Trauma-Informed Obstetric Care: Development and Implementation of a Stakeholder-Informed Toolkit for Obstetric Providers and Patients

创伤知情的产科护理：为产科提供者和患者开发和实施利益相关者知情的工具包

基本信息

批准号：
10524815
负责人：
Laura G Ward
金额：
$ 16.12万
依托单位：
MIRIAM HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-01 至 2027-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10524815
关键词：
Address Adherence Administrator Adopted Adoption American College of Obstetricians and Gynecologists Anxiety Appointment Attitude Behavior Therapy Behavioral Medicine Birth Breast Feeding Caring Cervical Clinic Clinical Collaborations Communities Computerized Medical Record Data Development Discipline of obstetrics Disclosure Discrimination Distress Educational workshop Elements Ensure Environment Environmental Risk Factor Evidence based intervention Feeling Feeling suicidal Foundations Fright Funding Future Goals Health Healthcare Hospitals Individual Infant Infant Health Intervention Interview Mental Health Mentored Patient-Oriented Research Career Development Award Mentorship Methodology Methods National Institute of Child Health and Human Development Nurse Administrator Nurses Outcome Outpatients Patient Education Patients Pelvic Pain Perception Perinatal Perinatal Care Perinatology Personal Satisfaction Physicians Population Post-Traumatic Stress Disorders Postpartum Period Pregnancy Pregnancy Complications Pregnant Women Premature Labor Prenatal care Procedures Process Proctor framework Protocols documentation Provider Qualitative Research Randomized Controlled Trials Recommendation Recording of previous events Replicating Effective Programs Reporting Research Research Methodology Research Personnel Resources Risk Safety Scientist Screening procedure Service setting Stress Substance abuse problem Survivors Testing Time Training Training Support Trauma Treatment Protocols United States Substance Abuse and Mental Health Services Administration Universities Violence Woman Women&apos s Health base career child bearing clinical encounter cost effective effectiveness implementation study effectiveness implementation trial evidence base experience formative assessment health administration high risk implementation evaluation implementation framework implementation outcomes implementation science implementation strategy implementation trial improved innovation knowledge base novel obstetric care perinatal mental health perinatal outcomes peripartum depression pilot test pilot trial postpartum care preference pregnancy hypertension pregnant premature professor provider factors psychological trauma resilience response scale up screening skills therapy development tool trauma care women of color working group

项目摘要

PROJECT SUMMARY/ABSTRACT Many pregnant women have experienced trauma, which can make perinatal care stressful and increase the risk of pregnancy-related health conditions. However, obstetric providers can modify procedures to reduce distress and enhance patients’ sense of control and safety. Although obstetric providers frequently care for trauma survivors, most are not trained in trauma-informed care (TIC). Additionally, there are no data on feasibility, appropriateness, or acceptability of TIC tools and interventions in the context of obstetrics. The goal of the proposed K23 project is to develop the first, stakeholder-informed obstetric TIC toolkit composed of treatment protocols, clinician training, trauma and violence screening tools, and other resources to help obstetric providers apply TIC practices to all clinical interactions in addition to identifying and providing support for trauma survivors. The obstetric TIC intervention toolkit (OB-TIC) will be developed in collaboration with key stakeholders (pregnant and postpartum patients, nurses, physicians, and administrators) to ensure that it is feasible, acceptable, appropriate, cost-effective, and clinically useful. Current practices and preferences will be characterized in qualitative interviews with stakeholders which will inform the development of OB-TIC in collaboration with a community working group of stakeholders. A pilot implementation trial of OB-TIC will be conducted in two outpatient obstetrics clinics to gather real-world data that will inform the final intervention toolkit, which will be tested on a larger scale in future (R01) studies. The K23 award will facilitate the candidate’s transition towards an independent research career focused on improving the well-being of women through trauma-informed perinatal healthcare and implementation science, which is directly in line with the NICHD pregnancy and perinatology priority of “improving the health of women before, during, and after pregnancy.” To date, the candidate’s training has focused on developing clinical expertise in perinatal behavioral medicine, and research experience in obstetrics, perinatal stress, and behavioral interventions for stress and discrimination. The K23 award will provide protected time for training in 1) implementation science methodology focused on the development of stakeholder informed interventions and scale-up and spread of evidence-based interventions; 2) qualitative research methodology, a foundational component of implementation science and stakeholder-based intervention development; 3) and trauma-informed care in obstetrics, which will provide a knowledge base for OB-TIC. Experts in each of the key training domains will provide individual mentorship in addition to specialized workshops and didactics. During the proposed K23 award, the candidate will be a Research Scientist at The Miriam Hospital and an Assistant Professor at Brown University. This environment is rich with innovation and collaboration and will enhance the candidate’s training and facilitate their research goals. The mentorship and skills gained as part of this K23 award, will prepare the candidate to pursue funding for an R01 focused on a randomized controlled trial of OB-TIC.

项目概要/摘要许多孕妇经历过创伤，这可能会给围产期护理带来压力，并增加然而，产科提供者可以修改程序以减少与妊娠相关的健康状况的风险。尽管产科医生经常护理，但仍会减轻患者的痛苦并增强患者的控制感和安全感。创伤幸存者中，大多数人没有接受过创伤知情护理 (TIC) 培训。此外，没有相关数据。产科背景下 TIC 工具和干预措施的可行性、适当性或可接受性。拟议的 K23 项目的目的是开发第一个利益相关者知情的产科 TIC 工具包，其中包括治疗方案、临床医生培训、创伤和暴力筛查工具以及其他提供帮助的资源除了识别和提供支持之外，产科服务提供者还将 TIC 实践应用于所有临床互动将与关键人员合作开发针对创伤幸存者的产科 TIC 干预工具包 (OB-TIC)。利益相关者（孕妇和产后患者、护士、医生和管理人员），以确保当前的实践和偏好将是可行的、可接受的、适当的、具有成本效益的和临床有用的。与利益相关者进行定性访谈，这将为 OB-TIC 的发展提供信息将与利益相关者社区工作组合作进行 OB-TIC 试点实施试验。在两个产科门诊进行，收集真实世界数据，为最终干预提供信息 K23 奖将在未来的研究中进行更大规模的测试。候选人向专注于改善妇女福祉的独立研究职业过渡通过创伤知情的围产期保健和实施科学，这直接符合 NICHD 妊娠和围产期重点是“改善妇女产前、产中和产后的健康” 迄今为止，候选人的培训重点是培养围产期临床专业知识。行为医学，以及产科、围产期应激和行为干预方面的研究经验 K23 奖将为以下方面的培训提供受保护的时间：1) 科学实施。方法侧重于制定利益相关者知情的干预措施以及扩大和传播基于证据的干预措施；2）定性研究方法，这是实施科学和基于利益相关者的干预措施发展；3) 和创伤知情护理；产科，将为每个关键培训领域的 OB-TIC 专家提供知识库。在拟议的 K23 期间，除了专业研讨会和教学之外，还提供个人指导。奖项，候选人将是米里亚姆医院的研究科学家和布朗大学的助理教授大学的环境充满创新和协作，将加强候选人的培训。并促进他们的研究目标，作为 K23 奖项的一部分获得的指导和技能将为他们的研究做好准备。为专注于 OB-TIC 随机对照试验的 R01 寻求资金的候选人。