An open-source public domain health risk assessment for use in primary care

用于初级保健的开源公共领域健康风险评估

• 批准号: 8331312
• 负责人: JOSEPH J SUDANO
• 金额: $ 48.79万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-30 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8331312
• 关键词: open; source; public; domain; health

DESCRIPTION (provided by applicant): Over half of all deaths before age 65 can now be attributed to lifestyle factors. In order to reduce the annual incidence of lifestyle-based causes of death, it is essential to understand the contribution of lifestyle factors that are potentially under the control of the individual and those that may be amenable to social, medical or pharmacological interventions. The health risk appraisal (HRA) can be an important tool in assessing the impact of these precursors of disease and trauma. Additionally, the 2009 National Committee for Quality Assurance (NCQA) release of their accreditation requirements for health plans, preferred provider organizations, managed care organizations and health and wellness promotion programs requires the administration of HRA's as part of the accreditation process. These new standards will stimulate broad utilization of the HRA and call for a systematic review/updating of currently available instruments. Similarly, the transformation of many primary care practices into patient centered medical homes will also stimulate the need for instruments and tools that can help facilitate provider-patient communication and patient education. However, little is known regarding the uptake, usability, acceptability and effectiveness of HRA's in diverse primary care settings. What information we do have is based on very few managed care settings, employer wellness programs and insurance plans among mostly white, middle-class, employed individuals. In short, there is no information, to our knowledge, regarding the use of HRA's among racial/ethnicity minority groups, the uninsured, the poor, or those with limited health literacy. We also know of no studies regarding provider or patient satisfaction with HRA's, yet alone the effects of HRA's on patient health outcomes or behavior/lifestyle changes. All of these are important research questions that need answered, but require one critically important tool-a proven HRA that is inexpensive and easy to field in a wide variety of primary care settings, some resource rich and others resource poor. This application is a first step in filling all of these knowledge gaps. To advance the science and knowledge regarding the use of HRA's in primary care clinical settings we propose the following aims: Aim 1: To re-engineer the Healthier People Network's Health Risk Appraisal (HPN-HRA) tool to a multi-platform, social-network-friendly, open-source code, and standards compliant software product, for use in the public domain either directly by users or indirectly by third-party applications via an Application Programmers Interface (API). Aim 2: To update current mortality risk algorithms, create new chronic disease and accidental death risk algorithms, and update the patient and provider reports in the HPN-HRA to provide estimates and recommendations based on systematic reviews of current scientific findings. Aim 3: To engage a local primary care practice based research network (PBRN) in the design and pilot testing of the new HRA as a prelude to a rigorous evaluation of the HRA in primary care to be carried out in a subsequent study.

描述（由申请人提供）：现在65岁之前所有死亡的一半以上可以归因于生活方式因素。为了减少基于生活方式的死亡原因的每年发生率，必须了解可能在个人控制下的生活方式因素的贡献以及可能受到社会，医学或药理干预措施的贡献。健康风险评估（HRA）可能是评估这些疾病和创伤前体的影响的重要工具。此外，2009年全国质量保证委员会（NCQA）发布了其对健康计划的认证要求，首选提供者组织，托管护理组织以及健康和保健促进计划，要求对HRA的管理作为认证过程的一部分。这些新标准将刺激HRA的广泛利用，并呼吁对当前可用仪器进行系统的审查/更新。同样，将许多初级保健实践转化为以患者为中心的医疗家庭也将刺激对有助于促进提供者的沟通和患者教育的工具和工具的需求。但是，关于HRA在不同的初级保健环境中的摄取，可用性，可接受性和有效性知之甚少。我们拥有的信息是基于很少有托管护理设置，雇主保健计划和保险计划，其中大多数是白人，中产阶级，受雇的个人。简而言之，据我们所知，没有关于HRA在种族/民族少数群体中使用HRA的信息，未投保的穷人或健康素养有限的人。我们还知道有关提供者或患者对HRA的满意度的研究，仅HRA对患者健康结果或行为/生活方式改变的影响。所有这些都是重要的研究问题，需要回答，但需要一个至关重要的工具 - 一个经过验证的HRA，在各种初级保健环境中廉价且易于实现，有些资源富裕，而另一些资源则很差。该应用程序是填补所有这些知识差距的第一步。 To advance the science and knowledge regarding the use of HRA's in primary care clinical settings we propose the following aims: Aim 1: To re-engineer the Healthier People Network's Health Risk Appraisal (HPN-HRA) tool to a multi-platform, social-network-friendly, open-source code, and standards compliant software product, for use in the public domain either directly by users or indirectly by third-party applications via an Application Programmers接口（API）。目标2：更新当前的死亡率风险算法，创建新的慢性疾病和意外死亡风险算法，并在HPN-HRA中更新患者和提供者报告，以根据当前科学发现的系统评价提供估计和建议。 AIM 3：将基于本地医疗实践的研究网络（PBRN）与新的HRA进行设计和试点测试，以此作为对初级保健中HRA进行严格评估的序幕，并在随后的研究中进行。