An Innovative Tailored Intervention for Improving Children's Postoperative Recovery

改善儿童术后康复的创新定制干预措施

基本信息

批准号：
10442290
负责人：
Zeev Kain
金额：
$ 29.91万
依托单位：
UNIVERSITY OF CALIFORNIA-IRVINE
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2022-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10442290
关键词：
Administrative Supplement Adult Age Ambulatory Surgical Procedures Anxiety Award Behavior Therapy Belief Child Clinical Collaborations Communities Companions Computer software Coping Skills Cost Control Data Development Educational process of instructing Ethnic Origin Ethnic group Event Family Funding Grant Growth Health Personnel Healthcare Home Hospitals Impairment Internet Intervention Language Latinx Manuals Minority Groups Modeling National Institute of Child Health and Human Development Operative Surgical Procedures Pain Parents Patient-Focused Outcomes Patients Perioperative Persons Physical Function Population Postoperative Pain Postoperative Period Process Provider Randomized Recovery Research Site Syndrome Technology Testing Text United States National Institutes of Health Work animation base chronic pain control trial cost disparity reduction effective intervention ethnic minority population evidence base experience handheld mobile device heuristics improved innovation intervention effect mHealth pain reduction postoperative recovery psychologic recruit satisfaction surgery outcome surgical disparities symposium tool usability

项目摘要

Abstract Over 60 million persons in the U.S. identify themselves as Latinx and 25.6% are children under the age of 16. Surgical disparities for adults and children have been identified as a major problem in the US and can be experienced at multiple points along a patient’s health care trajectory. Data from our center indicates that a substantial portion of Latinx children who undergo surgery experience high anxiety and postoperative pain as well as postoperative impairments in psychological and physical functioning as compared to White non-Latin children who undergo surgery. Recent growth in use of mobile devices provides us an opportunity to create low- cost mHealth behavioral interventions to reduce this disparity in surgical outcomes. In a previous NIH award, the PI developed and tested an evidence based mHealth tailored intervention (WebTIPS) that aims to prepare and be a companion of a child and their family during a surgical event. WebTIPS aims to enhance the recovery of the child in several ways such as reducing anxiety and pain and is based on information provision, modeling, and teaching of coping skills. WebTIPS, however, was developed and validated with a population of primarily White non-Latinx English-speaking children and their parents. Unfortunately, it is well established that mHealth interventions are significantly less effective when used with specific ethnic minorities unless they underwent a process of cultural adaptation. Over the past 4-years, we have established multiple academic and community collaborations, conducted extensive participatory research with Latinx stakeholders and used the heuristic framework and a modified ecological validity model to culturally adapt WebTIPS. The culturally adapted intervention is called L-WebTIPS. The primary aim of this administrative supplement is to refine L-WebTIPS for deployment through finalizing web programming and conducting think-aloud usability beta testing in a population of Latinx children undergoing surgery and their family. The overall aim of this supplement is to reduce surgical disparities in a population of Latinx children undergoing surgery. The NIH-ACS Symposium on Surgical Disparities Research and the resulting JAMA article call for using technology to optimize patient outcomes in a culturally relevant way. This supplement focuses on reducing such disparity by culturally adapting a previously developed and validated mHealth intervention. We submit that using a cultural adaption process for an existing intervention rather than start a de novo development will accelerate the process of reducing surgical disparities and bringing an effective mHealth intervention to the clinical settings and routine use. We submit that using a cultural adaption process for an existing validated intervention will accelerate the process of reducing surgical disparities and bringing an effective intervention to clinical settings and routine use.

抽象的在美国，超过6000万人认为自己是拉丁裔，而25.6％的儿童是16岁以下的儿童。成人和儿童的手术差异已被确定为美国的主要问题，可以是沿着患者的医疗保健轨迹多个点经验。来自我们中心的数据表明接受手术的大部分拉丁裔儿童经历了高度焦虑和术后疼痛与白色非拉丁蛋白相比，心理和身体机能的术后损害接受手术的孩子。移动设备的最新使用增长为我们提供了创造低 - 花费MHealth行为干预措施，以减少手术结果的这种差异。在先前的NIH奖中，PI开发并测试了基于证据的MHealth量身定制干预措施（WebTips）旨在在外科活动中准备并成为孩子及其家人的伴侣。 WebTips 旨在以几种方式来增强孩子的康复，例如减少动画和痛苦，并基于信息提供，建模和应对技能的教学。但是，WebTips已开发和验证有大量的白人非Latinx英语儿童及其父母。不幸的是，是很好地确定，与特定种族一起使用时，MHealth干预措施的效率明显降低除非少数群体经历了文化适应过程。在过去的4年中，我们已经建立了多次学术和社区合作，与Latinx进行了广泛的参与研究利益相关者并使用启发式框架和修改的生态有效性模型来适应 WebTips。文化适应的干预措施称为l-webtips。这种行政补充的主要目的是通过最终确定Web来完善L-Webtips进行部署在接受的拉丁裔儿童中的编程和进行思维可用性测试手术及其家人。这种补充的总体目的是减少正在接受的拉丁裔儿童的手术差异外科手术。 NIH-ACS外科差异研究和由此产生的JAMA文章呼吁使用的NIH-ACS研讨会以文化相关的方式优化患者结果的技术。这种补充侧重于减少这种通过在文化上适应先前开发和验证的MHealth干预措施来差异。我们提出使用现有干预而不是开始新开发的文化适应过程将加速减少手术差异并为临床环境带来有效的MHealth干预的过程和常规使用。我们认为，使用文化适应过程进行现有验证的干预措施将加速减少手术差异并为临床环境带来有效干预的过程和常规使用。