Administrative Core

行政核心

基本信息

批准号：
10211062
负责人：
CONSUELO HOPKINS WILKINS
金额：
$ 21.12万
依托单位：
VANDERBILT UNIVERSITY MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-05-19 至 2023-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10211062
关键词：
Accounting Administrative Supplement Adult Affect African American Asthma COVID-19 COVID-19 pandemic Caring Cessation of life Chicago Child Child health care Childhood Cities Clinic Code Data Distant Emergency Situation Ensure Ethnic Origin Family Foundations Future Guidelines Health Healthcare Home environment Hospitalization Human Internet Knowledge Language Length Low income Measures Medicaid Medical Minority Minority Groups Modality Modification New York Participant Patient Care Patients Physicians Policies Population Population Heterogeneity Primary Health Care Privacy Probability Process Provider Race Regulation Sampling Services Societies Surveys Technology Telemedicine Telephone Tennessee Testing Time Traction Trust Underrepresented Minority Underserved Population United States Dept. of Health and Human Services Visit Vulnerable Populations Work demographics design ethnic diversity health care availability health care delivery health care service utilization health disparity interest literacy pandemic disease pediatric patients personalized approach population health precision medicine prospective provider-level barriers racial diversity satisfaction service delivery social social health determinants telehealth uptake

项目摘要

The COVID-19 pandemic is not affecting everyone equally. In Nashville, Tennessee, the number of confirmed COVID-19 cases are higher in ZIP Code regions that are burdened by poorer social determinants of health and higher rates of conditions such as asthma. To allow for safe, effective, and physically distant care, telemedicine has emerged as a modality for preferred health care delivery. However, telemedicine requires access to technology, broadband internet access, technologic literacy, and in many cases, English proficiency. These are often inaccessible to vulnerable populations who, additionally, may have privacy concerns and be less trusting of telemedicine. Now that the Health and Human Services (HHS) guidelines for telemedicine are relaxed, creating greater ease for lower income diverse populations to access this modality from their home, it must be built to ensure access equity that allows for a more precise tailored approach. Despite indications that children are less often infected with COVID-19 than adults, utilization of overall child health care has decreased substantially since the pandemic gained traction with physical distancing requirements, but the use of telemedicine in children has not increased. This is especially true if those children are from underrepresented minority populations. We propose an administrative supplement to understand what makes telemedicine feasible and acceptable in underserved populations. In Aim 1, we will randomly select Vanderbilt Pediatric Primary Care patients who live in ZIP Code regions reflective of racially and ethnic diverse patient families with higher social needs (N=500) and measure retrospective telemedicine utilization during the early period of the COVID-19 pandemic (from March 1- June 30, 2020). We will conduct a 30-60 minute telephonic survey in the participant language of choice (English, Spanish, or Arabic) to assess telemedicine utilization, knowledge, interest, accounting for social determinants of health, COVID-19 impact, technology access, race/ethnicity, and patient trust. We will then use the knowledge gained to prospectively design and test modified telemedicine approaches, assessing the feasibility and acceptability of telemedicine visits provided to 100 low-income pediatric patients (50 English and 50 non-English). Process data collected will include selected telemedicine platform (of the HHS accepted choices), visit length, and patient-family and provider satisfaction. Qualitative data collected will identify both patient-family and provider barriers and facilitators. These data will inform policies and processes to create equitable telehealth approaches for diverse pediatric populations.

COVID-19大流行并没有平等影响每个人。在田纳西州纳什维尔，确认的数量在邮政编码区域中，COVID-19案件较高，这些地区受到较贫穷的卫生决定因素和诸如哮喘等疾病率更高。为了安全，有效和身体遥远的护理，远程医疗已成为首选医疗保健提供的一种方式。但是，远程医疗需要访问技术，宽带互联网访问，技术素养以及在许多情况下，英语水平。这些易受伤害的人群通常是无法访问的，此外，他们可能会有隐私问题并成为对远程医疗的信任较少。现在，远程医疗的健康与公共服务（HHS）指南是放松，使低收入种群从家中获得这种方式，使其更加轻松必须建立以确保允许更精确的量身定制方法的访问权益。尽管有迹象儿童感染了COVID-19的频率比成年人的频率较少，整体儿童保健的利用由于大流行在物理距离的要求中获得了大幅下降，但使用儿童的远程医疗尚未增加。如果这些孩子来自代表性不足的少数群体，则尤其如此。我们建议一种行政补充，以了解什么使在服务不足的人群中可行且可接受。在AIM 1中，我们将随机选择范德比尔特居住在邮政编码地区的小儿初级保健患者反映了种族和种族多样性的患者具有较高社会需求的家庭（n = 500）并在早期衡量回顾性远程医疗利用率 COVID-19-1920年3月1日至6月30日大流行期。我们将进行30-60分钟的电话以选择的参与语言（英语，西班牙语或阿拉伯语）评估远程医疗利用的调查，知识，兴趣，对健康的社会决定因素，COVID-19的影响，技术访问，技术访问，种族/民族和耐心的信任。然后，我们将利用获得的知识来设计和测试修改的远程医疗方法，评估提供给远程医疗访问的可行性和可接受性 100名低收入儿科患者（50名英语和50个非英语）。收集的过程数据将包括选定远程医疗平台（HHS接受选择），访问长度以及患者家庭和提供者的满意度。收集的定性数据将确定患者家庭和提供者的障碍和促进者。这些数据将告知政策和流程，以为各种儿科人群创建公平的远程医疗方法。