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Department of Population, Family and Reproductive Health

Research and Practice

The work of faculty in the child health area of interest extends to education and training, research, practice and policy. The areas of interest may be grouped into the following areas:

  • Early Childhood Systems
  • Children and Youth with Special Health Care Needs (CYSHCN)
  • Child Health Measurement
  • Policies to Promote Child Health
  • Child Development
  • Early Life Origins of Disease
  • Women's, Infants and Children (WIC) Program

Early Childhood Systems

Promoting the Cycle of Engagement Between the Family and the Provider

Christina Bethell, Narangerel Gombojav
The Cycle of Engagement (COE) is a model of parent-centered care for well-child visits in pediatrics to improve quality and outcomes of all aspects in well-child care. COE tools are web-based, parent-centered, and consist of the Well-Visit Planner (WVP) for pre-visit planning and the Online Promoting Healthy Development Survey (Online PHDS) for post-visit assessment of quality of care given.
Learn more at the Cycle of Engagement.

Early Childhood Home Visiting Applied Research Collaborative

Anne Duggan, Kay O’Neill, Cynthia Minkovitz, and Allison West
The Home Visiting Applied Research Collaborative (HARC) is a research and development platform that aims to intensify the use of breakthrough impact research methods to address national home visiting priorities around home visiting precision and impact among at-risk families and communities and to accelerate translation of research results into practice.
Learn more at Home Visiting Research Network.

Evaluation of New Jersey’s Project LAUNCH

Cynthia Minkovitz, Anne Duggan
Project Launch promotes a comprehensive, coordinated health system to address the physical, emotional, social, behavioral, and cognitive aspects of child wellness from pregnancy to age eight using evidence based practices. (Completed)

Evidence-Based Early Home Visiting for Parents with Intellectual Disabilities

Allison West
Evidence-based maternal and early childhood home visiting is a promising strategy to improve outcomes for children of parents with intellectual disabilities and other learning difficulties. The aims of this national study are to 1) evaluate current practices for addressing the needs of parents with learning diffciulties, and 2) assess multi-level factors associated with variability in practices.

Examining Early Childhood Teachers’ and Children’s Executive Functioning

Sara Johnson, Lieny Jeon
This study investigates the role of early childhood education teachers’ cognitive self-regulation skills in shaping these skills in their students, including opportunities to scaffold teacher skills to improve child functioning and achievement. Spencer Foundation.

Mother and Infant Home Visiting Program Evaluation

Anne Duggan, Cynthia Minkovitz, Kay O'Neill
National multi-site randomized trial and implementation study of evidence-based home visiting through DHHS's Maternal, Infant and Early Childhood Home Visiting Program. The study assesses impacts on intended outcomes, multi-level factors for service delivery, and program features that moderate impacts.


Identification of Exosomal MicroRNA Markers of Maternal Distress and Offspring Metabolic Health using the PREDICT cohort

Sara Johnson, Kellie Tamashiro, Neil Goldenberg
This pilot grant seeks to understand whether exposure to maternal distress during pregnancy is reflected in changes in the circulating exosome miRNA profile and predicts risk for negative metabolic health conditions, such as diabetes and obesity, in offspring.

Social Adversity, Epigenetics and the Obesity Epidemic

Sara Johnson
This project leverages the Johns Hopkins All Children’s Hospital PREDICT study to evaluate epigenetic mediators of the relationship between maternal lifetime and pregnancy- specific adversity and the early development of obesity in her offspring.

The Oral Microbiome in Early Life and Autism-Related Phenotypes

Sara Johnson, Heather Volk, Robert Yoken
This pilot grant is designed to evaluate the relationship of both the maternal prenatal oral microbiome and the child oral microbiome and autism-related phenotypes in the PREDICT cohort. Wendy Klag Center for Autism & Developmental Disabilities.

Research to Strengthen Home Visiting Impact on Parental Engagement in Children's Education

Anne Duggan, Allison West, Kay O’Neill
This project’s main objective is to adapt and test a set of observational research measures of home visitor – family communication. We have used these observational measures to code over 200 videos of actual home visits and have developed a toolkit to help home visitors and supervisors use them in their daily practice.

