This proposal aims to present the benefits that Children's National Medical Center will bring to the cooperative agreement method of planning and conducting research. We are committed to addressing the problem of the unacceptably high infant mortality rate in Washington D.C. We believe our participation will be beneficial because: a. There is substantial access to the populations of interest. The hospital's population includes large numbers of infants and sexually active adolescents, and access to women of child bearing age and families through their children. Hospital sponsored community initiatives include a comprehensive family advocacy program with demonstrated success in decreasing infant mortality, a program of services in southeast Washington D.C., and primary care clinics in Shaw and Adams Morgan. Strong community links exist with the Community of Hope, Family Place, Inc., and many other schools and health clinics. b. Our group includes a P.I., Co-investigator, Behavioral Scientist, and Collaborators with extensive research expertise and appropriate scientific knowledge. The investigators are experienced with clinical trials and protocol development. Our researchers have expertise in pediatrics, neonatology, adolescent medicine, health services research, statistics, epidemiology, quality of care assessment, pediatric intensive care, infant development, maternal substance abuse, adolescent behavior, and social psychology. c. A new research structure houses the Center for Health Services Research directed by the proposal's P.I. which enables resource and investigator recruitment and coordination of research efforts. d. Extensive support services are available including health educators, nutritionists, social workers, behavioral scientists, and a home care service with extensive experience in comprehensive (""""""""one-stop shopping"""""""") case management and patient follow-up (including home visits). In addition, all relevant staff resources are available. e. We are committed to the collaborative research process with other awardees and the NIH staff.
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