Transforming Hospitalizations of Autistic Adolescents via a Novel ABA Telehealth Platform

通过新型 ABA 远程医疗平台改变自闭症青少年的住院治疗

• 批准号: 10760972
• 负责人: Ronald Oberleitner
• 金额: $ 74.08万
• 依托单位: CARING TECHNOLOGIES, INC.
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-05 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10760972
• 关键词: Adoption; Behavior; Behavioral; Caregivers; Caring; Child; Clinical; Communication; Communities; Cost Analysis; Custom; Data; Evaluation; Family; Feedback; Geographic Locations; Guidelines; Health Insurance Portability and Accountability Act; Health system; Home; Hospitalization; Hospitals; Human; Hybrids; Instruction; Insurance Claim Review; Intelligence; Intervention; Length; Measures; Mediating; Medical; Medical Staff; Medicine; Outcome; Parents; Patients; Pattern; Persons; Phase; Positioning Attribute; Process; Provider; Report (document); Research; Resource-limited setting; Resources; Sampling; Schools; Security; Sedation procedure; Services; Structure; System; Technology; Testing; Time; Videoconferencing; Work; adolescent with autism spectrum disorder; applied behavior analysis; autistic children; care providers; care systems; clinical decision support; commercialization; design; digital health; experience; feasibility testing; hospital care; hospital readmission; improved; individuals with autism spectrum disorder; innovation; novel; prototype; recruit; restraint; satisfaction; skills; success; support tools; telehealth; telehealth systems; trend; usability

PROJECT SUMMARY There is an increasing trend for children with ASD with primary behavioral challenges to be hospitalized in medical facilities because accessible behavioral support resources are not available in local communities. Unfortunately, most community-based hospitals are not well equipped to meet optimal behavioral care with families consequently experiencing prolonged/protracted hospitalizations where behaviors may not be adequately treated and could potentially worsen. Further, the specific inability to adequately respond to challenging behaviors may limit the ability of children to be accepted into step-down facilities or return home safely and contribute to extremely stressful aspects of care. Prolonged hospitalizations also result in significant negative financial return for hospitals (un/under-reimbursement). In prior work, deploying a specialized brief Applied Behavioral Analysis (ABA) assessment and intervention explicitly designed for use during hospitalizations demonstrated improvements in challenging behaviors, decreases in restraint and staffing, and high levels of family satisfaction. Unfortunately, community access to this type of intervention is extremely limited by geographic location and provider availability. Appropriate telehealth and digital health systems that can facilitate tele-mediated support may hold great potential for increasing the availability of such care to children, families, and the providers and hospitals responsible for their care. While many technologies for real- time video conferencing are available (e.g. zoom), in order to be able to accurately support understanding of precursors and the context of key behaviors technologies capable of supporting intelligent surveillance, data- flagging, and efficient communication of key behaviors across human support teams (both expert and non- expert) over substantial periods of time (including when experts are not present) are needed to enable meaningful telemediated ABA service. The current project creates and tests the potential clinical value of an innovative telehealth platform to facilitate appropriate, efficacious ABA tele-assessment and intervention for adolescents with ASD displaying challenging behaviors during hospitalizations and post-discharge transition. In the first phase of this work, we propose co-design of the novel system with key stakeholders and feasibility testing to demonstrate both technical capacity and potential clinical value. In the second phase of this work, we hone the systems commercial value and conduct a rigorous trial to demonstrate clinical utility and financial return for children, families, systems of care, and payers.

项目摘要 对于ASD患有主要行为挑战的儿童的趋势越来越多。 医疗设施是因为当地社区无法获得可访问的行为支持资源。 不幸的是，大多数基于社区的医院都没有能力满足最佳行为护理 因此，家庭经历了行为可能不是行为的延长/旷日持久的住院 经过充分的治疗，可能会恶化。此外，具体无法充分回应 具有挑战性的行为可能会限制儿童被接受为迈出的设施或返回家园的能力 安全并有助于极大的护理方面。长时间住院也导致了重大 医院的财务回报负（未偿还/减少）。在先前的工作中，部署专门的摘要 应用行为分析（ABA）评估和干预明确设计用于使用 住院表明，挑战行为的改善，约束和人员配备的减少以及 高水平的家庭满意度。不幸的是，社区访问这种干预非常 受地理位置和提供商的可用性限制。适当的远程医疗和数字卫生系统 可以促进推出介导的支持可能具有增加此类护理的巨大潜力 儿童，家庭以及提供者和医院负责他们的护理。而许多用于实现的技术 可以使用时间视频会议（例如Zoom），以便能够准确地支持对 前体和关键行为的上下文，能够支持智能监视，数据 - 在人类支持团队中进行标记和有效的关键行为沟通（专家和非专家 专家）在很长一段时间内（包括不存在专家）来启用 有意义的征服ABA服务。当前的项目创建并测试了一个潜在的临床价值 创新的远程医疗平台，以促进适当，有效的ABA电视和干预措施 ASD的青少年在住院期间表现出具有挑战性的行为和分期过渡后。 在这项工作的第一阶段，我们提出了与关键利益相关者和可行性的新型系统的共同设计 测试以证明技术能力和潜在的临床价值。在这项工作的第二阶段， 我们磨练系统的商业价值并进行严格的试验以证明临床公用事业和财务 儿童，家庭，护理系统和付款人的回报。