Statewide Evaluations of Early Childhood Home Visiting Programs in Maryland and New Jersey

Maryland: Allison West and Anne Duggan | New Jersey: Anne Duggan and Cynthia Minkovitz, Anne Lilly
Utilization-focused evaluative research to increase the accessibility, effectiveness, efficiency, coordination, quality and impact of home visiting in improving outcomes and reducing health and developmental disparities of at-risk expectant families and families with young children.

Using Stakeholder-driven Research to Strengthen Coordination of Health and Human Services to Advance Early Childhood Care for Vulnerable Families

Cynthia Minkovitz, Anne Duggan, Allison West
Research to advance the building of early childhood systems of care for vulnerable families by strengthening the role of home visiting in coordinating health and human services. This project develops a framework for coordination, creates a set of indicators to measure its achievement, and assesses the extent of coordination at the state and local levels.

Children and Youth With Special Health Care Needs (CYSHCN)

CARE_PATH for Kids Model and Tools

Christina Bethell, Salvia Zeeshan, Mary Wahl
The CARE_PATH for Kids (CPK) is a 3-step whole child approach for families of children and youth with special health care needs to engage, plan, and imrove care planning and outcomes in partnership with their child’s care team(s).
Learn more at CARE_PATH.

Evaluation of Improving Services for Children and Youth with ASD/DD

Cynthia Minkovitz, Kristin Mmari (evaluators for Parents Place)
The goal of this project is to improve services for children and youth with autism spectrum disorder (ASD) and other developmental disabilities (DD) in the state of Maryland. (Completed)

Child Health Measurement

Maternal Child Health Measurement Research Network

Christina Bethell
(2016-2020) Supported by HRSA’s Maternal and Child Health Bureau, the Measurement Research Network (MRN) is a multidisciplinary, collaborative network of experts who represent the MCH lifespan and who are active in the measurement of health and well-being of MCH populations. Its purpose is to provide a sustainable platform to inspire, support, coordinate, and advance efforts related to MCH measurement, measurement innovation, and shared accountability to improve outcomes and systems performance on behalf of the nation’s children, youth, and families. The MRN has designed a measurement framework and agenda dedicated to supporting, coordinating, and advancing efforts related to MCH measurement, measurement innovation, and shared accountability. One of the most notable features of the MRN is the “MRN Measurement Compendium,” which provides over 1000 MCH measures from 11 different measure sets; its purpose is to allow users to quickly browse all by measure set, data source category, and/or 3 levels of topical categories.

Learn more at the MCH Measurement Research Network.

The National Data Resource Center for Child and Adolescent Health (DRC)

Christina Bethell, Narangerel Gombojav
(2018-2023) Supported by HRSA’s Maternal and Child Health Bureau, the purpose of the National Maternal and Child Health Data Resource Initiative (DRI) is to make available National Survey of Children’s Health (NSCH) findings at the national, regional, and state level through our online, user-friendly Interactive Data Query, downloadable data set features, and other website resources. Additionally, the DRI supports Title V Maternal and Child Health Service Block Grant programs and partners in accessing and effectively utilizing data from each level.
Learn more at the National Data Resource Center.

Policies to Promote Child Health

Building on the Momentum for Trauma-Responsive Policies and Approaches to Promote Thriving and Healing among vulnerable and diverse Californians

Christina Bethell
With support from The California Endowment, Dr. Bethell is working to promote trauma and ACEs screening in California. In 2019, California Governor Gavin Newsom set aside Marijuana Expenditures from Proposition 64 in order to fund this effort within the state. Dr. Bethell has explored and researched ways to best apply these expenditures to properly distribute them among those who need it most.

Learn more at California Prop 64 Expenditures.

Cookshop Longitudinal Evaluation

Kristin Mmari, Beth Marshall, Susan Gross, MaryCatherine Augustyn, David Paige
To examine the impact of a nutrition education program, Cookshop, on the knowledge, attitudes, and behaviors in regards to healthy eating among low-income elementary school students and their parents in New York City. (Completed)

District Splitting in Uganda

David Bishai
This study looks at the impact on health system performance from Uganda’s policy of decentralizing control and splitting districts. (Completed)

