Shared Decision Making in ADHD

多动症的共同决策

• 批准号: 8307482
• 负责人: Alexander Gabriel Fiks
• 金额: $ 12.61万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8307482
• 关键词: Accident and Emergency department; Adherence; African American; Attention deficit hyperactivity disorder; Award; Child; Child health care; Childhood; Complement; Computer Systems; Conduct Clinical Trials; Conflict (Psychology); Country; Data; Decision Aid; Decision Making; Device or Instrument Development; Educational workshop; Effectiveness; Ethnic Origin; Evidence based treatment; Family; Goals; Grant; Health; Impairment; Institute of Medicine (U.S.); Instruction; Intervention; K-Series Research Career Programs; Knowledge; Language; Length; Link; Longitudinal Studies; Measurement; Measures; Mentorship; Outcome; Parents; Patients; Population; Prevalence; Primary Health Care; Principal Investigator; Process; Race; Reporting; Research; Research Personnel; Role; Sampling; Schools; Severities; Socioeconomic Status; Structure; Subgroup; Symptoms; System; Training; Treatment outcome; Uncertainty; Validity and Reliability; Visit; Work; base; career; cohort; cultural values; effective intervention; functional disability; health information technology; improved; instrument; pediatrician; practice-based research network; preference; prototype; shared decision making; skills; symposium; treatment as usual

Alexander Fiks, MD, MSCE is an urban primary care pediatrician who studies health information technology (HIT) to improve child health outcomes. Dr. Fiks's research has found that although clinician-focused HIT interventions are effective, their impact could be increased by facilitating information exchange between clinicians and families in order to clarify treatment preferences and goals, a process called shared decision making (SDM). Although Dr. Fiks's long-term career goal is to become an independent investigator expert in the large-scale implementation of SDM using HIT for multiple pediatric conditions, this career development award will focus on Attention-Deficit/Hyperactivity Disorder (ADHD). ADHD is an ideal prototype condition for SDM: families choose between multiple evidence-based treatments; personal/cultural values influence their selection; treatment disparities exist; and little work has so far been done to untangle these effects to support decision making. During this award. Dr. Fiks will (1) assess the prevalence, determinants, and impact of SDM in primary care for a nationally representative sample of children with ADHD, (2) develop an instrument to measure families' preferences and goals for ADHD treatment, and (3) assess the feasibility and acceptability, and explore the outcomes of an ADHD, HIT-based SDM pilot intervention in primary care. The hypothesis of this proposal is that use of an instrument to capture families' ADHD treatment preferences and goals within an HIT-based system will facilitate SDM and improve adherence to and outcomes from treatment. This research, utilizing a pediatric practice-based research network, will complement formal coursework, workshop/conference participation, and skilled mentorship to train Dr. Fiks to achieve his career goals. Dr. Fiks's specific educational aims are to (1) develop expert skills to evaluate the effectiveness of HIT-enabled SDM including the study of longitudinal/clustered data and the conduct of clinical trials, (2) develop advanced skills in health measurement and instrument development, and (3) advance his knowledge of approaches to encourage SDM including the use of decision aids and HIT. This 5 year award will provide Dr. Fiks with the training and pilot data needed to launch an R01-level trial of SDM for ADHD. RELEVANCE (See Instructions): Prioritized by the Institute of Medicine, shared decision making (SDM) promises to match families to acceptable treatments and improve child health outcomes. By capturing, transferring, and processing health information, computer systems can support SDM on a large-scale. This grant explores the role of these systems to facilitate SDM for ADHD, a condition impairing more than 4 million children in this country.

Alexander Fiks，医学博士，MSCE 是一位研究健康信息技术的城市初级保健儿科医生 （HIT）以改善儿童健康结果。 Fiks 博士的研究发现，虽然以临床医生为中心的 HIT 干预措施是有效的，可以通过促进双方之间的信息交流来增加其影响 临床医生和家庭为了澄清治疗偏好和目标，这一过程称为共同决策 制作（SDM）。尽管 Fiks 博士的长期职业目标是成为一名独立调查专家 使用 HIT 大规模实施 SDM 治疗多种儿科疾病，这一职业发展 该奖项将重点关注注意力缺陷/多动症（ADHD）。 ADHD 是一个理想的原型条件 对于 SDM：家庭在多种循证治疗之间进行选择；个人/文化价值观的影响 他们的选择；存在待遇差异；到目前为止，还没有做多少工作来理清这些影响 支持决策。在此颁奖期间。 Fiks 博士将 (1) 评估患病率、决定因素和 SDM 对具有全国代表性的多动症儿童样本的初级保健的影响，(2) 制定 测量家庭对 ADHD 治疗的偏好和目标的工具，以及 (3) 评估可行性和 可接受性，并探讨初级保健中 ADHD、基于 HIT 的 SDM 试点干预的结果。这 该提案的假设是使用一种工具来捕获家庭的多动症治疗偏好并 基于 HIT 的系统内的目标将促进 SDM 并提高遵守率和结果 治疗。这项研究利用基于儿科实践的研究网络，将补充正式的研究 课程作业、研讨会/会议参与以及熟练的指导，以培训 Fiks 博士实现其职业生涯 目标。 Fiks 博士的具体教育目标是 (1) 培养评估以下课程有效性的专业技能 HIT 支持的 SDM，包括纵向/聚类数据的研究和临床试验的进行，(2) 培养健康测量和仪器开发方面的高级技能，以及 (3) 提高他的能力 了解鼓励 SDM 的方法，包括使用决策辅助和 HIT。这个5年奖 将为 Fiks 博士提供启动针对 ADHD 的 SDM R01 级试验所需的培训和试点数据。 相关性（参见说明）： 共同决策 (SDM) 是医学研究所优先考虑的项目，承诺将家庭与 可接受的治疗并改善儿童健康结果。通过捕获、传输和处理健康状况 信息，计算机系统可以支持大规模的SDM。这笔赠款探讨了这些的作用 系统以促进 ADHD 的 SDM，这种疾病在该国影响了超过 400 万儿童。