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Active Research Projects

The Weitzman Lab is advancing knowledge about disease and treatment experiences, quality of life, risk behaviors, and health outcomes of youth with a chronic illness, including in investigations that “add the voice of the patient” into disease registries and cohort studies. The Weitzman Lab is currently recruiting for several studies and periodically has openings for post-doctoral fellows or collaborative opportunities. If you are interested in learning more, please feel free to contact Melissa Brogna at Melissa.Brogna@childrens.harvard.edu for more information.

Substance Use Among Youth

Adolescent outcomes of Post-operative opioid Exposure (APEX)

The aim of this observational study is to develop and validate screening algorithms designed to detect “early warning signs” of opioid use disorder risk factors and to develop and validate a time-series prediction model designed to preduct a clinical trajectory and the likelihood of development of risks of opioid use disorder in adolescents undergoing painful orthopedic surgeries. The study will recruit 10,000 adolescents receiving opioids for orthopedic surgeries and their parents across multiple sites in the US.

Project Lead Investigators: Dr. Sharon Levy, MD, MPH and Dr. Joe Cravero, MD

Project Investigators: Dr. Vidya Chidambaran, MD, MS, MM; Dr. Gabriel Brat, MD; Dr. Elissa Weitzman, ScD, MSc; Griffin Weber, MD, PhD; Denis Agniel, PhD, MS

Funder: NIH/NIDA-CTN

Status: Study start-up

Modeling Adjuvant Responses in Human Blood In Vitro to Inform Opioid Vaccine Development

The primary goal of this project is to develop an optimally adjuvanted fentanyl (FEN) vaccine by modelling immune responses of youth with a history of opioid use to candidate adjuvants in vitro. Opioid vaccines show great treatment promise as they can induce drug-specific antibodies (Abs) to form an Ab-drug complex in the blood too large to cross the blood-brain barrier, thus protecting from opioid binding to brainstem receptors that mediate respiratory suppression and overdose.

We will also investigate perspectives relevant to safety, efficacy, and perceived likely benefits of an opioid vaccine with exploration of how these factors vary among youth in contrast to parents, concerns for reduced efficacy of therapeutic use of fentanyl, and in relation to personal and family history of substance use disorder and treatment.

Project PI: Dr. Ofer Levy, MD, PhD

Investigator: Dr. Elissa Weitzman, ScD, MSc

Funder: NIH/NIAD

Status: Actively recruiting

Publication: Weitzman ER, Kossowsky J, Blakemore LM, et al. Acceptability of a Fentanyl Vaccine to Prevent Opioid Overdose and Need for Personalized Decision-Making [published online ahead of print, 2022 May 17]. Clin Infect Dis. 2022;ciac344. doi:10.1093/cid/ciac344

Presentation

Understanding stakeholder perspectives about a fentanyl vaccine and the need for precision vaccine promotion

Integrating SBIRT into Pediatric Primary Care

The goal of this project is to create new access to a full range of high-quality Screening, Brief Intervention, and Referral to Treatment (SBIRT) services, in a statewide network of pediatric primary care practices. The Adolescent Substance Use and Addiction Program (ASAP) and the Pediatric Physicians Organization of Children’s (PPOC), have partnered to re-envision SBIRT in pediatric primary care with a new multidisciplinary model wherein a specially trained, licensed independent clinical social worker (LICSW) is brought on staff in a pediatric primary care office to deliver brief interventions, brief treatment and support referrals and serve as a bridge to the ASAP team of pediatric addiction medicine specialists. Primary care physicians participate in SBIRT through administering screens, providing positive reinforcement and brief medical advice, connecting with the LICSW for warm hand-offs, prescribing medication, monitoring with drug testing, reinforcing the medical importance of substance use treatment, and helping coordinate referrals to outside providers. This project will provide high quality SBIRT services annually to more than 33,000 adolescents and young adults. This project is directed by Dr. Sharon Levy and evaluated by Dr. Elissa Weitzman. As the project evaluator, Dr. Weitzman is leading the team in developing both short and long evaluation measures, including measures that demonstrate the financial sustainability of integrated SBIRT services.

Project Director: Dr. Sharon Levy, MD, MPH

Project Evaluator: Dr. Elissa Weitzman, ScD, MSc

Funder: SAMHSA

Status: Data analysis

Publication: Levy S, Fuller A, Kelly S, Lunstead J, Weitzman ER, Straus JH. A phone consultation call line to support SBIRT in pediatric primary care. Frontiers in Psychiatry, Addictive Disorders. 2022 May 11; 13:882486. PMCID: PMC9130490.

