Addressing Social Determinants of Health in Disadvantaged Children with Asthma

解决患有哮喘的弱势儿童健康的社会决定因素

基本信息

批准号：
10321174
负责人：
Lisa Cicutto
金额：
$ 3.95万
依托单位：
UNIVERSITY OF COLORADO DENVER
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-10 至 2023-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10321174
关键词：
11 year old Address Adoption Age Area Asthma Caregivers Characteristics Child Childhood Childhood Asthma Chronic Disease Clinical Nurse Specialists Colorado Communication Communities Companions Complex Counseling Data Disadvantaged Dissemination and Implementation Enrollment Evaluation Exploration, Preparation, Implementation, and Sustainment Family Future Grant Healthcare Hospitalization Hot Spot Intervention Interview Knowledge Learning Link Low income Mentorship Methodology Methods Minority Parents Pediatric Hospitals Phase Play Primary Health Care Provider Public Health Pulmonology Questionnaires Randomized Research Research Design Research Methodology Research Personnel Resources Risk Role School Nursing Schools Self Assessment Site Source Students System Training Universities Visit Work asthma exacerbation base career career development community engagement design disparities in morbidity dissemination trial evidence base experience follow-up global health health disparity health equality high risk population implementation framework implementation strategy improved improved outcome interest lower income families medical schools metropolitan mortality parent grant programs research study school district screening skill acquisition social health determinants urgent care

项目摘要

PROJECT SUMMARY / ABSTRACT Our diversity supplement proposal, “Addressing Social Determinants of Health in Disadvantaged Children with Asthma,” seeks to provide Mfonobong Udoko, MD, experience in conducting qualitative methodology research to assess and manage social determinants of health (SDOH). Dr. Udoko will utilize our UG3 parent grant to evaluate the role of SDOH in children with asthma, ages 5 to 12 years, from low-income communities. We are applying community-based participatory methods with high risk populations and communities to contextualize dissemination and implementation (D&I) of our Colorado school-based asthma program (Col- SBAP) that reduces asthma exacerbations and missed school days, while also addressing SDOH which our pilot identified as a major driver of asthma disparities. Our dissemination trial will include two interventions: our evidence-based Col-SBAP and an approach to key SDOH. This two-step level of intervention, called Stop Asthma Attacks (SAA), is designed for sustainable delivery by school asthma navigators and school nurses who coordinate with primary care and community resources. In partnership with our community stakeholders, the Exploration, Preparation, Implementation, Sustainment (EPIS) D&I framework is being applied during the UG3 planning phase to iteratively adapt our current implementation guide to tailored implementation plans that meet local community and site-specific needs, resources and priorities (EPIS Phases 1 & 2). We will then conduct a UH3 dissemination trial with a randomized stepped-wedge study design in asthma “hot spot” school systems across five Colorado regions to evaluate implementation strategies across these school systems (EPIS phase 3, UH3 trial) and to apply the work from EPIS phases 1-3 to develop a “dissemination playbook” to guide future program adoption by other school systems (EPIS Phase 4). Dr. Udoko will obtain input from various stakeholders on assessing and providing resources to address SDOH. This information will be used to develop our DECIPHeR dissemination playbook for our staff to obtain information on SDOH, enhance their ability to refer families to appropriate resources and then follow up on these referrals. The following Specific Aims will support our parent UG3 grant: Supplement Aim 1a and 1b. Compare the strengths and limitations of 2 different approaches for SDOH screening + intervention from multiple stakeholders: a) self-assessment by caregivers using a printed questionnaire; b) navigator led interview of caregivers based on a questionnaire. Supplement Aim 1c. Across stakeholder groups, identify characteristic features of current SDOH screening + intervention that leads to successful management of SDOH needs. Dr. Udoko will provide important information as a companion to our DECIPHeR “dissemination playbook” on methods to obtain information on SDOH and to link families to the appropriate resources, assure their follow-up, and improve communication within our parent grant DECIPHeR communities.

项目概要/摘要我们的多元化补充提案“解决弱势儿童健康的社会决定因素” 与哮喘”寻求提供 Mfonobong Udoko 医学博士在进行定性方法方面的经验 Udoko 博士将利用我们的 UG3 母体进行评估和管理健康社会决定因素 (SDOH) 的研究。拨款用于评估 SDOH 对低收入社区 5 至 12 岁哮喘儿童的作用。我们正在对高风险人群和社区应用基于社区的参与方法，以将我们科罗拉多州校本哮喘计划（Col- SBAP）可减少哮喘发作和旷课，同时还解决我们的 SDOH 问题试点被确定为哮喘差异的主要驱动因素我们的传播试验将包括两项干预措施：基于证据的 Col-SBAP 和关键 SDOH 的方法这种两步级别的干预称为“停止”。哮喘发作 (SAA) 旨在由学校哮喘导航员和学校护士可持续提供服务他们与初级保健和社区资源进行协调与我们的社区利益相关者合作，探索、准备、实施、维持 (EPIS) D&I 框架在 UG3 规划阶段迭代调整我们当前的实施指南以适应量身定制的实施计划满足当地社区和特定地点的需求、资源和优先事项（EPIS 第 1 和 2 阶段）。在哮喘“热点”学校进行 UH3 传播试验，采用随机阶梯楔形研究设计科罗拉多州五个地区的系统，以评估这些学校系统的实施策略（EPIS 第 3 阶段，UH3 试验）并应用 EPIS 第 1-3 阶段的工作来开发“传播手册” 指导其他学校系统未来计划的采用（EPIS 第 4 阶段）。Udoko 博士将获取意见。各利益相关者评估和提供资源以解决 SDOH 问题。为我们的员工制定 DECIPHeR 传播手册，以获取有关 SDOH 的信息，增强他们的能力能够将家庭转介至适当的资源，然后对这些转介采取后续行动。目标将支持我们的 UG3 母基金：补充目标 1a 和 1b 的优点和局限性。 2 种不同的 SDOH 筛查方法 + 多个利益相关者的干预： a) 自我评估护理人员使用打印的调查问卷； b) 导航员根据调查问卷对护理人员进行访谈。补充目标 1c。在利益相关者群体中，确定当前 SDOH 筛查的特征 + Udoko 博士的干预将为成功管理 SDOH 需求提供重要帮助。信息作为我们的 DECIPHeR“传播手册”的配套材料，介绍获取信息的方法 SDOH 并将家庭与适当的资源联系起来，确保他们的后续行动，并改善沟通在我们的家长资助 DECIPheR 社区内。