This research study aims to find out the effect of REPOSE, a screening and patient navigation intervention, on the receipt of equitable care among racially and ethnically diverse children with Sleep Disordered Breathing (SDB).
In this study, parents and their child will participate in the REPOSE Patient Navigation Intervention, where the child will be screened for SDB at their pediatric well-visit. If the child's screening is positive, the parent will be asked if they and the child would like to be a part of the REPOSE Patient Navigation Intervention. The REPOSE patient navigation will utilize a patient navigator that will a) ID and address dynamic individual barriers to care, b) provide education and social support for parents and children who are diagnosed with SDB, and c) coordinate care between medical providers and parent/child to complete evidence-based care (e.g., sleep study, tonsillectomy). The navigator will follow patients to completion of recommended treatment or up to 6 months after enrollment.
Patient Navigation has been proven to benefit adult cancer patients but has not been tested in pediatric patients with sleep-disordered breathing. This study is an effort to demonstrate whether patient navigation is effective in increasing the receipt of equitable care for children with SDB. The REPOSE Intervention is designed to guide parents of children with SDB through and around barriers in the complex healthcare system to achieve timely diagnosis and treatment.
Pain control after tonsillectomy is imperative but often difficult. Current post-operative pain medication regimens include opioid analgesics and are often still inadequate. Though not standard of care, it is our practice to prescribe a single dose of oral steroid medication on the third day after surgery, when pain and swelling are at their peak, in order to assist with pain control and reduce opioid consumption. Though this practice has a rational theoretical basis, there is no prospective data supporting or discounting it. We aim to compare pain control, opioid consumption, and complication rates in children receiving post-operative steroids versus those who do not.