Mentee Project: Preventing Inter-Generational Substance Use: Assessing Caregiver and Provider Goals for Pediatrician Guidance to Prevent Adolescent Substance Use

The pilot study will use qualitative interviews with caregivers to investigate attitudes and beliefs regarding: (a) acceptability of pediatrician screening for caregiver SU, (b) desire for pediatrician guidance about caregiver actions that may prevent/address adolescent SU, and (c) attitudes toward a new model for engaging caregivers via pediatric care settings in preventing adolescent SU and mitigating harms. Qualitative interviews with providers will assess current practices around involving families in SU prevention, desire for education and support around efficacious ways to support parents, and barriers to engaging parents with substance use in primary care to prevent adolescent SU.

Project PI: Dr. Jessica Calihan

Research Mentors: Dr. Sharon Levy & Dr. Elissa Weitzman

Funder: FIRST Research Network

Status: Actively recruiting

Development and Evaluation of a Precision Prevention Intervention for Adolescents with Substance Use Disorder

The goal of this project is to build and evaluate a model for precision prevention of AUD (PPAUD) that can propel health protecting behavior change among adolescents and young adults (AYA), using an approach that joins the goals for personalization with those for broad delivery and scale. In this study, we aim to understand AYA willingness to anticipate in a PPAUD project in relation to genetic risk, substance use behaviors, and to understand acceptability of the model in relation to differently framed potential benefits and motivators.

Project PI: Dr. Elissa Weitzman, ScD, MSc

Status: Data analysis

Publication: Weitzman ER, Blakemore LM, Pierce S, Kossowsky J, Levy S. Returning genetic information about risk for alcohol use disorder to adolescents: Findings of preliminary qualitative study of precision prevention. 2024 February. AJPM Focus, 3(1) https://doi.org/10.1016/j.focus.2023.100153 

Presentation

Acceptability of a brief personalized prevention model for reducing alcohol and other substance use risk among youth: findings from a qualitative study

  • Authors: Elissa Weitzman, ScD, MSc, Laura Blakemore, Joe Kossowsky, PhD, Sydney Pierce, Sharon Levy, MD, MPH
  • Presented at: INEBRIA 2022

Adolescent Screening To Help Eliminate Misuse (ASC-THEM)

The goal of this project is to assess the psychometric properties of three substance use screening tools among children and adolescents in pediatric primary care, when compared to the gold standard diagnostic interview for substance use disorders. The three tools to be tested are the Brief Screener for Tobacco, Alcohol and Drugs (BSTAD); Screening to Brief Intervention (S2BI) screening tool; and the Tobacco, Alcohol, Prescription medications, and other Substance (TAPS) Tool. This project presents an opportunity to improve substance use screening tools for adolescents in three ways: briefer, more efficient screens, individual substance risk level determination, and refined risk levels.

Project PI: Dr. Sharon Levy, MD, MPH 

Project Investigator: Dr. Elissa Weitzman, ScD, MSc

Funder: NIH/NIDA-CTN

Status: Data analysis

Publications: Levy S, Brogna M, Minegishi M, et al. Assessment of Screening Tools for Identifying Substance Use Disorders in Adolescents: Results of the Adolescent Screening To Help Eliminate Misuse Trial. JAMA Netw Open. Published online 2023.

Levy S, Minegishi M, Brogna M, et al. Comparing the Performance of WMH-CIDI-SAM with Adolescents to Diagnoses Made by Pediatric Addiction Medicine Specialists. Journal of Addiction Medicine. Published online 2023 September.

Evaluation of SBIRT in Primary Care for Adolescents and Young Adults

This project aims to collect evidence about the effects of screening, brief intervention, and referral to treatment (SBIRT)- integrated care, by measuring and comparing substance use, mental health and health service use outcomes for adolescents and young adults receiving primary care in practices with and without integrated SBIRT services.

Project Co-PIs: Dr. Elissa Weitzman, ScD, MSc; Dr. Sharon Levy, MD, MPH

Funder: Conrad N. Hilton Foundation

Status: Data analysis 

Digital Health

Leveraging Social Media to Engage Adolescent Participants in Patient-Centered Cohort Research for the Clinical Care of Rheumatic Diseases

Detailed and sensitive investigations with longitudinally engaged cohorts of youth are needed to understand the multifaceted experience of chronic illness and the impact of the disease course and treatment on the developing child. To attain this, we need nimble and scalable approaches for engaging youth in regularly sharing information germane to their health. Social media may address this need: youth participation in social media is ubiquitous and large percentages of youth engage around health and social behaviors. The purpose of our project is to understand the feasibility and value of collecting social media data from a cohort of teens with a chronic rheumatic condition, to augment understanding of psychosocial risks associated with chronic illness and complement structured patient-reported and clinical metrics. Findings will inform the nationally prioritized research goal of enabling cohort engagement and data donation for health research, and development of patient-centered interventions vital to improve outcomes.

