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Social determinants of health and critically ill children

Abela studies recovery outcomes for kids and families

Karla Abela

Karla Abela, PhD, RN, CCRN-K, CPN, wants to know how social determinants of health (SDoH) such as food insecurity, housing instability, or lack of educational support affect children recovering from life-threatening illness and their families.

Her research project, “Examining the Influence of Social Determinants of Health on Health Outcomes of Critically Ill Children and Their Families: A Pilot Study,” was selected for a $10,000 Dean’s Research Award. Abela, an assistant professor at Cizik School of Nursing at UTHealth Houston, will study the long-term recovery of children and their families who have spent time in pediatric intensive care units (PICUs). 

“Pediatric critical care has traditionally focused on the immediate health crisis,” she said. “Once children leave the hospital, their recovery and their families’ are shaped by factors beyond the ICU. This study focuses on understanding how these external elements impact a family’s well-being in the following months.”

Abela and her team seek to bridge a significant gap in the field. Small sample sizes and inconsistent methods have often hampered understanding of how SDoH shape outcomes for critically ill children and their families. By examining the relationships between these social factors, demographic characteristics, and health outcomes, the research could not only pave the way for more holistic pediatric care but also significantly improve the quality of care for families experiencing critical illness.

The study, which will run for one year, will look at how hospitalization characteristics such as length of a PICU stay, risk of death, and use of invasive ventilation affect the mental health and quality of life of critically ill children and their parents. Acorda will study data collected at admission and six months later to assess the cumulative impact of various SDoH on recovery and analyze how these factors influence broader health outcomes over time.

“We are eager to learn more about the long-term challenges families face so we can work toward improving critical care practices for children. Our long-term goal is to develop a reasonable process for screening for SDoH in the PICU,” said Abela. 

Co-investigators on the project Darlene Acorda, PhD, RN, CNE, CPNP-PC, an assistant professor at Cizik School of Nursing; Bibek Bista, MBBS, MPH, an assistant professor of pediatric critical care medicine, and Areeba Makhdoom, MD, a pediatric critical care fellow, at McGovern Medical School at UTHealth Houston; and Wenyaw Chan, a biostatistics professor at the UTHealth School of Public Health.

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