly activity is a critical part of Adolescent Medicine fellowship training at CHOP. Our fellows benefit from committed research mentors in the Division of Adolescent Medicine (described on Investigators page), as well as mentors and collaborators across CHOP and the University of Pennsylvania. In addition to participating in fellows’ research didactics and attending Division research seminars, all fellows are required to complete an independent scholarly project. Our fellows typically present their work at national meetings, such as the Society for Adolescent Health and Medicine and the Pediatric Academic Societies, and publish their research findings in reputable peer-reviewed journals.

Recent Fellows’ Research Projects

Assessing Risk and Resilience in Youth Participating in Students Run Philly Style, a Community Running and Mentorship Program (Chris Renjilian)
This observational cohort study evaluates the impact of a community youth development program that engages youth with adult mentors through a progressive long-distance running training program on risk and resilience from the effects of toxic stress.

BE in CONTROL - Behavioral Economic Incentives to Improve Glycemic Control among Adolescents and Young Adults with Type 1 Diabetes: An RCT (Charlene Wong)
This randomized controlled trial employs daily financial incentives and connected glucometer devices to test strategies to improve glycemic control among youth with type 1 diabetes.

Changes in Young Adult Primary Care under the Affordable Care Act (Charlene Wong)
Data from the Medical Expenditure Panel Survey (MEPS) was analyzed to assess how young adult use of primary care changed after the implementation of the ACA's extended dependent coverage provision.

Consumer Choices and Decision Support on the Health Insurance Exchanges (Charlene Wong)
This set of studies tracks the tools available on the ACA's health insurance exchanges over the first three enrollment periods to help consumers make health plan choices.

Disordered Eating and Body Dissatisfaction among Adolescents Living with HIV (Zachary McClain)
This cross-sectional, mixed method study included surveys, qualitative interviews, and a retrospective chart review to determine the incidence of ED in a sample of HIV+ adolescents and to examine associations between ED and HIV biomarkers, psychiatric co-morbidities, medication adherence, retention in care, high risk sexual behaviors, and food insecurity.

Examining the Role of Supportive Family Connection in Violence Exposure among Male Youth in Urban Environments (Alison Culyba)
Male youth in low resource neighborhoods in Philadelphia were interviewed regarding their relationships with adult family members and their exposure to violence.

HIV Transmission Potential among HIV-Positive Youth (Sarah Wood)
This retrospective cohort study aims to identify risk factors for increased HIV transmission potential, defined as co-occurring sexually transmitted infection and HIV viral load >1500 copies/ml.

Missed Opportunities for HIV Screening among Adolescents in Healthcare Settings (Caroline Salas-Humara)
This mixed method study employs a retrospective chart review as well as semi-structured interviews to determine the prevalence and correlates of missed opportunities for sexual health and HIV screening of adolescents in primary care and ED settings in the 3 years prior to diagnosis of HIV.

Modifiable Environmental Features Associated With Adolescent Homicide (Alison Culyba)
This population-based case control study assessed associations between environmental neighborhood features and adolescent homicide. This study identified environmental features that might be targeted in future studies designed to reduce youth violence by improving neighborhood context.

Pediatric Price Transparency: Still Opaque and Opportunities for Improvement (Charlene Wong)
The availability of price data for pediatric care on children's hospital and state-based price transparency websites is described to inform QI efforts at CHOP around price transparency.

Pediatric Provider Networks in the ACA Health Insurance Marketplaces (Charlene Wong)
The inclusion of pediatric generalists and subspecialists is compared to adult providers in the ACA's marketplace plan networks to inform discussions on network adequacy for youth.

Protective Effects of Adolescent-Adult Connection on Male Youth in Urban Environments (Alison Culyba)
This study examined associations between adult connection and school performance, substance use, and violence exposure among male youth in low resource neighborhoods in Philadelphia. The results suggested that fostering adult connection may help safeguard youth living in urban environments.

Role of Adult Connection in Violence Prevention among Youth during Daily Activity (Alison Culyba)
This population-based case control study of assault-injured youth in Philadelphia is studying whether having an adult connection is associated with lower odds of violent assault injury in adolescent males.

