Pediatric hospitalist in the Division of General Pediatrics at Nemours/Alfred I. duPont Hospital for Children, Assistant Professor of Pediatrics at Sidney Kimmel Medical College at Thomas Jefferson University, and Nemours Site Lead for the DE-CTR ACCEL Community Engagement and Outreach Core, Program Director of the Pediatric Hospital Medicine Fellowship at Nemours
Dr. Nerlinger is a pediatrician and researcher at Nemours/Alfred I. duPont Hospital for Children. Her research focuses on the evaluation of health system-community partnerships, specifically medical-legal partnerships (MLPs). Medical-legal partnerships are partnerships between healthcare providers and civil legal aid attorneys to recognize and address legal needs such as housing and food insecurity that can affect health outcomes.
- What is the importance of this research?
With increasing recognition of the role social determinants of health play in contributing to health disparities, health systems and communities are in need of evidence-based interventions such as medical-legal partnership to help address social determinants. My goal is to help increase the evidence base of this promising intervention by examining associations between legal services and health outcomes, social determinants of health, healthcare utilization, and healthcare costs.
2. Why did you want to conduct this research?
I have a background and additional training in pediatric advocacy and health policy. I am not only interested in how medical-legal partnership addresses social determinants of health, but also how MLP allows for recognition of patterns of patient needs. Partnering with civil legal aid attorneys in this manner helps inform the need for systemic policy change.
3. How does this research relate to your other work?
As a pediatric hospitalist, I treat acute medical conditions, but oftentimes social determinants of health are affecting a child’s risk of readmission and adverse health outcomes. Referral to medical-legal partnership offers a tangible solution for families screening positive for social determinants of health. Strengthening the evidence for MLP will help identify more sustainable funding sources through healthcare dollars, as currently many MLPs are grant funded.
4. What aspect of the DE-CTR was most helpful to you for this research?
Having dedicated time and mentorship to conduct this research through the Mentored Research Development Award was key to its success. With these resources I was able to finish data analysis of my work with the largest pediatric medical-legal partnership in the country based in Washington, DC. I then used these studies to inform the creation and evaluation of a pediatric medical-legal partnership in Delaware. This will be rolling out over the next year through a collaboration among the Stubbs Early Education Center, Nemours Jessup Street Clinic, and Delaware Community Legal Aid Society, Inc. with funding from Delaware First Lady Tracey Quillen Carney’s First Chance Delaware Initiative. Resources through the DE-CTR ACCEL Community Engagement and Outreach Core also will be key to ensure the community voice is represented before, during, and after implementation.
5. What advice would you give to a junior researcher?
Don’t be afraid to think outside of the box when it comes to interdisciplinary research. Research surrounding partnerships between health systems and community-based organizations has its challenges, including those of data collection and data sharing. However, it also offers great potential for creative solutions to some of the community’s most pressing concerns.
If you would like to participate in an upcoming edition of ASK THE RESEARCHER, please email Amanda Scott.