Project PI: Dr. Elissa Weitzman, ScD, MSc

Funder: NIH/NIAMS

Status: Data analysis

Publication: Weitzman ER, Minegishi M, Cox R, Wisk LE. Associations among patient-reported outcomes measures of physical and psychological functioning and willingness to share social media data for research among adolescents with a chronic rheumatic disease: a cross-sectional study. JMIR Pediatrics and Parenting. In press.

Mentee Project: Health-Related Social Media Use by Parents of Children with Rheumatic Diseases

Families of children with rheumatic diseases experience high treatment and disease burdens due to a lack of evidence based treatment decisions and a lack of psychosocial support. By engaging support systems via social media, these families may have the resources for future healthcare decision-making. This project surveyed parents of children with rheumatic diseases to understand the attitudes, beliefs and behaviors of their social media use and how it potentially affects decisions made about their child’s healthcare.

Project PI: Dr. Jonathan Hausmann, MD

Primary Mentor: Dr. Elissa Weitzman, ScD, MSc

Funder: Childhood Arthritis and Rheumatology

Status: Data analysis

Publications: Hausmann J, Vizcaino-Riveros J, Marin AC, Minegishi M, Cox R, Chang M, Schanberg LE, Natter M, Weitzman ER. Feasibility and efficacy of online strategies to recruit parents of children with rheumatic diseases for research. ACR Open Rheumatology, 2022 May;4(5):410-416. PMID: 35150085.

Hausmann J, Weitzman, ER. The Promises and Perils of Social Media for Pediatric Rheumatology. Rheum Dis Clin N Am;48(1):233-243.doi:10.1016/j.rdc.2021.09.005

Presentation

Health-related Social Media Use by Parents of Children with Rheumatic Diseases

  • Authors: Jonathan S Hausmann, Vincent Del Gaizo, Kara M. Magane, Alexandra C. marin, Shannon Malloy, Sanjay Mishra, Tory Aquino, Marc D. Natter, Laura E. Schanberg, Elissa R. Weitzman
  • Presented at: ACR Convergence 2020

Mentee Project: Mobile Health Assessment of Interplay Among Sleep, Pain, and Inhibitory Control in Adolescent Marijuana Use

Pediatric chronic pain is a common, complex, and highly debilitating developmental health concern that has been associated with multiple risk factors for heavy and frequent marijuana use. However, the longitudinal interplay among chronic pain and two key risk factors, sleep disturbances and decreased inhibitory control, as it relates to marijuana use in adolescence, remains minimally explored. This study aims to map the unfolding of pathophysiological processes using a combination of mobile health assessment tools, to implement personalized, early intervention in these vulnerable adolescents.

Project PI: Dr. Joe Kossowsky, PhD, MMSc

Primary Mentor: Dr. Elissa Weitzman, ScD, MSc

Funder: NIH

Status: Actively recruiting

Publication: Nestor B, Chimoff J, Koike C, Weitzman ER, Riley B, Uhl K, Kossowsky J. Adolescent and Parent Perspectives on Digital Phenotyping in Youth with Chronic Pain: A Survey Study. Journal of Medical Internet Research. In Press.

Presentation: Wallace, D.A., Johnson, D.A., Redline, S., Sofer T., Kossowsky J. (2023) Rest-activity rhythmicity across the lifespan: findings from the National Health and Nutrition Examination Survey (NHANES). Sleep, Indianapolis, USA

Mentee Project: Harnessing Social Media to Increase Device Uptake and Improve Outcomes in Young People with Type 1 Diabetes

Harnessing social media engagement among adolescents and young adults (AYA) with type 1 diabetes (T1D) can help support their self-care and disease management motivation to improve glycemic control. This career development award proposes to describe self-reported interactions with diabetes-focused social media using mixed qualitative and quantitative methods, focusing on potential impacts on device uptake/use, self-care, and glycemic control in adolescents ages 13-25 years old with T1D. Guidance from an advisory board of AYA will advise on content and delivery of an acceptable intervention; this intervention will be piloted and help inform the design of a future clinical trial.

