Achieving Pediatric Health Equity by Responding to Identified Sociomedical risks with Effective Unified Purpose –Co-design and Evaluation of the RISEUP System

以有效统一的目的应对已识别的社会医学风险，实现儿科健康公平 — RISEUP 系统的共同设计和评估

• 批准号: 10364787
• 负责人: Andrew Finkel Beck
• 金额: $ 40万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10364787
• 关键词: Achieving; Pediatric; Health; Equity; Responding

PROJECT SUMMARY Equity gaps in child health outcomes result, at least in part, from insufficiently addressed social determinants of health, defined as “the conditions in which people are born, live, learn, work, play, worship, and age.” Patient and family needs related to determinants like toxic housing, access barriers, and socioeconomic deprivation undermine health and shift attention away from completion of follow-up visits, medication fills, and other ser- vices that promote optimal health and well-being outcomes. Insufficiently addressed social determinants ex- plain much of the persistence in health disparities. As a result, healthcare systems that effectively monitor for risks and then integrate proactive responses to both medical and social needs will be more likely to achieve better, equitable outcomes. Thus, the objective of this project is to co-design and evaluate the “Responding to Identified Sociomedical risks with Effective Unified Purpose” System (RISEUP) to best meet both the medical and social needs of children and their communities. The central hypothesis is that an integrated system co- designed with healthcare-, human service-, payer-based stakeholders, and parents of pediatric patients, will promote better, more equitable outcomes across conditions by enhancing situation awareness and informing cross-sector actions directed at common root causes. This hypothesis will be tested through three specific aims: 1) Identify common root causes of health equity gaps across three chronic pediatric conditions (asthma, type 1 diabetes, and sickle cell disease) using an integrated monitoring system; 2) Co-design a response sys- tem to operationalize shared theory and address medical-social risks; and 3) Evaluate the effects of a medical- social monitoring and response system on patient- and population-level health outcomes, employing RISEUP in the care of children with asthma, diabetes, and sickle cell living in high-morbidity, high-poverty communities. The contribution of the proposed research is to co-design and evaluate RISEUP, this monitoring and response system in partnership with healthcare-, human service-, and payer-based stakeholders, and parents of pediat- ric patients. This research is significant because both medical and social data together would provide AHRQ- prioritized 360-degree views of children and communities, getting us closer to those factors at the root of poor health. This proposal is innovative in its monitoring of disparities’ root causes and the co-design and evaluation of integrated, coordinated response systems. Such data integration, accelerated by human-centered co-design and population-based quality improvement, holds great promise for subsequent scale and spread. Expected outcomes include a potentially transformative template for healthcare and human service systems to collabora- tively monitor and respond to disparities. Indeed, RISEUP will positively affect children by facilitating a preven- tive approach to addressing the social determinants and equitably improving outcomes for children, a vulnera- ble and AHRQ-prioritized population.

项目概要 儿童健康结果的公平差距至少部分是由于没有充分解决儿童健康问题的社会决定因素造成的。 健康，被定义为“人们出生、生活、学习、工作、娱乐、崇拜和老年的条件”。 与有毒住房、进入障碍和社会经济剥夺等决定因素相关的家庭需求 损害健康，并将注意力从完成随访、药物配药和其他服务上转移开。 促进最佳健康和福祉结果的恶习没有得到充分解决。 因此，医疗保健系统能够有效地监测健康状况的差异。 风险，然后整合对医疗和社会需求的积极响应将更有可能实现 因此，该项目的目标是共同设计和评估“响应”。 通过“有效统一目标”系统 (RISEUP) 识别社会医学风险，以最好地满足医疗风险 和儿童及其社区的社会需求的中心假设是一个综合系统共同 与医疗保健、公共服务、支付者利益相关者以及儿科患者家长一起设计，将 通过提高形势意识和通报信息，在各种条件下促进更好、更公平的结果 针对共同根本原因的跨部门行动将通过三个具体问题进行检验。 目标：1) 确定三种慢性儿科疾病（哮喘、 1 型糖尿病和镰状细胞病）使用综合监测系统 2）共同设计响应系统； 实施共享理论并解决医疗社会风险；以及 3) 评估医疗-社会风险的影响； 采用 RISEUP 对患者和人群层面的健康结果进行社会监测和响应系统 照顾生活在高发病率、高贫困社区的患有哮喘、糖尿病和镰状细胞病的儿童。 拟议研究的贡献是共同设计和评估 RISEUP，这种监测和响应 系统与医疗保健、公共服务和支付者的利益相关者以及儿科家长合作 这项研究意义重大，因为医疗和社会数据共同提供了 AHRQ- 优先考虑儿童和社区的 360 度视角，让我们更接近贫困根源的因素 该提案在监测差异的根本原因以及共同设计和评估方面具有创新性。 通过以人为本的协同设计加速这种数据集成。 和基于人口的质量改善，为后续的规模和传播带来了巨大的希望。 成果包括医疗保健和人类服务系统协作的潜在变革模板 事实上，RISEUP 将通过促进预防措施对儿童产生积极影响。 采取积极的方法解决社会决定因素并公平地改善儿童的成果，这是一个弱势群体 ble 和 AHRQ 优先人群。