Developing a Novel eHealth Application for Oral Systemic Issues during Pregnancy

开发针对怀孕期间口腔系统问题的新型电子健康应用程序

• 批准号: 8713323
• 负责人: STEVEN M CHRISTIANSEN
• 金额: $ 21.92万
• 依托单位: C/J MEDIA, INC.
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8713323
• 关键词: Address; Adherence; Adoption; Adult; American College of Obstetricians and Gynecologists; American Dental Association; Applications Grants; Area; Attitude; Behavior; Behavioral; Benefits and Risks; Birth; Businesses; Case Management; Characteristics; Child; Child health care; Chronic; Clinic; Clinical; Collaborations; Communication; Comorbidity; Consensus; Dental; Dentistry; Dentists; Development; Diffusion; Diffusion of Innovation; Dimensions; Electronic Health Record; Elements; Ensure; Epidemic; Etiology; Familiarity; Focus Groups; Future; Goals; Guidelines; Health; Health Communication; Health Personnel; Health education; Healthcare; Healthcare Systems; Healthy People 2020; Human Resources; Infant Health; Interdisciplinary Study; Intervention; Interview; Knowledge; Link; Maternal Health; Medical; Medicine; Methodology; Methods; Mothers; Motivation; Mouth Diseases; Oral; Oral health; Outcome; Parents; Patients; Periodontal Diseases; Phase; Practice Guidelines; Pregnancy; Pregnant Women; Prenatal care; Prevalence; Prevention; Professional Organizations; Provider; Public Health; Publishing; Reporting; Research; Resources; Risk; Self Efficacy; Small Business Technology Transfer Research; System; Technology; Technology Transfer; Testing; Time; Translating; Translations; United States National Institutes of Health; Visit; Women' s Health; base; clinical practice; design; eHealth; early childhood; evidence base; experience; graphical user interface; health information technology; health literacy; implementation research; information model; innovation; interoperability; motivational enhancement therapy; novel; offspring; pregnant; prenatal; prenatal health; prototype; public health relevance; response; skills; theories; usability

DESCRIPTION (provided by applicant): Oral disease is a "silent epidemic" because of its prevalence and missed prevention opportunities. Evidence has established connections between oral-systemic etiologies, including the effects of periodontal disease (PD), and a range of health outcomes and co-morbidities across the lifecourse (e.g., adverse pregnancy and birth outcomes; early childhood carries; chronic conditions throughout adulthood). Pregnancy represents a sensitive period in the lifecourse increasing risk for poor oral health among mothers and their offspring. Although research indicates approximately 40% of pregnant women experience PD, only 23-35% of pregnant women report visiting a dentist during pregnancy. Subsequently, provider guidelines, endorsed by the American College of Obstetricians and Gynecologists (ACOG) and the American Dental Association (ADA), confer the importance of receiving oral health education, assessment, and treatment during pregnancy. However, barriers to positive oral healthcare practices during pregnancy include: a) misconceptions among pregnant women about risks/benefits of oral healthcare during pregnancy; b) prenatal providers not assessing, advising or referring patients on oral health issues during prenatal care visits; and c) lack of communication and patient case management between prenatal and oral health providers. Lack of familiarity with guidelines, low self-efficacy and environmental constraints (e.g., lack of time; other resources) has also been documented. Thus, it is imperative to address this gap in translating evidence-based research into prenatal care practice. Our long-term goal is to increase oral-systemic prevention efforts during pregnancy, thus potentially decreasing risk for poor health across the lifecourse. The objective of this project is to develop and determine the usability and feasibility of a consumer-driven eHealth application that will facilitate the translation of the oral healthcare guidelines into practice duing prenatal visits. This will be achieved through the following aims: (1) assess clinical system for interoperability with the eHealth application and identify key characteristics and features among stakeholders (prenatal providers; oral health providers; clinic personnel) through consumer-based research based on dimensions of the Consolidated Framework for Implementation Research and Diffusion of Innovations; (2) develop and pretest an interactive prototype based on information derived from Aim 1, advisory board input, and Information-Motivation-Behavioral Skills (IMB) and Brief Motivational Interviewing constructs/mechanisms; and (3) conduct usability and feasibility to evaluate the acceptability and preliminary impacts on changes in providers' IMB constructs, including practice behaviors per the guidelines. This innovative, timely and theory-driven project has the potential to translate pregnancy-related oral-systemic evidence into practice and facilitate inter-professional collaborations, thus decreasing gaps in the healthcare system. The multi-disciplinary team has the skills and expertise to ensure aims are successfully achieved and that this novel intervention leads to a marketable product that shifts the current practice paradigm.

描述（由申请人提供）：口腔疾病是一种“寂静的流行病”，因为它的流行和错过的预防机会。证据已经建立了口腔系统病因，包括牙周疾病（PD）的影响，以及整个生命阶段的一系列健康结果和合并症（例如，不良怀孕和出生结果；早期的童年；早期的幼稚骑士；整个均一年的慢性病）。怀孕代表了生命时期的一个敏感时期，增加了母亲及其后代口腔健康状况不佳的风险。尽管研究表明大约40％的孕妇经历了PD，但只有23-35％的孕妇报告在怀孕期间访问牙医。随后，由美国产科医生和妇科学院（ACOG）和美国牙科协会（ADA）认可的提供者指南赋予接受口腔健康教育，评估和治疗期间的重要性。但是，怀孕期间口服阳性医疗保健实践的障碍包括：a）孕妇对怀孕期间口腔医疗保健的风险/益处的误解； b）产前提供者在产前护理期间未评估，建议或转介患者有关口腔健康问题的建议； c）产前和口腔健康提供者之间缺乏沟通和患者病例管理。还记录了对准则缺乏准则，自我效能低下和环境限制（例如，缺乏时间；其他资源）。因此，必须解决将基于证据的研究转化为产前护理实践的差距。我们的长期目标是增加怀孕期间的口腔系统预防工作，从而有可能降低整个生命过程中健康状况不佳的风险。该项目的目的是开发和确定由消费者驱动的eHealth应用程序的可用性和可行性，这将有助于将口腔医疗保健指南转化为实践中的产前访问。这将通过以下目的实现：（1）评估与EHealth应用程序互操作性的临床系统，并通过基于消费者的研究来确定利益相关者（产前提供者；口腔健康提供者；临床人员）之间的关键特征和特征，该研究基于基于消费者的研究，以实施和扩散Innovation的巩固框架； （2）基于AIM 1，顾问委员会输入以及信息动机 - 行为技能（IMB）和简短的动机访谈构建体/机制的信息，开发和预测的交互式原型； （3）提高可用性和可行性，以评估对提供商IMB构建体变化的可接受性和初步影响，包括根据指南的实践行为。这个创新，及时和理论驱动的项目有可能将与妊娠有关的口腔系统证据转化为实践，并促进专业间协作，从而减少医疗保健系统的差距。多学科团队具有确保目标成功实现目标的技能和专业知识，并且这种新颖的干预措施会导致一种可转移当前实践范式的可销售产品。

项目成果

Identifying Implementation Science Characteristics for a Prenatal Oral Health eHealth Application.

确定产前口腔健康电子医疗应用的实施科学特征。

• DOI: 10.1177/1524839918793628
• 发表时间: 2020
• 期刊: Health promotion practice
• 影响因子: 1.9
• 作者: Vamos,CherylA;Green,ShanaM;Griner,Stacey;Daley,Ellen;DeBate,Rita;Jacobs,Tom;Christiansen,Steve
• 通讯作者: Christiansen,Steve