Feeding Baltimore’s Children: The Impact of Community Eligibility

Susan Gross, Anne Palmer, Marycatherine Augustyn
The project collected and analyzed data from the Maryland State Department of Education to determine if implementation of the Community Eligibility Provision (CEP) in City Schools has a quantifiable impact on the rate of: school meal participation; meals served; absenteeism; tardiness; academic achievement; and school advancement and graduation. In addition, through surveys, the project worked to determine if implementation of CEP had an impact on food insecurity rates among families with children attending Baltimore City Public Schools. Principal responsibilities included project management, data analysis, and report and manuscript preparation. (Completed)

The Impact of Waivers on Summer Meal Participation in Maryland

Susan M. Gross, Marycatherine Augustyn
The aim of this study is to assess the impact of the change in USDA Summer Food Service Program waiver regulations on summer meal participation rates and provider participation in selected school districts in Maryland. Principal Responsibilities as the principal investigator include supervision of data management and analysis, project monitoring and manuscript writing.

Maryland Prenatal to Age Three Initiative

Cynthia Minkovitz, Allison West
Develop a robust prenatal-to-age-three policy agenda and action plan in Maryland focused on expanding statewide access to high quality programs designed to support children’s healthy development and build a strong foundation.

Payment for Progress: Investing to Catalyze Child and Family Well-Being Using Personalized and Integrated Strategies to Address Social and Emotional Determinants of Health

Christina Bethell
This project is built on prior work led by CAHMI and AcademyHealth to develop a framework, measures, data, knowledge, capacity and consensus in the field to advance a national agenda for promoting child and family well-being by addressing the social and emotional determinants of health (SEDH) and ACEs in children’s health services. Publication.

Step Wedge Trial of Crèches and Play Pens to Prevent Child Drowning in Bangladesh

David Bishai, Natalia Alfonso
This study will compare injury rates and child developmental outcomes among children exposed and unexposed to crèche-type day care and the introduction of play pens in rural Bangladesh. (Completed)

Strengthen the Evidence Base for Maternal and Child Health Programs

Cynthia Minkovitz, Donna Strobino, Holly Grason, Susan Gross
This project provides support and resources to assist State Title V MCH programs in incorporating available scientific evidence in developing State Action Plans and responding to national and state performance measures.
Learn more at, and visit the MCH Digital Library.

Using Census Data on State Public Health Spending to Identify State Policies tied to Lower IMR

David Bishai
This study examines 25 years of data on state spending on health, state spending on hospitals and Medicaid spending to assess the association of spending to infant mortality. (Completed)

Child Development

Evaluation of the Knit to Quit Program in Baltimore City (Sponsor: Lerner Center for Health Promotion)

Allison West
Despite robust evidence linking perinatal tobacco exposure with poor maternal and child outcomes, a majority of pregnant women receiving opioid maintenance medication treatment smoke cigarettes. B’more for Healthy Babies (BHB) and the Baltimore City Health Department (BCHD) designed Knit to Quit, a group intervention to support smoking cessation among clients and staff at local substance use disorder treatment and recovery programs serving women of reproductive age. The model integrates psychoeducation and motivational messaging within a semi-structured group knitting class to improve participants’ knowledge, self-efficacy, and motivation to quit, increase social support for quitting, reduce stress, and, ultimately, reduce tobacco use. The goal of this project is to evaluate implementation and effectiveness of the Knit to Quit intervention.

Fetus to Five

Sara Johnson
Study of social influences on self-regulatory development from the prenatal period to age 5. (Completed)

Leveraging Progress to Advance Knowledge, Data and Resources to Build a Culture of Health for Children Youth and Families

Christina Bethell, Narangerel Gombojav
(2018-2020) One of the core foundations of the CAHMI has been to build resilience and overall support for children who have experienced trauma and adverse childhood experiences (ACEs). With funding from the Robert Wood Johnson Foundation, CAHMI is committed to RWJF’s goal of “Creating a Culture of Health” by focusing on research promoting whole child, person, and population well-being, through policy and practice.

New Jersey Preschool Development Grant Birth through Age Five

Cynthia Minkovitz, Anne Duggan, Anne Lilly
This two-generational approach promotes a comprehensive, coordinated early childhood system of care to address the physical, social-emotional, behavioral cognitive aspects of child wellbeing and school readiness from prenatal through age five.

Understanding and Promoting Language Development in Young Children in Baltimore City

Sara Johnson, Tracy King, Megan Bair-Merritt
Study of the role of maternal psychosocial distress on language development in very low-SES families, and piloting on novel language processing technology (LENA). (Completed)

Early Life Origins of Disease

To learn more, visit the Center on Early Life Origins of Disease.