Project PI: Dr. Tara Kaushal Maxwell, MD

Research Mentor: Dr. Elissa Weitzman, ScD, MSc

Funder: Beatson Foundation

Status: Actively recruiting

Chronic Illness in Youth

Mentee Project: Delivering Contextualizing Population Data to Motivate Health Care Transition Preparation

The goal of this project is to understand how adolescents and young adults (AYA) with Type 1 Diabetes (T1D) navigate the health care system during transition and to develop, implement, and evaluate a novel intervention designed to motivate preparation for transition among AYA with T1D. This research will provide preliminary evidence to inform a multi-site, longitudinal intervention to improve transition preparation, and ultimately positively impact health outcomes for AYA with T1D.

Project PI: Dr. Lauren Wisk, PhD

Primary Mentor: Dr. Elissa Weitzman, ScD, MSc

Funder: NIH/NIDDK

Status: Actively recruiting and data analysis

Patient-Reported Outcomes: Quality of Life for Youth with Chronic Illness

Clinical Validation of PROMIS® Pediatric Measures in Diverse Research Networks

Clinical measures of disease used in research and healthcare delivery settings do not fully capture the impact and burden of chronic diseases and their treatment on the lives of children and adolescents. To more fully capture youth’s experiences and perspectives, the Patient-Reported Outcomes Measurement Information System® (PROMIS®) Pediatric measures were designed but remain underutilized by the research and clinical communities. “Clinical Validation of PROMIS Pediatric Measures in Diverse Research Networks” aims to leverage existing data collection networks to conduct a multi-site longitudinal evaluation of PROMIS measures in children and adolescents with rheumatic disease, cancer, and inflammatory bowel disease.

As PI of Project 1, Dr. Weitzman is leading a national, multi-site study of PROMIS measures in youth with rheumatic disease (juvenile idiopathic arthritis, lupus) and their parent proxies. This research will enhance the clinical validity, meaningfulness, and usefulness of the PROMIS Pediatric measures to help promote the adoption of patient-centered measures in routine clinical care and research to improve the health of children and adolescents with chronic medical conditions.

For more information please visit: https://www.peprconsortium.org/

Project PI: Dr. Elissa Weitzman, ScD, MSc

Funder: NIH/NIAMS

Status: Data analysis

Publications: Weitzman ER, Gaultney A, von Scheven E, et al. Construct validity of Patient-Reported Outcomes Measurement Information System Paediatric measures in juvenile idiopathic arthritis and systemic lupus erythematosus: cross-sectional evaluation. BMJ Open. 2023;13(1):e063675. Published 2023 Jan 27. doi:10.1136/bmjopen-2022-063675

Forrest CB, Schuchard J, Bruno C, Amaral S, Cox ED, Flynn KE, Hinds PS, Huang I, Kappelam MD, Krishnan JA, Kumar R, Lai J, Paller AS, Phipatanakul W, Schanberg LE, Sumino K, Weitzman ER, Reeve BB. Self-Reported Health Outcomes of Children and Youth with 10 Chronic Diseases. Journal of Pediatrics. 2022 Jul: 246:207-212.e1. doi: 10.1016/j.jpeds.2022.02.052.  

Weitzman ER, Wisk LE, Salimian PK, et al. Adding patient-reported outcomes to a multisite registry to quantify quality of life and experiences of disease and treatment for youth with juvenile idiopathic arthritis. J Patient Rep Outcomes. 2018;2:1. doi:10.1186/s41687-017-0025-2

Hersh A, Salimian PK, Weitzman ER. Using Patient Reported Outcome Measures to Capture the Patient’s Voice in Research and Care of Juvenile Idiopathic Arthritis HHS Public Access. Rheum Dis Clin North Am. 2016;42(2):333-346. doi:10.1016/j.rdc.2016.01.004

Presentations

Responsiveness of PROMIS Pediatric measures to changes in health-related quality of life among children and adolescents undergoing treatment for cancer

  • Authors: Courtney Mann, Justin Baker, Antonia Bennett, David Freyer, Pamela Hinds, Nicole Lucas, Jennifer Mack, Laura Schanberg, Lillian Sung, Elissa Weitzman, Janice Withycombe, B.B Reeve
  • Presented at: ISOQOL 2019

Associations among patient-reported outcomes measures of physical and psychological functioning and willingness to share social media data for research among adolescents with a chronic rheumatic disease

  • Author: Elissa R. Weitzman, ScD, MSc
  • Presented at: ISOQOL 2020