Virtual Family-Centered Rounds to Improve Health and Quality of Life Outcomes for Neonates and their Caregivers

以家庭为中心的虚拟查房，以改善新生儿及其护理人员的健康和生活质量

• 批准号: 10708948
• 负责人: Jennifer Rosenthal
• 金额: $ 18.01万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-22 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10708948
• 关键词: 2 arm randomized control trial; Address; Adult; Adverse event; Affect; Anxiety; Award; Caregivers; Caring; Child; Child Care; Child Health; Childhood; Clinical Trials; Control Groups; Critical Illness; Data; Data Collection; Diabetes Mellitus; Dimensions; Distress; Equity; Evaluation; Face; Failure; Family; Family Study; Family health status; Growth; Health; Health Insurance Portability and Accountability Act; Hospitalization; Hospitalized Child; Hospitals; Human Milk; Hybrids; Hypertension; Inequity; Infant; Infrastructure; Intelligence; Intervention; Interview; Length of Stay; Life; Low income; Measures; Mental Depression; Methods; Misinformation; Neonatal; Neonatal Intensive Care Units; Neonatology; Newborn Infant; Nurses; Obesity; Outcome; Outcome Measure; Parents; Patients; Personal Satisfaction; Persons; Phase; Physicians; Population Heterogeneity; Process; Provider; Quality of life; Randomized; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Reporting; Research; Risk; Rural; SF-36; Sample Size; Secure; Sepsis; Site; Speed; Statistical Data Interpretation; Surveys; Technology; Testing; Time; Translations; Travel; Trust; Work; arm; biomedical referral center; care delivery; cognitive development; design; efficacy evaluation; efficacy trial; experience; feeding; group intervention; health related quality of life; implementation/effectiveness; improved; innovation; lower income families; multi-site trial; multidisciplinary; neonatal health; neonatal outcome; neonate; pilot test; pilot trial; population based; post-traumatic stress; prevent; primary outcome; programs; psychologic; randomized trial; shared decision making; standard of care; telehealth; treatment arm; trial comparing; virtual; virtual assessment

PROJECT SUMMARY / ABSTRACT The project objective is to improve neonatal and family health and quality of life outcomes by optimizing family- centered rounds (FCR) for parents or guardians (“parents” hereafter). This award provides the necessary support to conduct a virtual FCR trial to (1) determine efficacy of the virtual FCR intervention and (2) understand the factors affecting the implementation and impact of the intervention. Our research team has expertise encompassing telehealth implementation and evaluation, clinical trials, stakeholder engagement, mixed methods, neonatology, and advanced statistical analyses. The focus of this project is the study of FCR in the neonatal intensive care unit (NICU). FCR is recognized as a best practice for hospitalized children. Benefits of FCR include fewer harmful errors, improved family experience, reduced parental anxiety, and shortened hospital stays. However, FCR is infrequently conducted in the NICU, because it is only possible when parents can be at the bedside during the rounding process. Importantly, the circumstances that prevent parents form being physically present in the NICU (e.g., financial, work, travel, and childcare constraints) disproportionately hinder underserved families, particularly rural and low-income families. Telehealth use to conduct virtual FCR has potential to mitigate these problems. Telehealth transforms the rounding paradigm by virtually bringing the parents to the neonate’s bedside, ensuing more opportunities to reconcile misinformation and more collaborative conversations that improve information sharing, shared decision-making, and trust. Although our team has pilot tested virtual FCR, our pilot trial was not powered for hypothesis testing. Additionally, this proposed trial includes additional health and quality of life outcomes. We pursue three Specific Aims: Evaluate the impact of virtual FCR on parental activation and wellbeing (AIM 1) and neonatal outcomes (AIM 2). Conduct a mixed methods evaluation of the virtual FCR intervention (AIM 3). This project utilizes existing UC Davis telehealth program infrastructure. Outcomes include FCR parent attendance, parent experience, parent activation, parent distress, parent health-related quality of life, breast milk feeding, growth failure, adverse events and errors, and length of stay. By accomplishing these aims, we will advance the delivery of an innovative telehealth solution to improve the health and quality of life of children and their families. Our telehealth solution is a strategy that allows FCR to actually be family-centered; our intervention acknowledges the barriers parents face to engage in care and provides them with an alternative way to join rounds. Standard FCR does not equitably allow diverse populations to engage in their child’s care, and virtual FCR has potential to address this inequity. Completion of this proposal will provide essential data that will be used in an R01 application to conduct a multi-site pragmatic virtual FCR trial.

项目摘要 /摘要 该项目的目标是通过优化家庭来改善新生儿和家庭健康以及生活质量 - 为父母或监护人（以下称为“父母”）的集中回合（FCR）。该奖项提供了必要的 支持进行虚拟FCR试验以（1）确定虚拟FCR干预的效率和（2） 了解影响干预的实施和影响的因素。我们的研究团队有 专业知识包括远程医疗实施和评估，临床试验，利益相关者参与， 混合方法，新生儿学和高级统计分析。 该项目的重点是对新生儿重症监护病房（NICU）中FCR的研究。 FCR被认为是 住院儿童的最佳实践。 FCR的好处包括更少的有害错误，改善家庭 经验，降低父母的焦虑并缩短住院。但是，FCR很少进行 在NICU中，因为只有在父母在圆形过程中才有可能在床边。 重要的是，防止父母形式在NICU中出现的情况（例如，财务， 工作，旅行和育儿约束）不成比例地阻碍了服务不足的家庭，尤其是农村和 低收入家庭。 远程医疗用于进行虚拟FCR有可能减轻这些问题。远程医疗改变了 通过实际上将父母带到新生儿的床边来解决范式，从而获得更多机会 调和错误信息和更多协作对话，以改善信息共享，共享 决策和信任。尽管我们的团队已经测试了Virtual FCR，但我们的试点审判没有为 假设检验。此外，该建议的试验包括额外的健康和生活质量。 我们购买了三个具体目标：评估虚拟FCR对父母激活和福祉的影响（AIM 1）和新生儿结果（AIM 2）。对虚拟FCR干预进行混合方法评估（目的 3）。该项目利用现有的UC Davis远程医疗计划基础架构。结果包括FCR父母 出勤，家长经验，父母激活，父母遇险，父母健康相关的生活质量，乳房 牛奶喂养，不断增长的失败，不良事件和错误以及住院时间。 通过完成这些目标，我们将推动提供创新的远程医疗解决方案以改进 儿童及其家人的健康和生活质量。我们的远程医疗解决方案是一种允许的策略 FCR实际以家庭为中心；我们的干预承认父母面临照顾的障碍 并为他们提供另一种加入回合的方式。标准FCR不同样允许潜水员 人群从事孩子的照顾，虚拟FCR有可能解决这种不平等。完成 该提案将提供必不可少的数据，该数据将在R01应用中使用以进行多站点务实 虚拟FCR试验。