What is the NICH program?
When most people hear the word “nich,” they think of “niche” – a specialty. An OHSU Doernbecher Children’s Hospital program called Novel Interventions in Children’s Healthcare (NICH) embodies this definition perfectly: it is a specialty program that fits into the many crevices of families’ lives to help them optimally support their children’s health.
What is the purpose of NICH?
Developed in 2011 by Dr. Michael Harris, NICH specializes in behavioral interventions for children who have complex or chronic health conditions and come from families with limited resources. NICH’s goal with every family is simple – to improve their child’s health. In order to do this, NICH observes barriers to care, problem-solves for the family, empowers families to continue these solutions, and then supports families in doing this independently. The NICH team includes nine interventionists who each serve a caseload of eight patients.
How do NICH interventionists help OHSU Doernbecher patients and their families?
One of the most unique aspects of NICH is that interventionists are available to patients and their families 24/7. This round-the-clock service allows interventionists to form strong bonds with families and to better understand the challenges that are preventing them from adequately following their child’s medical regimen. Interventionists affect change across numerous systems that children are engaged in – this generally includes the child’s home, the child’s school, the child’s medical appointments and sometimes even hobbies that the child is involved in.
Interventionists are able to delve into a family’s situation in a way that most medical professionals can’t due to their limited time. This allows interventionists to see a more complete picture of the situation and why a child may be struggling to follow through on doctor’s orders. For example, a child with Type 1 diabetes may be instructed to refrigerate her insulin and check her blood sugar 4-5 times a day. However, if that child’s family is living out of their car (with no refrigerator), and her parents speak limited English, they may not fully understand the number of times per day that she’s supposed to be checking her blood sugar, and her health will deteriorate as a result.
In order to help this family support their daughter’s health, the NICH interventionist might first search for resources to help the family find affordable housing, and would then help the family attend appointments with an interpreter that speaks the correct dialect of their language. Once the family’s basic needs had been met, the interventionist could then help to support this young girl in optimally managing her diabetes which might include changing her diet, and exercising more. In many cases like this, NICH has helped the family grocery shop to find healthy and culturally relevant foods, enrolled the child in a sport at school for increased activity and provided athletic equipment for the child.
How does NICH help providers and care teams at OHSU Doernbecher?
While these interventions obviously benefit the patients and families enrolled in NICH, providers and care teams benefit as well. When their patients’ social needs are being met, physicians are able to truly focus on medical issues during appointments. Providers and patients also report that having a NICH interventionist on board as a mediator can help to build trusting and respectful relationships among doctors and their patients.