Improving Follow-up After an Emergency Visit for Asthma

改善哮喘紧急就诊后的随访

• 批准号: 6803475
• 负责人: JOSEPH J ZORC
• 金额: $ 13.17万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-25 至 2008-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6803475
• 关键词: adolescence (12-20); asthma; behavioral /social science research tag; child (0-11); clinical research; educational resource design /development; emergency health services; health care quality; health care service utilization; health education; health services research tag; human subject; longitudinal human study; outpatient care; parent offspring interaction; patient care management; patient oriented research; quality of life; telemedicine

DESCRIPTION (provided by applicant): The primary goal of this award is to support the research career development of Dr. Joseph J. Zorc. During fellowship training in pediatric emergency medicine and early work as an investigator, Dr. Zorc has focused his research career on improving outcomes for inner-city children with asthma who are seen in the emergency department (ED). With the support of Dr. Kathy Shaw, Dr. Julian Allen and other mentors and colleagues, Dr Zorc has developed a program of formal coursework, seminars, and individual mentoring to be completed over a 5-year period. The program, which is structured around a formal Master's of Science degree in Clinical Epidemiology, focuses on improving skills in interventional research and understanding the principles of patient adherence to therapy. Prevalence and morbidity from childhood asthma have increased substantially in recent decades. Inner-city children are particularly at risk for poor outcomes and frequently obtain their asthma care in the ED. Prior studies have had limited success in improving primary care follow-up, quality of care, and long-term outcomes after a pediatric ED visit for asthma. Prior ED-based interventions by this and other investigators have been designed to address barriers to follow-up with a primary care provider such as an inability to obtain a follow-up appointment or lack of transportation. Focus groups and surveys of inner-city families have found that beliefs about the benefits of follow-up care and the role of preventive asthma medications have a strong impact on adherence to therapy. In the research projects outlined in this proposal, Dr. Zorc will develop a brief educational video about the benefits of follow-up asthma care using a multi-disciplinary panel of experts at the Children's Hospital of Philadelphia and focus groups of parents of children with asthma. This educational video will then be combined into an intervention along with symptom screening and a reminder phone call that has been demonstrated to improve follow-up rates in a previous study. The combined intervention will be tested using a randomized trial design to determine its efficacy on healthcare utilization, asthma controller medication use, symptoms, and quality of life during the 6 months following an ED visit. The expected goal of the project will be to develop an intervention that can subsequently be tested in a newly developed, federally-funded research network of pediatric EDs.

描述（由申请人提供）： 该奖项的主要目标是支持约瑟夫·佐克（Joseph J. Zorc）博士的研究职业发展。 在小儿急诊医学和研究人员的早期工作中，佐尔克博士的研究生涯将其研究生涯改善了在急诊科（ED）中看到的哮喘内城市儿童的成果。在凯西·肖（Kathy Shaw）博士，朱利安·艾伦（Julian Allen）博士以及其他导师和同事的支持下，佐尔克（Zorc）博士开发了一项正式课程，研讨会和个人指导计划，将在5年内完成。该计划围绕临床流行病学的正式科学硕士学位构建，重点是提高介入研究的技能，并理解患者遵守治疗的原理。近几十年来，儿童哮喘从童年哮喘起的患病率和发病率大大增加。市中心的儿童尤其面临不良预后的风险，并经常在ED中获得其哮喘护理。在儿科ED访问哮喘之后，先前的研究在改善初级保健随访，护理质量和长期结局方面取得了有限的成功。该研究人员和其他研究人员的先前基于ED的干预措施已旨在解决与初级保健提供者进行后续行动的障碍，例如无法获得后续任命或缺乏交通工具。城市家庭的焦点小组和调查发现，对后续护理的好处和预防哮喘药物的作用的信念对依从性治疗具有很大的影响。在该提案中概述的研究项目中，Zorc博士将使用一个多学科的专家小组在费城儿童医院和哮喘子女父母的焦点小组中使用多学科的专家小组来制定有关随访哮喘护理的好处。然后，该教育视频将合并为干预措施以及症状筛查，并在先前的研究中已证明可以提高随访率的提醒电话。合并干预将使用随机试验设计进行测试，以确定其在ED访问后的6个月内对医疗保健利用，使用哮喘控制器用药，症状和生活质量的功效。该项目的预期目标是开发一种干预措施，随后可以在新开发的联邦资助的小儿EDS研究网络中进行测试。