Improving Follow-up After an Emergency Visit for Asthma

改善哮喘紧急就诊后的随访

• 批准号: 6677376
• 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/6677376
• 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 Joseph J. Zorc 博士的研究事业发展。 在儿科急诊医学进修培训和早期研究员工作期间，Zorc 博士将其研究生涯的重点放在改善在急诊科 (ED) 就诊的内城区哮喘儿童的治疗效果。在 Kathy Shaw 博士、Julian Allen 博士和其他导师和同事的支持下，Zorc 博士制定了一个包含正式课程、研讨会和个人指导的计划，将在 5 年时间内完成。该项目围绕临床流行病学正式理学硕士学位构建，重点是提高介入研究技能和了解患者坚持治疗的原则。近几十年来，儿童哮喘的患病率和发病率大幅增加。内城区的儿童尤其面临不良后果的风险，并且经常在急诊室接受哮喘护理。先前的研究在改善初级保健随访、护理质量以及哮喘儿科急诊就诊后的长期结果方面取得的成功有限。本研究人员和其他研究人员之前进行的基于急诊科的干预措施旨在解决初级保健提供者随访的障碍，例如无法获得后续预约或缺乏交通。焦点小组和对市中心家庭的调查发现，对后续护理的好处和预防性哮喘药物的作用的信念对治疗的依从性有很大影响。在本提案概述的研究项目中，Zorc 博士将制作一个简短的教育视频，介绍后续哮喘护理的好处，其中包括费城儿童医院的多学科专家小组和哮喘儿童家长的焦点小组。然后，该教育视频将与症状筛查和提醒电话结合起来进行干预，这在之前的研究中已被证明可以提高随访率。将使用随机试验设计对联合干预措施进行测试，以确定其在急诊就诊后 6 个月内对医疗保健利用、哮喘控制药物使用、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儿科急诊研究网络中进行测试。