Early Life Determinants of Autism Spectrum Disorders and other Developmental Disabilities

Xiaobin Wang, Dani Fallin, Li-ching Lee, Anne Riley, Rebecca Landa, Mei-Cheng Wang, Yuelong Ji, Xiumei Hong, Guoying Wang, Nilanjan Chatterjee, Tak Igusa, and faculty at Boston Medical Center
The goal is to investigate preconception, pre- and peri-natal risk factors and diagnostic and service patterns for ASD in a prospective birth cohort.

Early Life Determinants of Obesity in U.S. Urban Low-Income Minority Birth Cohort

Xiaobin Wang, Bruce Lee, Tina Cheng, Sally Radovick, Xiumei Hong, Guoying Wang, Hongkai Ji, and faculty at Boston Medical Center
The major goals of this project are to identify early life risk and protective factors for obesity development; explore the mediating effect of the epigenome; and to develop predictive models.

Inter-generational Link of Cardio-Metabolic Risk: Integrate Multi-OMICs with Birth Cohort

Xiaobin Wang, Tina Cheng, Guoying Wang, Xiumei Hong, and faculty at Harvard
To investigate the inter-generational link of cardio-metabolic outcomes and explore epigenetic underpinnings in the Boston Birth Cohort.

In Utero Exposure to Metals and Vitamins B on Placenta and Child Cardiometabolic Outcomes

Guoying Wang, Xiaobin Wang, Irina Burd, Hongkai Ji
This project investigates the effect of maternal exposure to toxic metals/trace elements and Vitamin B status on placental pathology and child cardio-metabolic outcomes.

Maternal Stress and Preterm Birth: Role of Genome and Epigenome

Xiumei Hong, Xiaobin Wang, Pam Surkan, Winnie Tang, Hongkai Ji, Irina Burd
The major goal of this project is to investigate the interactions of maternal stress and maternal genome on risk of preterm birth (PTB); and the role of the maternal epigenome in mediating gene – stress interaction on PTB risk.

Prenatal Multi-Level Stressors and Alterations in Maternal and Fetal Epigenomes

Xiaobin Wang, Pam Surkan, Winnie Tang, Xiumei Hong, Hongkai Ji, and other faculty at BSPH, SOM and Boston Medical Center
We aim to test the hypothesis that maternal psychosocial stressors can affect maternal and offspring DNA methylation profiles that is detectable at birth in the Boston Birth Cohort.

Preterm Birth, Maternal and Cord Blood Metabolome, and Child Metabolic Risk

Xiaobin Wang, Frank Hu, Xiumei Hong, Guoying Wang, Irina Burd, Sally Radovick, Hongkai Ji, and other faculty at BSPH, SOM, Harvard, MIT and Boston Medical Center
This study aims to investigate whether prematurity and maternal and fetal metabolic characteristics can jointly affect the future development of child adverse metabolic outcomes in the Boston Birth Cohort.

Women's, Infants and Children (WIC) Program

The USDA Johns Hopkins University Women, Infants and Children’s Program (WIC)

​David Paige, Susan Gross, Marycatherine Augustyn
WIC provides nutrition education, healthy supplemental foods and referral services to over 10,000 low income women, infants and children in Maryland. Services are provided at 12 clinic locations and numerous community locations, including shelters for the homeless, victims of domestic abuse and Head Start Centers in Baltimore. The program is by the Maryland Department of Health and Mental Hygiene through the funding of the United States Department of Agriculture. While the WIC Program is at its core a nutrition program focused on improving the nutrition and health of Maryland’s most vulnerable residents, there are numerous associated studies and projects. These include efforts to promote and support breastfeeding, as well as studies that address reducing maternal obesity, providing residents with the tools to make healthy food choices and improving healthy food access in Baltimore City.
Learn more at WIC.

Hopkins Participant Research Innovations Laboratory for Enhancing WIC Services (HPRIL)

David Paige, Laura Caulfield, Susan Gross, Marycatherine Augustyn
The overall study objective is to improve participation and retention of children 1-4 years of age. JHU will select up to five WIC local agencies (LA) as sub-grantees and provide training, technical assistance and evaluation.
Learn more at HPRIL.