EAST PROVIDENCE — Bradley Hospital recently received a pair of funding sources for studies it is conducting: Pediatric Anxiety Research Center (PARC) and Early Intervention to Promote Cardiovascular Health of Mothers and Children (ENRICH).

PARC) has been awarded $11 million in funding from the Patient-Centered Outcomes Research Institute (PCORI) to undertake a groundbreaking study comparing three different methods of delivering outpatient exposure-based cognitive behavioral therapy (CBT) for youth with anxiety and/or obsessive-compulsive disorder (OCD) seeking treatment at partner community health centers across the state.

Anxiety disorders are among the most prevalent and earliest mental health conditions affecting youth, with significant implications for their social, academic, and family lives. Despite evidence supporting cognitive behavioral therapy (CBT) with exposure as an effective treatment, access to these outpatient services is often limited, especially for youth from historically marginalized backgrounds. Traditional outpatient models can also present challenges such as transportation issues and childcare needs, further exacerbating access barriers.

In light of the COVID-19 pandemic, telehealth has emerged as a promising alternative to conventional in-person care, demonstrating potential in overcoming these barriers. However, there is a critical need for research to identify which delivery methods are most beneficial for youth. This study aims to fill that gap by comparing three approaches to delivering outpatient exposure-based CBT for children and adolescents aged 5-18: In-person (including office and home/community-based sessions), via telehealth, and with a flexible model (a combination of telehealth and in-person sessions).

All three treatment options involve a team-based approach to care that builds on prior PARC research and clinical service innovations. In this approach, patients meet with licensed clinicians on a monthly basis, but work primarily with non-licensed, specially trained providers. The team-based approach allows licensed providers to serve more patients.

The study will involve the recruitment of over 500 patient and family participants and will be conducted over a period of 72 months. By evaluating the effectiveness and accessibility of these different service models, PARC aims to set a new standard for pediatric anxiety treatment and improve outcomes for youth across diverse communities. Results of this study are expected to increase equitable access to care for all youth with anxiety, determine which treatment delivery method works best for whom, and establish a service model that can be used in similar practice settings across the country.

“Over many years and many different studies, it has been our goal to take the work of PARC outside of primary hospital and academic settings,” said Jennifer Freeman, PhD, director of PARC at Bradley Hospital and professor of psychiatry and human behavior at Brown University. “This funding will allow for meaningful partnership with numerous community health settings to expand high quality anxiety treatment for youth who have been historically underrepresented in clinical science and underserved in clinical practice.” The PARC team has worked closely with groups of policy, agency, provider, payer, community, and patient/family partners who will also contribute to the research process throughout the project.

Bradley, along with The Miriam Hospitals, were also awarded $4.2 million from the National Institutes of Health (NIH) to advance Phase II of the groundbreaking Early Intervention to Promote Cardiovascular Health of Mothers and Children (ENRICH) program. This multi-phase study aims to enhance cardiovascular health and address health disparities affecting both mothers and children up to the age of 5.

In partnership with California Polytechnic State University (Cal Poly), Bradley and The Miriam hospitals will focus on reaching mothers and their young children from low socio-economic backgrounds, residing in low-resource rural or urban communities, and living in regions with elevated cardiovascular disease risk factors. This collaborative effort is designed to address and mitigate disparities in cardiovascular health, particularly in underserved populations.

In Rhode Island, the ENRICH program will be implemented statewide. The research team will collaborate with the Rhode Island Department of Health’s existing home visiting program to engage families already receiving care, ensuring that the program is seamlessly integrated into existing services. Home visitors will provide education and support to help clients meet their goals related to several aspects of cardiovascular health including healthy eating, physical activity, and sleep.

The Phase II funding will support the implementation of an enhancement to home visiting designed to promote cardiovascular wellness among mothers and their children, further advancing the mission of the ENRICH program to reduce health inequities and improve long-term health outcomes.

“Maternal morbidity and mortality rates have risen across the United States, and cardiovascular disease is one of the leading causes of death among pregnant and postpartum people,” said Stephanie Parade, PhD, director of early childhood research at Bradley Hospital. “There are deeply concerning racial and ethnic disparities in maternal mortality, cardiovascular disease, and cardiovascular disease risk. Our goal with this initiative is to identify and implement effective interventions to counter these troubling trends.”

For more information about the ENRICH program and its initiatives, please visit www.hvenrich.org.