Treatment Adherence

Rachelle Ramsey, PhD, is an assistant professor of pediatrics within the Center for Health Technology Research and Division of Behavioral Medicine & Clinical Psychology at Cincinnati Children’s. She currently serves as the clinical psychologist in the Difficult-to-Treat (DTT) clinic within the Division of Pulmonary Medicine. She specializes in the assessment and treatment of poor adherence and self-management behaviors in adolescents with asthma. Her research background focused on cognitive variables that influence the transactional relationship between parent and child adjustment to chronic conditions. She has served as a clinical interventionist on multiple NIH-funded randomized clinical trials to promote pediatric self-management and medication adherence for a variety of chronic conditions, including epilepsy, inflammatory bowel disease, and asthma. Her long-term goal is to develop a technology-assisted, stepped-care, adherence-promotion intervention for adolescents with asthma.

"The Adherence Center fellowship provided me with the specialized training in adherence assessment and treatment and allowed me to gain strong research skills in the development and execution of randomized controlled clinical trials. Working with multiple faculty members across a broad spectrum of pediatric chronic conditions also provided me with a comprehensive understanding of adherence assessment and treatment that I now bring to my own line of research in pediatric asthma." - Dr. Ramsey

After completing fellowship, I accepted a clinical faculty position in the Division of Behavioral Medicine and Clinical Psychology at Cincinnati Children's. While my day-to-day activities primarily involve provision of direct clinical care to patients and families, I also collaborate with psychology and medical colleagues on clinical research projects, coordinate program development opportunities, and provide clinical supervision for psychology trainees. I attribute much of my success with obtaining this position to opportunities from completing the T32 fellowship in the Adherence Center. One of the best features of this fellowship was the ability to customize my training program with the support of the faculty. This allowed me to participate in the right balance of research, clinical work, and other activities to help me be an attractive candidate for the jobs I wished to pursue. Faculty members actively sought out opportunities that fit my interests, even if it was not directly within their current scope of research. I also valued the support of my Scholarly Oversight Committee (SOC), which was a multidisciplinary group to help me shape my professional “story” and guide me through the process of applying for a faculty position. Additionally, it was inspiring to be amongst a group of faculty members, fellows, research coordinators, and other team members that are conducing cutting-edge research in the field of adherence, using technological innovations, and successfully navigating the NIH grant process. Despite their own busy (and productive!) schedules, the Adherence Center faculty assured that my training was a priority…it made all the difference!

Years in the program: 2014-2016

Current position: Assistant Professor of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center

I am currently an assistant professor within the Divisions of Developmental and Behavioral Sciences and Gastroenterology at Children’s Mercy Hospital. My work is primarily focused on the assessment and management of barriers to adherence and the allocation of treatment responsibility in patients with liver disease or transplantation. I also serve as the clinical psychologist on the multi-disciplinary liver transplant team, helping to establish standards for psychosocial care and providing clinic-based adherence promotion services and consultation to patients and their families.

The unique training opportunities afforded by this fellowship were critical in preparing me for my current position. My diverse experiences in research and clinical activities during fellowship have allowed me to apply my skills in adherence assessment and intervention to a new pediatric population, and have helped guide my efforts in integrating psychosocial services into routine liver care. I will always be grateful to the faculty for their support and mentorship, and for giving me the skills and confidence necessary to navigate this next step in my professional development.

Years in program: 2013-2015

Current position: Assistant Professor, Divisions of Developmental and Behavioral Sciences and Gastroenterology, Children’s Mercy Hospital, Kansas City, MO

Lauren Szulczewski, PhD, is an Assistant Professor of Pediatrics at Cincinnati Children’s within the Division of Behavioral Medicine & Clinical Psychology. Her current role is a clinical psychologist within the Cancer and Blood Diseases Institute (CBDI), working with children and their families to address adjustment and assist in promoting optimal management of chronic and acute illnesses. Within this position, she serves families both in the inpatient and outpatient settings and is also involved in program development and research. During her fellowship she coordinated and conducted intervention sessions for a randomized-control study that was aimed to improve adherence outcomes for adolescents and young adults who had undergone kidney transplantation. Additionally, Lauren worked on several program development projects throughout CBDI and obtained additional formal training on quality improvement methodology. She continues to collaborate with her primary mentor on other research studies and is now able to implement further program development as a member of the CBDI interdisciplinary team. Lauren’s fellowship prepared her for her position in an academic medical center by providing her with strong skills in the treatment of children with chronic conditions and their families, as well as built her understanding and utilization of research methodology and implementation. Finally, the emphasis on identifying personal career goals and professional development during fellowship helped her to better understand her own values as a psychologist, as well as promote relationships with mentors and other trainees that have already and will continue to support Lauren’s goals throughout her career.

