{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T04:11:03Z","timestamp":1788667863751,"version":"build-2803163510"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the impact of implementation of a cleft nurse navigator (CNN) program on failure to thrive (FTT), readmission rates, and disparities among patients with cleft lip and\/or palate (CL\/P).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study comparing outcomes before and after CNN implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>\n                      <jats:bold\/>\n                      Tertiary pediatric craniofacial center with a multidisciplinary cleft care team.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients, Participants<\/jats:title>\n                    <jats:p>Patients with CL\/P undergoing definitive cleft repair at a single institution from January 2010 to June 2024 (n\u2009=\u2009992).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Implementation of a CNN program in 2016 focused on feeding support, care coordination, growth monitoring, and family outreach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>Primary outcomes included rates of FTT, admission for FTT, and readmission for FTT. Secondary analyses evaluated racial and insurance-based disparities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 992 patients, 433 (43.6%) were pre-CNN and 559 (56.4%) post-CNN. FTT rates were similar (18.2% vs 16.8%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.556). Readmission for FTT was lower post-CNN (1.1% vs 4.6%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Pre-CNN, readmission was higher among non-white than white patients (9.1% vs 2.4%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.002), equalizing post-CNN (1.4% vs 1.0%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.621). Insurance-based differences in readmission also decreased post-CNN. On multivariable regression, pre-CNN treatment (OR 5.0, 95% CI 1.9-13.1,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.001), neonatal intensive care unit stay (OR 14.5, 4.2-50.1,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), public insurance (OR 2.7, 1.1-6.6,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.027), and non-white race (OR 2.5, 1.0-5.9,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.044) independently predicted readmission.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CNN implementation was associated with reduced readmissions for FTT and reduced racial and insurance-based disparities in readmission among patients with CL\/P.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656261483542","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T16:17:29Z","timestamp":1788452249000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Failure to Thrive After Implementation of a Cleft Nurse Navigator Program: A Reduction in Readmissions and Disparities"],"prefix":"10.1177","author":[{"given":"Kirin","family":"Naidu","sequence":"first","affiliation":[{"name":"Children's Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel A","family":"Ryan","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia A","family":"Mahmoud","sequence":"additional","affiliation":[{"name":"Children's Hospital of 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