CommunityRx for Hunger - Resubmission 01

CommunityRx for Hunger - 重新提交 01

基本信息

批准号：
9884800
负责人：
Stacy Tessler Lindau
金额：
$ 68.67万
依托单位：
UNIVERSITY OF CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-03-04 至 2023-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9884800
关键词：
Academy Address Admission activity Adoption Adult Algorithms American Attitude Caregivers Caring Child Child Health Child Nutrition Child health care Chronic Client satisfaction Clinical Communication Communities Decision Making Double-Blind Method Education Educational Intervention Family Feeling Food Goals Health Health Care Costs Health Personnel Health Promotion Healthcare Hospitalization Hospitalized Child Hospitals Household Hunger Intervention Knowledge Legal Guardians Link Low income Medicine Methods Mission Online Systems Outcome Parents Pathway interactions Pediatric Hospitals Pediatrics Periodicity Physicians Process Provider Public Health Public Health Practice Randomized Randomized Controlled Trials Research Research Methodology Resources Role Science Policy Secure Self Care Self Efficacy Self Management Severities Shame Social Conditions Stigmatization Surveys Target Populations Telephone Testing Text Messaging Time United States United States Centers for Medicare and Medicaid Services United States National Institutes of Health Visit Work adult nutrition base caregiving coping ethnic diversity evidence base experience family management food insecurity food resource food security grandparent group intervention health care service utilization health disparity implementation science improved injured low socioeconomic status primary outcome programs racial diversity satisfaction screening secondary outcome social social stigma socioeconomic disadvantage socioeconomic disparity socioeconomics treatment as usual

项目摘要

PROJECT SUMMARY/ABSTRACT Food insecurity is a prevalent, modifiable and overlooked determinant of health and health disparities along socioeconomic and racial lines in the United States. Lower income caregivers (parents, custodial grandparents, legal guardians) of children with illness requiring hospitalization are particularly vulnerable to food insecurity due to healthcare costs and prioritizing food for the child. The U.S. Centers for Medicare & Medicaid Services, the American Academy of Pediatrics, the National Academy of Medicine and others are calling for healthcare-based screening and intervention to address food insecurity, endorsing growing evidence about the deleterious effects on health and healthcare. Most caregivers and healthcare providers endorse that it is acceptable for providers to address food insecurity and related needs, yet physicians rarely screen or make referrals for these needs. Barriers include concerns about compromising caregiver or patient satisfaction by causing feelings of stigma and providers' lack of knowledge about food insecurity. The proposed mixed-methods research will fill a gap in knowledge about how best to intervene to support food insecure caregivers. We will conduct a double-blind randomized controlled trial to test the effect of the CommunityRx-Hunger (CRx-H) intervention on caregiver and child health outcomes over 12 months. CRx-H leverages hospital discharge processes used to prepare caregivers to care for an ill child, including education and activation of self- and family management strategies. Caregivers of hospitalized children will be screened for food insecurity, stratified by food security status, and randomized to either usual care (UC) or CRx-H. UC includes a hospital admission packet with information about food resources in the hospital. In addition to UC, CRx-H includes, at discharge: a brief educational intervention about food insecurity and common co-occurring needs, information about quality community resources for food and other support, and text messages from a community resource navigator over 90 days post-discharge. The specific aims of this research are to: (1) Evaluate the effects of CRx-H versus UC on food insecure caregiver self-efficacy, caregiver and child food insecurity, and adult and child health outcomes; (2) Among food secure and insecure caregivers, evaluate the effects of CRx-H versus UC on caregiver satisfaction with care and stigma; (3) Qualitatively assess food insecure caregivers' perspectives about: (a) their experiences with and attitudes toward the CRx-H intervention, (b) the role of stigma as a barrier to self- and family management, and (c) how healthcare providers can sensitively and effectively intervene to support food insecure caregivers.. Our objective is to improve self- and family management among food insecure caregivers with an ill child. The long-term goal of this work advances the mission of the NIMHD by generating evidence on public health practices to promote the health of caregivers and their families and to reduce health disparities due to socioeconomic disadvantage.

项目摘要/摘要粮食不安全是一种普遍，可修改和被忽视的健康和健康差异的决定因素美国的社会经济和种族界限。较低的收入照顾者（父母，保管祖父母，法定监护人）需要住院的儿童的儿童特别容易受到粮食不安全的影响为医疗保健费用并确定儿童食物的优先级。美国医疗保险和医疗补助服务中心，美国儿科学会，美国国家医学院等人呼吁基于医疗保健筛查和干预以解决粮食不安全，认可越来越多的证据证明有害影响关于健康和医疗保健。大多数护理人员和医疗保健提供者都赞同提供者可以接受解决粮食不安全和相关需求，但医生很少筛选或针对这些需求进行推荐。障碍包括对损害护理人员或患者满意度的担忧，引起污名和提供者缺乏对粮食不安全的了解。拟议的混合方法研究将填补空白了解如何最好地干预以支持粮食不安全的护理人员。我们将进行双盲随机对照试验，以测试CommunityRx-Hunger（CRX-H）干预对护理人员和儿童健康结果超过12个月。 CRX-H利用用于准备的医院出院过程护理人员照顾一个生病的孩子，包括教育和激活自我和家庭管理策略。住院儿童的护理人员将被筛查，以确保粮食不安全，按粮食安全状况分层，以及随机分配给常规护理（UC）或CRX-H。 UC包括一个医院入院包，其中包含有关医院的食物资源。除UC外，CRX-H还包括，出院时：简短的教育干预关于粮食不安全感和共同出现的需求，有关食品优质社区资源的信息和其他支持，以及分期收理后90天内的社区资源导航器的短信。这这项研究的具体目的是：（1）评估CRX-H与UC对食品不安全护理人员的影响自我效能感，照料者和儿童粮食不安全以及成人和儿童健康成果；（2）在食物中安全以及不安全的护理人员，评估CRX-H与UC对护理人员对护理和污名的满意度的影响；（3）定性评估粮食不安全的看护人对：（a）他们在态度和态度的看法采取CRX-H干预，（b）污名作为自我和家庭管理障碍的作用，以及（c）如何医疗保健提供者可以敏感有效地干预以支持粮食不安全的护理人员。是为了改善与生病的孩子的粮食不安全护理人员之间的自我管理。长期目标这项工作通过为公共卫生实践提供证据来促进NIMHD的使命护理人员及其家人的健康，并因社会经济劣势而降低健康差异。