Years in program: 2013-2015

Current position: Assistant Professor of Pediatrics, Division of Behavioral Medicine and Clinical Psychology

I am currently a tenure-track assistant professor in the department of psychology at Auburn University. My work is primarily focused on health management during the transition from adolescence to young adulthood and I continue to actively collaborate with the faculty at Cincinnati Children’s. The training I received at the Center for Adherence Promotion and Self-Management has played an invaluable role in my career development. While a fellow, I had the opportunity to work with a number of the Adherence Center faculty, all of whom are leaders in their field. Working in the Adherence Center expanded my research and clinical skills repertoire and provided me with a new level of flexibility I could take with me on the job market. Rather than being someone who was only trained to work with one population, I had expertise that I could mold to the opportunities available at various academic institutions. In addition, during my fellowship years I was able to gain teaching experience and advanced training and mentorship on being a university professor while enrolled at the Preparing Future Faculty program at the nearby University of Cincinnati. This wouldn’t have been possible without the support of my mentors at Cincinnati Children's. They listened to what I wanted for my career and provided me with the resources to achieve my goals. Finally, thanks to the excellent mentorship and training I received from Dr. Kevin Hommel, I was able to develop and submit a successful Career Development Award proposal to the Crohn’s and Colitis Foundation of America in my final year of fellowship. Coming into my new academic position with a grant in hand has been a great advantage that I otherwise would not have had had it not been for my training at the Adherence Center. I am grateful for the investment the Adherence Center faculty made in me as well as the support they provided as I explored various career paths and opportunities.

Years in program: 2011 to 2013

I currently serve as a clinical psychologist within the Cancer and Blood Diseases Institute (CBDI), working with patients to improve coping with the demands of having a chronic illness, improve their adherence to treatment, educate parents, and teach non-pharmacological strategies to assist with pain management.  Through this role, I provide clinic-based, outpatient, and inpatient services and am also involved with both research and CBDI program development. During my fellowship within the Adherence Center, I contributed to a study working to improve the transition from pediatric to adult care among young adults with sickle cell disease with the goal of improving patient adherence/self-management and disease outcomes. I continue to collaborate in this area with Dr. Lori Crosby and look forward to developing quality improvement projects within the CBDI to improve psychological care for patients with hematologic and immunologic disorders. My fellowship within the Adherence Center provided me with specialized treatment in adherence assessment and treatment and helped her to further develop strong research skills. This fellowship had many benefits including dedicated mentors across domains, excellent didactics addressing issues of professional development, manuscript/grant development, adherence research methodology, intervention, measurement, and clinical service development. I found following fellowship that I was well-prepared for a position in an academic medical center and will continue to use the skills provided to develop our clinical service using patient-reported outcomes to measure success.

Years in program: 2012-2013

Current position: Assistant Professor of Pediatrics in the Division of Behavioral Medicine and Clinical Psychology and Cancer and Blood Diseases Institute at Cincinnati Children's

My fellowship provided a range of training opportunities to strengthen my clinical and research skills in preparation for my faculty position. Specifically, innovative research studies expanded my knowledge of telehealth interventions, instrument development and validation, and novel clinical assessment methodologies (e.g., tablets and apps). Participation in the Psychology Research Group (PRG) as well as grant and manuscript preparation activities enhanced my scientific writing and increased my knowledge about the funding process. Weekly Adherence Center didactics provided the opportunity to learn about cutting-edge research and interventions in the field and professional development issues. Department and hospital-wide fellows’ seminars provided additional training in professional development, including how to successfully transition from postdoc to faculty. The cohort-based model of training in Behavioral Medicine and Clinical Psychology was an added strength of the overall postdoctoral program, allowing me to cultivate strong and supportive peer relationships. Overall, I greatly enjoyed, benefited from, and appreciated the training that I received.

Years in program: 2012-2013

Current position: Assistant Professor of Pediatrics in the Division of Behavioral Medicine and Clinical Psychology Cincinnati Children’s

I am currently an Assistant Professor within the Division of Public Health, Department of Family and Preventive Medicine, and an investigator at the Huntsman Cancer Institute. My fellowship at Cincinnati Children's Center for Adherence and Self-Management was critical in preparing me for my current and future work. The fellowship allowed me to tailor my training to my needs and interests, and thus allowed me to publish and collect data on, and to work with multidisciplinary clinical teams across illness populations. The breadth of these experiences gave me maximal flexibility when applying for jobs. Also, the mentorship I received through the fellowship from faculty in the Adherence Center and throughout Behavioral Medicine and Clinical Psychology was top-notch. The faculty not only provided multiple opportunities to develop my clinical and research skills, but also excellent career development mentorship. The skills I developed in adherence assessment and intervention, collaborations with multidisciplinary teams for clinical care and research, and navigating professional issues, helped me to transition smoothly into my new position and to start a program of research in a new area.

