Perinatal Nurse Home Visiting Enhanced with mHealth Technology

移动医疗技术增强围产期护士上门服务

基本信息

批准号：
8448577
负责人：
LINDA F.C. BULLOCK
金额：
$ 59.65万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-04-01 至 2017-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8448577
关键词：
AIDS/HIV problem Address Afghanistan Alcohol or Other Drugs use Award Baltimore Battered Women Benchmarking Birth Car Phone Centers for Disease Control and Prevention (U.S.)Child Child Development Child health care Client Clinical Communication Barriers Communities Consent Data Data Collection Devices Early Intervention Effectiveness Electronics Enrollment Ensure Evidence based intervention Frequencies Funding Grant Health Health Care Reform Health education Home Ranges Home environment Home visitation House Call Human Development Infant Health Institutes Intervention Interview Linear Regressions Logistic Regressions Maternal Health Medicaid Mental Depression Mental Health Methods Modeling Mothers Nurses Outcome Pa-11 Pamphlets Paper Participant Perception Perinatal Perinatal Nursing Personal Satisfaction Phase Pregnancy Pregnancy Outcome Pregnant Women Premature Infant Privacy Public Health Randomized Recruitment Activity Research Resources Rural Safety Sampling Secure Security Sensitivity and Specificity Severities Site Social Security Solutions Technology Testing Time Uganda Underrepresented Minority United States National Institutes of Health Virginia Wireless Technology Woman Work World Health base community planning compare effectiveness design empowerment encryption evidence base experience global health health application health disparity improved infant outcome innovation instrument intimate behavior intimate partner violence open source prenatal prevent programs psychologic satisfaction screening sound

项目摘要

DESCRIPTION (provided by applicant): This study addresses PA-11-104 calling for Reducing Health Disparities among Minority and Underserved Children. The Institute of Medicine1, World Health Organization2 and Centers for Disease Control and Prevention3 recognize that prenatal home visitation, which improves the well-being of mother and children, presents an opportunity to provide early intervention to reduce intimate partner violence (IPV) and the impact the exposure has on the children. Major challenges for nurses and other home visitors (HV) are to accurately identify abused women and facilitate their accessing resources needed to change their situation. HVs often find it difficult to assess and intervene for IPV in the intimacy of home settings. The use of mHealth technology may increase the sensitivity of screening instruments and reduce communication barriers between HVs and clients regarding IPV, as well as enhance implementation of IPV interventions and allow for a more standard delivery of an intervention. Building on the successful trial testing the DOVE IPV intervention in prenatal home visiting programs (NR009093), we propose to test mHealth technology using an open-source application, eMOCHA, to improve assessment of IPV and to deliver the DOVE intervention. The proposed eMOCHA DOVE study will first (Specific Aim/Phase 1) compare sensitivity and specificity of two different approaches for IPV assessment; paper and pencil versus the eMOCHA mHealth technology. Phase 2 (Aim 2) will compare effectiveness of the DOVE intervention delivered in standard form (paper brochure) versus mHealth eMOCHA DOVE application. In Phase 1 women enrolled in a perinatal home visiting program and consenting to the study, will be randomized to one of the two assessment groups and assessed for IPV at enrollment, birth and 2 months post birth. Women who are IPV positive (IPV+) at any of the assessment times will be re-randomized to receive the DOVE intervention by one of the two approaches. 1600 Medicaid eligible pregnant women in a perinatal home visiting program (800 from urban Baltimore and 800 from rural Virginia) will be recruited for Phase I and 400 IPV+ women (200 from each site) for Phase II. Women participating in Phase 2 will receive 6 home visit interventions over 6 months. Maternal outcomes related to IPV and mental health and selected infant outcomes will be collected at enrollment, 3, 6, 12, and 18 months after entry into Phase 2. Specific Aim 1 will use logistic and linear regression models to examine the proportion of women experiencing IPV through mHealth technology versus paper and pencil on the same validated assessments. Specific Aim 2 (comparing effectiveness of two intervention administrations) will be assessed with logistic and linear regression models for categorical (proportion abused and premature infants) and continuous outcome variables (e.g. depression, frequency and severity of physical, psychological, sexual IPV, use of community resources) respectively. Study findings will assist nurse home visitation programs to use best approaches for routine assessment of IPV and implement empowerment interventions to reduce IPV and improve maternal infant health outcomes.