Seeing Health Insurance and HealthCare.gov through the Eyes of Young Adults (Charlene Wong)
Young adults shopping for insurance on HealthCare.gov were observed and interviewed during the open enrollment to make recommendations about how to improve the online marketplace.

Social Support as a Facilitator of Adherence to HIV Pre-Exposure Prophylaxis among Young Men who have Sex with Men (Sarah Wood)
This mixed method study explores the potential role of social support in PrEP adherence.

Sustained Virologic Suppression among Adolescents and Young Adults with Behaviorally-acquired HIV (Sarah Wood)
This retrospective cohort study identified high rates of virologic failure and low rates of sustained virologic suppression among HIV positive youth receiving care at CHOP from 2002-2015.

The Role of Resilience in Healthcare Transitions Among Adolescent and Young Adult Kidney Transplant Recipients (Sheila Quinn)
This mixed-methods study examines how resilience mediates a successful healthcare transition using both a novel patient-centered definition of success, and more conventional provider-driven outcome measures such as medication adherence and allograft outcomes.

The Sexual and Reproductive Health Needs of Adolescent Female Bhutanese Refugees (Cherie Priya Dhar)
This qualitative study aims to determine the sexual and reproductive health needs of adolescent females of the Nepali-speaking Bhutanese refugee community.

The Use and Cost of Inpatient Care, Retail Based Clinics and Urgent Care Centers by Youth (Charlene Wong)
This set of studies uses a large, national claims database to describe the most common and costly hospitalizations among young adults since the ACA and to compare the use and cost of retail clinics and urgent care centers by adolescents and young adults compared to children.

Using Social Media to Engage Children and Youth with Their Health (Charlene Wong)
This set of studies examines and describes innovative ways to utilize social media to better engage children and youth with their health.

Recent Fellow’s Publications (Selected)

Culyba AJ, Ginsburg KR, Fein JA, Branas CC, Richmond TS, Miller E, Wiebe DJ. Examining the role of supportive family connection in violence exposure among male youth in urban environments. J Interpers Violence. 2016 Apr 24. doi:10.1177/0886260516646094. [Epub ahead of print]

Culyba AJ, Ginsburg KR, Fein JA, Branas CC, Richmond TS, Wiebe DJ. Protective effects of adolescent-adult connection on male youth in urban environments. J Adolesc Health. 2016 Feb;58(2):237-40.

Culyba AJ, Jacoby SF, Richmond TS, Fein JA, Hohl BC, Branas CC. Modifiable neighborhood features associated with adolescent homicide. JAMA Pediatr. 2016; 170(5):473-480.

McClain Z, Hawkins LA, Yehia BR. Creating welcoming spaces for lesbian, gay, bisexual, and transgender (LGBT) patients: An evaluation of the health care environment. Journal of Homosexuality. 2016;63(3):387-393.

Quinn SM, Ambrosino JM, Doyle EA, Weyman K, Tamborlane WV, Jastreboff AM. Utility of psychosocial screening in young adults with Type 1 Diabetes transitioning to adult providers. Endocrine Practice. 2016; 22(9):1104-10. PMID: 27295017.

Quinn SM, Louis-Jacques J. Menstrual management and reproductive considerations in adolescent and young adult women with underlying hematologic or oncologic disease. Current Opinions in Pediatrics. 2016;28(4):421-427. PMID:27138999

Wong CA, Asch DA, Vinoya CM, Ford CA, Baker T, Town R, Merchant RM. Seeing health insurance and HealthCare.gov through the eyes of young adults. J Adolesc Health. 2015 Aug;57(2):137-43.

Wong CA, Ford CA, French B, Rubin DM. Changes in young adult primary care under the Affordable Care Act. Am J Public Health. 2015 Nov;105 Suppl 5:S680-5.

Wong C, Nirenburg G, Polsky D, Town R, Baker T. Insurance plan presentation and decision support on HealthCare.gov and state-based web sites created for the Affordable Care Act. Ann Intern Med. 2015 Aug 18;163(4):327-8.

Wood SM, Dowshen N, Lowenthal E. Time to improve the global human immunodeficiency virus/AIDS care continuum for adolescents: A generation at stake. JAMA Pediatrics. 2015 Jul;169(7):619-20.