Actively Recruiting

Phase Not Applicable
Age: 0 - 18Years
All Genders
NCT06428175

Hospital-to-Home Transitional Care Interventions (H2H-TCI) Children/Youth With Special Health Care Needs (CYSHCN)

Led by Duke University · Updated on 2025-09-11

480

Participants Needed

2

Research Sites

179 weeks

Total Duration

On this page

Sponsors

D

Duke University

Lead Sponsor

P

Patient-Centered Outcomes Research Institute

Collaborating Sponsor

AI-Summary

What this Trial Is About

Aim 1: Compare the effectiveness of focused dose vs extended dose hospital-to-home Transitional Care Interventions (H2H-TCI) on health service use and parent-reported confidence for hospitalized CYSHCN. Aim 2: Compare the effectiveness of focused and extended dose H2H-TCI among vulnerable CYSHCN subgroups. Hypothesis: Both H2H-TCI arms will improve primary outcomes more for CYSHCN with higher versus lower clinical complexity; while extended H2H-TCI will better mitigate racial/ethnic outcome disparities than focused H2H-TCI. Aim 3: Evaluate implementation context, processes, and mechanisms via a multi-phase mixed methods study design.

CONDITIONS

Official Title

Hospital-to-Home Transitional Care Interventions (H2H-TCI) Children/Youth With Special Health Care Needs (CYSHCN)

Who Can Participate

Age: 0 - 18Years
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Child is a child or youth with special health care needs who has seen two or more distinct specialty areas for outpatient visits in the past 12 months
  • Child is under 18 years old
  • Child is hospitalized on a general pediatrics inpatient service at a participating site
  • Adult parent or caregiver of the child is 18 years or older
Not Eligible

You will not qualify if you...

  • Child will be discharged to a location other than home (e.g., long-term care, residential facility, skilled nursing, rehabilitation, psychiatric facility)
  • Child is a ward of the state or has an ongoing social services investigation
  • Child is already receiving transitional care or intensive longitudinal care coordination programs as part of bundled alternative payment care models
  • Parent or caregiver is under 18 years old
  • Parent or caregiver has diminished capacity to provide consent or participate
  • Parent or caregiver's primary language is not English or Spanish

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Trial Site Locations

Total: 2 locations

1

UNC Hospitals

Chapel Hill, North Carolina, United States, 27514

Actively Recruiting

2

DUHS

Durham, North Carolina, United States, 27701

Actively Recruiting

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Research Team

J

Jennifer Thomas, MPH

CONTACT

How is the study designed?

Study Type

INTERVENTIONAL

Masking

DOUBLE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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