C. S. Mott Children's Hospital
General Pediatrics: Child Health Evaluation and Research (CHEAR) Unit
Gary L. Freed MD, MPH - Director
In this era of increasingly limited resources for children’s programs in general, and children’s health programs in particular, it is incumbent upon those who care for children to assure that all of those resources are apportioned to effective programs, and those eligible for participation are enrolled. Unfortunately, many government programs related to child health at the community, state or federal level consume large amounts of resources, but have never been evaluated to determine their true effectiveness or the proportion of eligible children they reach.
There is, then, a compelling need in this era of increasingly limited resources for children’s programs to assure that all resources are indeed allocated to effective programs. This imperative is coupled with the increasing realization that although programs must be held accountable for achieving results, few programs have sufficient resources built into their funding to ensure that appropriate and rigorous evaluation takes place.
Commensurate with these challenges are new opportunities. This is a time of dramatic change in health and social welfare policy at the state and national level affecting children. The time is right for the state of Michigan and for the nation to address these issues in a deliberate and rigorous fashion.
In concert with the Deans of the various health science schools at the University of Michigan, the leadership of the Division of General Pediatrics leadership organized the Child Health Evaluation and Research (CHEAR) Unit. The Division of General Pediatrics serves as the administrative and intellectual home of the Unit. The CHEAR Unit is comprised of core faculty (one each) from the Schools of Medicine, Social Work, Dentistry, Pharmacy, and Nursing and one from each of three departments in the School of Public Health (Epidemiology, Health Management and Policy, and Health Behavior/Health Education). Collaboration among disciplines is the hallmark of the CHEAR Unit as multidisciplinary teams work together to address complex issues.
The Child Health Evaluation and Research Unit addresses these problems by providing a mechanism and structure for the timely review and evaluation of community, state and national children’s policies and programs. The CHEAR Unit focus is on the health of children. Nationally, other centers exist to monitor specific aspects of child well being. However, none focuses specifically on the evaluation of child health programs or policies, or the interface of child health programs and issues with other areas of social concern or child welfare policy. It is this interface, often overlooked or unrecognized, that frequently has the greatest impact on the lives of children. Thus, a significant gap exists within the current policy analysis and program evaluation arena for this type of concentrated and focused activity. Within these areas, CHEAR Unit studies are conducted to assess trends and developments, identify key issues, highlight unique opportunities for system/program reform, and convene and link constituents. The Unit’s efforts examine the financial, health and social impact of programs and policies.
The core faculty meet quarterly to discuss child-focused research projects ongoing in each of their home units. In addition, new opportunities for collaboration and needs for expertise on current projects and future applications are discussed. Faculty members are encouraged to bring requests for proposals to the larger group to gauge interest in multidisciplinary efforts; other core faculty suggest potential collaborators within their schools or departments who possess the expertise requested. In this fashion, faculty become aware of the rich scholarly resources that exist across disciplines and schools throughout the University. Such interchange facilitates cooperation and involvement of faculty from different backgrounds and interests.
The focus of the projects conducted by the CHEAR Unit broadly encompass four areas of policy analysis and evaluation:
1) The interface and interaction between health and social welfare programs.
2) Specific governmental programs designed to produce measurable outcomes in improving children’s health and well being.
3) The mechanisms by which federal programs are implemented at the state and community level and the differential impact of state-to-state and community-to-community variation in performance.
4) The structure and function of the health care system for children.
Additional faculty research efforts can also be found within the Division of General Pediatrics.
