Disseminating a Model Intervention to Promote Improved ADHD Care in the Community

传播模型干预措施以促进改善社区多动症护理

基本信息

批准号：
7623427
负责人：
JEFF N. EPSTEIN
金额：
$ 16.88万
依托单位：
CINCINNATI CHILDRENS HOSP MED CTR
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-06-01 至 2011-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7623427
关键词：
Academic Detailing Academy Address Adoption Affect American Area Attention deficit hyperactivity disorder Attitude Behavior Behavior Disorders Caring Child Childhood Communities Consensus Consumer Satisfaction Control Groups Country Data Collection Development Disease Distal Effectiveness Evidence based intervention Evidence based practice Evidence based treatment Failure Funding Mechanisms Geographic Locations Goals Guidelines Internet Intervention Medical center Mental Health Mental Health Services Mental disorders Methodology Methods Modeling Modification NIH Program Announcements National Health Policy Online Systems Outcome Patients Pediatric Hospitals Pediatrics Physicians Policies Procedures Provider Public Health Questionnaires Randomized Randomized Controlled Clinical Trials Recommendation Recruitment Activity Reliance Research Research Design Rewards Risk Rural Science Services Speed System Techniques Testing Time Training Treatment outcome Videoconferences Videoconferencing Waiting Lists base clinical practice community based practice community setting cost design effective intervention evidence base evidence based guidelines falls high risk implementation research improved innovation intervention program pediatrician programs public health relevance research based treatment satisfaction service intervention success telehealth treatment as usual

项目摘要

DESCRIPTION (provided by applicant): The American Academy of Pediatrics (AAP) has established a set of consensus guidelines for pediatricians to follow. These guidelines can be challenging to implement in typical community-based practices. Cincinnati Children's Hospital Medical Center (CCHMC) has developed a program called the ADHD Collaborative to promote the adoption of these guidelines among community pediatricians. The program focuses on modifying the office system using academic detailing and quality improvement (QI) methodology to accommodate prescribed practice changes. The ADHD Collaborative has been very successful at recruiting practices in the Greater Cincinnati area, changing practice behaviors, and sustaining these practice behaviors over time at minimal cost to the project and to the office practice. Now that sustainability and effectiveness have been established, the next step is to modify the ADHD Collaborative model to make it amenable to widespread dissemination. The primary goal of the proposed study is to modify the ADHD Collaborative intervention to make it transportable and then evaluate this version in terms of effectiveness, consumer satisfaction, and costs.. A transportable intervention is described that utilizes telehealth videoconferencing, a web portal, and long-distance data collection. Initially, three pediatric practices will be recruited to test and refine the distal intervention delivery methodology. Then, eight new pediatric practices will be randomly assigned to receive the distal intervention or to a control group (treatment as usual). Information about pediatric practice behavior will be collected at baseline, 6-months, and 1-year post- baseline. The study design will allow for a preliminary assessment of the feasibility and effectiveness of the distal intervention in terms of rates of evidence-based practice behaviors to patients, change in pediatrician attitudes, consumer satisfaction, and costs. Significance: The proposed research has high public health significance since it addresses a core issue in community mental health delivery, the promotion of evidence-based care to children. This research proposes an innovative set of intervention techniques that will allow the delivery of an effective intervention model to a greater number and more geographically diverse set of pediatric practices than is currently feasible using existing methods. PUBLIC HEALTH RELEVANCE: A quality improvement program has been developed and tested by the PI that promotes the adoption of evidence-based practices among community pediatricians. The program focuses on modifying the office system using academic detailing and quality improvement (QI) methodology to accommodate prescribed physician practice changes. Modes of disseminating this tested intervention to a geographically diverse audience will be evaluated by the proposed research.

描述（由申请人提供）：美国儿科学会（AAP）已建立了一系列共识指南，供儿科医生遵循。这些准则在典型的基于社区的实践中实施可能具有挑战性。辛辛那提儿童医院医疗中心（CCHMC）开发了一项名为ADHD合作的计划，以促进在社区儿科医生中采用这些准则。该计划的重点是使用学术细节和质量改进（QI）方法来修改办公系统，以适应规定的实践更改。多动症的合作组织在更大的辛辛那提地区招募实践，改变了实践行为，并以最低的成本和办公室的实践来维持这些实践行为。既然已经建立了可持续性和有效性，下一步是修改多动症协作模型，以使其适合广泛传播。拟议的研究的主要目的是修改ADHD协作干预措施，以使其可运输，然后根据有效性，消费者满意度和成本评估此版本。.描述了一项可运输干预措施，它利用远程医疗视频会议，网站门户网站和长距离数据收集。最初，将招募三种儿科实践来测试和完善远端干预措施。然后，将随机分配八种新的儿科实践，以接受远端干预或对照组（照常治疗）。有关小儿实践行为的信息将在基线，6个月和基线后1年收集。研究设计将允许对远端干预的可行性和有效性进行初步评估，以对患者的循证实践行为率，儿科态度的变化，消费者满意度和成本的变化。意义：拟议的研究具有很高的公共卫生意义，因为它解决了社区心理健康提供的核心问题，促进对儿童的循证护理。这项研究提出了一套创新的干预技术，该技术将使有效的干预模型交付到比目前可行的可行数量的儿科实践数量更大，地理上多样化的小儿实践集。公共卫生相关性：PI已制定和测试了一项质量改进计划，该计划促进了社区儿科医生在社区儿科医生中采用基于证据的实践。该计划着重于使用学术细节和质量改进（QI）方法来修改办公系统，以适应规定的医师实践的更改。拟议的研究将评估将这种测试干预措施传播给地理上不同受众的模式。