Summaries of Independent Scientist (K) Awards

Forrest, Christopher

Institution: Johns Hopkins University
Grant Title: Child Health Services Outcomes Research
Grant Number:  K02 HS00003
Duration: 4 years (2000-2004)
Total Award: $423,300

Project Description: This project had three main research goals:

1. To improve understanding of the mechanisms by which the financial and organizational features of managed care influence children's access to medical care, specialty care service use, and healthcare expenditures.
2. Assess the effects of alternative models of generalist and specialist involvement in patient care on coordination of care and the effectiveness of the specialty referral process.
3. To develop a new research program focused on examining longitudinal changes in child health.

Career Goals: Dr. Forrest is an Associate Professor of Health Policy and Management at the Johns Hopkins School of Public Health. He wanted to diversify his expertise in child health research and expand his mentoring and capacity building activities in the field.   He sought new skills in the analysis of multilevel and longitudinal study designs, which would be necessary for developing the proposed new program of research.  At the same time, he desired to expand his mentorship activities of doctoral and post-doctoral trainees, and faculty within and outside of his institution. 

Progress to Date: Dr. Forrest successfully completed his K02 grant in August 2004.  The publications listed below highlight his research findings.  Research results provided empirical justification for a national reevaluation of how the gatekeeping role of primary care physicians is implemented.

Highlights and Specific Accomplishments:

• 2004 Recipient of the Nemours Child Health Services Research Award presented at the Academy Health meeting.
• Memberships:
  • Ambulatory Pediatric Association.
  • AcademyHealth.
  • American Public Health Association.
  • International Society for Quality of Life Research.
  • Jointly appointed in the Departments of Health Policy and Management and Pediatrics.

K-Generated Publications (selected):

Forrest CB, Shi L, von Schrader S, Ng J.  Managed care, primary care, and the patient-practitioner relationship. Journal of General Internal Medicine 2002. 17:270-77.

Shi L, Forrest CB, von Schrader S, Ng J.  Vulnerability and the patient-practitioner relationship: The roles of gatekeeping and primary care performance. American Journal of Public Health 2003. 93:138-44.

Forrest CB, Nutting P, Starfield B, von Schrader S.  Family physicians' referral decisions: Results from the ASPN referral study. Journal of Family Practice 2002. 51:215-22.

Forrest CB, Nutting P, Werner JJ, Starfield B, von Schrader S, Rohde C.  Managed health plan effects on the specialty referral process: results from the ASPN referral study.  Medical Care 2003. 41:242-253.

Forrest CB, Majeed A, Weiner JP, Carroll K, Bindman AB. Referral of children to specialists in the United States and United Kingdom. Archives of Pediatric and Adoloscent Medicine 2003. 157:279-85.

Forrest CB.  Primary care gatekeeping and referrals: Effective filter or failed experiment?  British Medical Journal 2003. 326:692-95.

Braun BL, Fowles JB, Forrest CB, et al. Which enrolles bypass their gatekeepers in a point-of-service plan? Medical Care 2003. 41(7):836-41.

Forrest CB, Shipman SA, Doughterty D, Miller MR. Outcomes research in pediatric settings: Recent trends and future directions. Pediatrics 2003. 111:171-78.

Forrest CB.  Outcomes research on children, adolescents, and their families: Directions for future inquiry.  Medical Care 2004. 42(4 Suppl):III19-23.

Forrest CB, Riley AW.  Childhood origins of adult health: A basis for life-course health policy.  Health Affairs 2004 Sep-Oct. 23(5):155-64.

Forrest CB, Weiner JP, Fowles J, et al. Self-referral in point-of-service plans.  JAMA 2001. 285:2223-231.

Forrest CB, Reid RJ.  Prevalence of health problems and primary care physicians' specialty referral decisions.  Journal of Family Practice 2001. 50:427-32.

Forrest CB, Majeed A, Weiner JP, et al. Comparison of specialty referral rates in the United Kingdom versus United States: Retrospective cohort analysis.  British Medical Journal 2002. 325:370-71.

Forrest CB, Simpson L, et al. Child health services research. Challenges and opportunities. Journal of the American Medical Association 1997. 22:1787-93.

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