Hospital-to-Home Transitional Care Interventions (H2H-TCI) Children/Youth With Special Health Car… (NCT06428175) | Clinical Trial Compass
RecruitingNot Applicable
Hospital-to-Home Transitional Care Interventions (H2H-TCI) Children/Youth With Special Health Care Needs (CYSHCN)
United States480 participantsStarted 2025-08-28
Plain-language summary
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.
Who can participate
Age range18 Years
SexALL
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Inclusion criteria
✓. Child is a CYSHCN, defined as having seen two or more distinct specialty areas for outpatient visits during the 12 months prior to index hospitalization admission date
✓. Age of hospitalized child is under 18 years old
✓. Child hospitalized on a general pediatrics inpatient service line at participating site
✓. Adult parent/caregiver for the child is 18 years or older
Exclusion criteria
✕. Child will be discharged to any location besides home (e.g., long-term care or residential facility, skilled nursing facility, inpatient acute rehabilitation, psychiatric facility)
✕. Child is a ward of the state or has an ongoing social services investigation
✕. Child is already receiving transitional care, intensive longitudinal care coordination (e.g., organ/disease-specific clinical program, clinical division within the same institution as the hospital \[e.g., Children's Complex Care Program at UNC; Complex Care Service at Duke\]), and/or longitudinal population health care coordination as part of a bundled alternative payment care model.