Years in program: 2011-2013

Meghan McGrady completed her PhD at the University of Cincinnati and her residency at Cincinnati Children's.

Years in program: 2012

I am currently in a research-focused junior faculty position at an academic medical center. My fellowship in the Cincinnati Children's Adherence Center prepared me for this role by strengthening my research skills, providing me access to high-quality studies and datasets, supporting me to spend my time conducting analyses and writing, and exposing me to emerging concepts and analytic approaches in adherence research. The targeted adherence training I received within a specific disease group gave me the foundation to establish a programmatic line of research that I am able to independently continue to build as I move beyond fellowship. In addition, the exposure I received to clinical care and research in other disease groups broadened my understanding of adherence across pediatric chronic conditions, which has allowed me to expand my research to new conditions and populations in my current position. Finally, the supportive and collegial environment gave me not only the confidence but also the network of mentors and collaborators that I needed to move from trainee to my next step as an early career professional.

Years in program: 2010-2012

Current position: Assistant Professor in the Department of Pediatrics at Baylor College of Medicine, Huston Tx.

Shanna M. Guilfoyle, PhD, specializes in the assessment and treatment of psychological comorbidities associated with pediatric epilepsy. Broadly, she has studied child, caregiver, and family functioning and their impact on pediatric chronic disease management and adherence across a variety of pediatric chronic conditions (i.e., obesity, transplant, cancer, inflammatory bowel disease, type 1 diabetes). She has served as a clinical interventionist on multiple NIH-funded randomized clinical trials to promote pediatric self-management and medication adherence.

"This fellowship provided me with the specialized training in adherence assessment and treatment, along with developing strong research skills in the development and execution of randomized controlled clinical trials. The ability to work with multiple faculty members across a broad spectrum of pediatric chronic conditions allowed me to have a more enhanced understanding of adherence measurement and barriers that impede adherence intervention that are unique to specific populations." - Dr. Guilfoyle

Years in program: 2009-2011

Current position: Associate Professor of Pediatrics, Director of O’Grady Residency Program, in the Division of Behavioral Medicine and Clinical Psychology Cincinnati Children’s Hospital Medical Center, Cincinnati, OH

Christopher Siracusa obtained a Bachelor of Arts in psychology at Ohio University, received his MD at The American University of the Caribbean School of Medicine, and completed his residency training in general pediatrics at Akron Children’s Hospital.

Current position: Assistant Professor of Pediatrics at Cincinnati Children's

I am currently assistant professor with joint appointments in Developmental and Behavioral Sciences, and Gastroenterology. I work primarily with the Inflammatory Bowel Disease (IBD) team, with my time spent evenly between clinical work, research, and program development. I provide clinic-based and outpatient psychological services to youth with Crohn’s disease and ulcerative colitis, and conduct clinical research that focuses primarily on adherence to medical regimens, disease/treatment knowledge, and transition to adult care. I am also involved in program development, with focus on the development of a multidisciplinary IBD clinic and the development of a standard care transition program that assists youth with IBD in transitioning from pediatric to adult health systems. My fellowship at Cincinnati Children’s offered me specialized training in models of translational research, adherence intervention, measurement, and methodology, and clinical program development; skills which make me uniquely poised to make novel contributions to the field of pediatric adherence research and clinical practice.

Years in program: 2008-2010

Current position: Clinical Psychologist, Division of Developmental and Behavioral Sciences and Gastroenterology, Children’s Hospital Mercy and Clinics, Kansas City, MO.

Lisa Ingerski is currently an Assistant Member in the Department of Psychology at St. Jude Children’s Research Hospital in Memphis, TN. Her current faculty position is distributed across both research and clinical (30 percent) activities. The two-year fellowship in the Adherence Center provided the opportunity to collaborate with other early career psychologists and to function, in large part, as a junior faculty member. Participation in rich and varied research and clinical activities as a postdoctoral fellow provided a solid foundation from which to begin an academic career with a focus on adherence in oncology, sickle cell disease, and HIV/AIDS pediatric populations.

Years in program: 2008-2010

Current position: Assistant Professor, St Jude Children’s Hospital Department of Psychology, Memphis, TN.