Health IT to reduce disparities in risks for sleep-related infant deaths

健康信息技术可减少与睡眠相关的婴儿死亡风险的差异

• 批准号: 10431776
• 负责人: EILEEN M MCDONALD
• 金额: $ 66.89万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-16 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10431776
• 关键词: Academy; African American; African American population; Algorithms; American; Asphyxia; Back; Back to Sleep; Baltimore; Beds; Belief; Birth; Black race; Caring; Cessation of life; Child; Childhood; Childhood Injury; Cities; Clinic; Clinical; Clinical Informatics; Communication; Communities; Computerized Medical Record; Counseling; Data; Disadvantaged; Disclosure; Economically Deprived Population; Environment; Family; Feedback; Funding; Health; Health Personnel; Health care facility; Healthcare; Home; Infant; Intervention; Knowledge; Life; National Institute on Minority Health and Health Disparities; Newborn Infant; Outcome; Parents; Patients; Pediatrics; Peer Review; Persons; Population; Prevention Measures; Prevention Research; Primary Health Care; Provider; Public Health; Publications; Randomized; Randomized Controlled Trials; Reporting; Research; Risk; Site; Sleep; Smoke; Source; Sudden infant death syndrome; Supination; Surveys; System; Testing; Theory of Change; Training; Training Activity; United States National Institutes of Health; United States Public Health Service; Visit; Work; base; behavior change; care providers; disadvantaged population; disparity reduction; effectiveness evaluation; experience; follow-up; health disparity; health information technology; high risk; improved; infant death; injury prevention; innovation; motivational enhancement therapy; pediatrician; portability; programs; racial and ethnic disparities; response; satisfaction; skills; socioeconomic disadvantage; standard of care; supine sleep; tool

PROJECT SUMMARY/ABSTRACT This proposal is in response to PAR19-093, and its aims are consistent with NIMHD and OBSSR priorities. This research will examine how a unique health information technology (HIT) tool impacts patient and provider outcomes when implemented in a pediatric primary care clinic serving a socioeconomically disadvantaged population that is primarily Black/African American. Aim 1. To test the impact of implementing a new EMR-based Infant Sleep Assessment (ISA) and brief communication training on a) pediatric clinicians’ delivery of anticipatory guidance (both positive and unintended negative consequences); and b) parents’ satisfaction with care, infant safe sleep knowledge, beliefs, reported practices, and observed infant sleep environments. Aim 2. To assess how implementing the new EMR-based ISA and brief communication training is perceived by pediatric clinicians in terms of its advantages, disadvantages, and impact on their delivery of anticipatory guidance. For Aim 1, a randomized controlled trial will compare outcomes between a Standard of Care (SOC) and an ISA group. Each of 12 half-day clinic sessions will be randomly assigned to SOC or ISA. Clinicians (N=88) and the parents of their newborn patients (N=188 per study group) will remain in their assigned group throughout the study. The ISA group will complete the tool at their 2-month well-baby visit, and both groups will have this visit audio recorded. Follow-up data will be collected by an in-home survey and observation when the infant is 3-4 months old. For Aim 2, a brief survey will be completed by the clinicians at the end of their study participation. Results will be disseminated through peer-reviewed publications, presentations and summary briefs distributed through electronic media to the pediatric, injury prevention, public health, clinical informatics, and health disparities communities.

项目概要/摘要 该提案是对 PAR19-093 的回应，其目标与 NIMHD 和 OBSSR 的优先事项一致。 这项研究将探讨独特的健康信息技术 (HIT) 工具如何影响患者和提供者 在为社会经济弱势群体提供服务的儿科初级保健诊所实施时的结果 主要是黑人/非裔美国人的人口。 目标 1. 测试实施新的基于 EMR 的婴儿睡眠评估 (ISA) 的影响并简要介绍 a) 儿科的沟通培训 儿科提供预期指导（积极的和 b) 父母对护理的满意度、婴儿安全睡眠知识、 信念、报告的实践和观察到的婴儿睡眠环境。 目标 2. 评估实施基于 EMR 的新 ISA 和简短沟通培训的感受 儿科医生的优点、缺点以及对他们提供预期治疗的影响 指导。 对于目标 1，随机对照试验将比较护理标准 (SOC) 和护理标准之间的结果 ISA 组。每 12 个半日门诊将被随机分配给 SOC 或 ISA 临床医生（N = 88）和 ISA 组。 新生儿患者的父母（每个研究组 N=188）将始终留在指定的组中 ISA 小组将在两个月的婴儿健康检查中完成该工具，两个小组都会有这个工具。 后续数据将通过婴儿出生时的家庭调查和观察来收集。 3-4 个月大 对于目标 2，酋长将在学习结束时完成一项简短的调查。 结果将通过同行评审的出版物、演示文稿和摘要进行传播。 通过电子媒体向儿科、伤害预防、公共卫生、临床信息学、 和健康差异社区。