Asthma Management Support Training in Pediatrics

儿科哮喘管理支持培训

• 批准号: 7102160
• 负责人: PAULA LOZANO
• 金额: $ 23.33万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-05-10 至 2008-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7102160
• 关键词: asthma; behavioral /social science research tag; clinical research; clinical trials; counseling; family; health care personnel education; health education; health services research tag; human subject; human therapy evaluation; middle childhood (6-11); motivation; patient oriented research; pediatrics; physicians; preschool child (1-5); respiratory disease /disorder therapy; self care; training

DESCRIPTION (provided by applicant): Pediatric self-management support interventions have lagged behind those for adults. Collaborative management requires that providers appreciate the challenges of behavior change and acknowledge patients' readiness to change, while enhancing self-efficacy. The aims of this Exploratory/Developmental R21 are (1) to evaluate the feasibility and acceptability of an intervention to enhance collaborative management by pediatrics residents and families of children with asthma, (2) to estimate the effect size on resident skill and patient-centered outcomes, and (3) to evaluate reliability of the objective standardized clinical examinations (OSCEs) used to assess resident skill. We will conduct a pilot RCT of the Collaborative Management in Pediatrics (CMP), a curriculum for training residents in behavior change techniques for collaborative management of children with asthma and their families. CMP is a pediatric adaptation of Brief Negotiation, an approach based on Motivational Interviewing developed by Kaiser Permanente. We will consent, recruit and randomize 20 first year pediatrics residents. Intervention residents will receive CMP training (two 3-hr sessions) and control residents will learn traditional asthma patient education. OSCEs with standardized patients will evaluate resident skill before and after training, and 6 months later. We will recruit 5-10 children aged 2-12 y with persistent asthma from the clinic panels of each resident. After informed consent and screening, parent report of process and outcome measures (e.g. symptom days, controller adherence, use of written care plan, tobacco avoidance, other self-care behaviors and satisfaction) will be obtained by phone survey. The survey will be repeated at 6 wks and 3 m. Baseline and 3 m hair samples will be assayed for nicotine to determine tobacco smoke exposure. Patients of intervention residents will be scheduled for a planned asthma care visit to focus on health behaviors, and a phone call one week later to follow-up on behavior change goals. Patients of control residents will be scheduled for an asthma education visit. The proposed activities will yield data to inform design and implementation of a full-scale effectiveness RCT. We hypothesize that CMP will be feasible, acceptable and lead to clinically significant improvements in resident counseling skills and patient-centered outcomes. In addition, this novel project will advance the field by providing tools for training pediatricians in collaborative management.

描述（由申请人提供）：儿童自我管理支持干预措施落后于成人。协作管理要求提供者认识到行为改变的挑战并承认患者愿意改变，同时提高自我效能。本探索性/发展性 R21 的目的是 (1) 评估干预措施的可行性和可接受性，以加强儿科住院医师和哮喘儿童家庭的协作管理，(2) 估计对住院医师技能和以患者为中心的影响大小结果，(3) 评估用于评估住院医师技能的客观标准化临床检查 (OSCE) 的可靠性。我们将开展儿科协作管理 (CMP) 试点随机对照试验，该课程旨在培训住院医生行为改变技术，以协作管理哮喘儿童及其家人。 CMP 是简短谈判的儿科改编版，简短谈判是一种基于 Kaiser Permanente 开发的动机访谈的方法。我们将同意、招募并随机分配 20 名一年级儿科住院医生。干预居民将接受 CMP 培训（两次 3 小时的课程），对照居民将学习传统的哮喘患者教育。 OSCE 与标准化患者一起评估培训前后以及 6 个月后的住院医师技能。我们将从每个住院医师的诊所小组中招募 5-10 名 2-12 岁患有持续性哮喘的儿童。经过知情同意和筛选后，将通过电话调查获得家长关于过程和结果测量的报告（例如症状天数、控制者依从性、书面护理计划的使用、避免吸烟、其他自我护理行为和满意度）。该调查将在 6 周和 3 m 时重复进行。将检测基线和 3 m 头发样本的尼古丁含量，以确定烟草烟雾暴露情况。干预居民的患者将被安排进行有计划的哮喘护理访问，重点关注健康行为，并在一周后通过电话跟进行为改变目标。对照居民的患者将被安排进行哮喘教育访问。拟议的活动将产生数据，为全面有效性随机对照试验的设计和实施提供信息。我们假设 CMP 是可行的、可接受的，并且会在临床上显着改善住院医师咨询技能和以患者为中心的结果。此外，这个新颖的项目将通过提供用于培训儿科医生协作管理的工具来推动该领域的发展。