Evaluating a mobile health tool to improve management of pediatric acute respiratory illness in Uganda

评估移动医疗工具以改善乌干达儿科急性呼吸道疾病的管理

基本信息

批准号：
10704533
负责人：
Laura E Ellington
金额：
$ 18.49万
依托单位：
UNIVERSITY OF WASHINGTON
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：
2022-09-15 至 2027-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10704533
关键词：
Active Learning Acute Address Adherence Adoption Africa South of the Sahara Antibiotics Asthma Breathing Bronchiolitis Bronchodilator Agents Case Management Categories Cessation of life Chest Child Childhood Chronic Disease Clinical effectiveness Collaborations Community Health Aides Complex Consolidated Framework for Implementation Research Coughing Data Development Plans Diagnosis Disease Education Effectiveness Environment Epidemiology Evaluation Feasibility Studies Focus Groups Goals Grant Guideline Adherence Guidelines Health Impact evaluation Information Sciences Infrastructure Integrated Health Care Systems International Interruption Intervention Interview Leadership Life Lung Maps Master of Science Measures Mentored Clinical Scientist Development Program Mentorship Methods Morbidity - disease rate National Heart, Lung, and Blood Institute Outcome Outcome Assessment Outcome Measure Penetration Physicians Pneumonia Pragmatic clinical trial Prevention strategy Process Public Health Public Health Schools Quasi-experiment Recommendation Research Research Activity Research Personnel Resource-limited setting Resources Running Series Surveys Symptoms Systems Integration Testing Time Training Training Activity Triage Uganda Universities Washington Wheezing World Health Organization aged care delivery career development clinical care clinical decision support college cost design evidence base experience global health implementation determinants implementation facilitation implementation outcomes implementation research implementation science implementation strategy improved improved outcome low and middle-income countries mHealth medical schools mortality participant retention pediatric health outcomes pilot test point of care pragmatic trial preference primary outcome prototype respiratory skills smartphone application support tools tool treatment strategy trial design usability

项目摘要

Candidate: Dr. Ellington is a pediatric pulmonologist at the University of Washington (UW) and K12 UW-Implementation Science Training Grant recipient (NHLBI). She completed a Master of Science in Epidemiology at the UW School of Public Health and has a long-term track record of successful global health research. Dr. Ellington’s long-term goal is to become an independent physician-investigator working to improve health outcomes of pediatric respiratory conditions in resource-constrained settings. Her career development plan includes coursework, experiential learning, and mentorship to achieve training goals in 1) complex qualitative and mixed methods, 2) pragmatic clinical trials and quasi- experimental studies, 3) advanced implementation science, and 4) global health leadership. Environment: The proposed training and research activities will be facilitated by existing strong international collaborations, resources, infrastructure, and academically rigorous environments of the UW Schools of Medicine and Public Health and the Makerere University Lung Institute and College of Computing & Information Science. Research: Acute lower respiratory illnesses (ALRI) are a leading cause of childhood mortality in children under 5 years, despite effective prevention and treatment strategies. The majority of deaths occur in sub-Saharan Africa. Major challenges in case management exist in low- and middle-income countries (LMICs), including poor adherence to ALRI guidelines, lack of health worker training, and lack of decision support to recognize wheezing illnesses (asthma and bronchiolitis), which represent up to 50% of ALRI in children. Acute Lower Respiratory Illness Treatment Evaluation (ALRITE) is a comprehensive guideline- and evidence-based ALRI clinical decision support mobile health tool Dr. Ellington developed with her team. ALRITE has demonstrated preliminary acceptability and usability in Ugandan health centers but requires optimization for health system integration and pilot-testing in clinical care. Dr. Ellington proposes a feasibility study in 4 Ugandan health centers to 1) identify promising implementation strategies for the ALRITE intervention to optimize implementation, 2) pilot-test study feasibility of the ALRITE tool and its effectiveness for diagnosis and management of wheezing illness and pneumonia in children 1-59 months using an interrupted time series design, and 3) assess the outcomes of implementation following ALRITE deployment and barriers/facilitators of ALRITE use. Successful completion of these aims will improve implementation of decision support tools in Uganda and other LMICs, provide critical preliminary data to support Dr. Ellington’s planned R01 for a cluster RCT evaluating clinical effectiveness of the ALRITE intervention in LMICs, and provide Dr. Ellington with the training and experience needed to transition to research independence.

候选人：Ellington 博士是华盛顿大学 (UW) 和 K12 的儿科肺科医生她获得了威斯康星大学实施科学培训补助金 (NHLBI) 的理学硕士学位。华盛顿大学公共卫生学院流行病学专业，在全球范围内取得成功的长期记录艾灵顿博士的长期目标是成为一名独立的医生研究员。致力于改善资源有限环境中儿科呼吸系统疾病的健康结果。她的职业发展计划包括课程作业、体验式学习和指导，以实现培训目标 1) 复杂的定性和混合方法，2) 实用的临床试验和准实验研究，3) 先进的实施科学，4) 全球卫生领导力。环境：拟议的培训和研究活动将由现有的强大的国际合作、资源、基础设施和严谨的学术环境威斯康星大学医学与公共卫生学院和麦克雷雷大学肺脏研究所和学院计算与信息科学研究：急性下呼吸道疾病 (ALRI) 是一个领先的领域。尽管预防和治疗有效，但仍导致 5 岁以下儿童死亡大多数死亡发生在撒哈拉以南非洲地区。低收入和中等收入国家 (LMIC) 中存在这些问题，包括对 ALRI 指南的遵守情况不佳、缺乏卫生工作者培训不足，缺乏识别喘息疾病（哮喘和哮喘）的决策支持细支气管炎），占儿童急性下呼吸道疾病治疗的 50%。评估 (ALRITE) 是一项全面的基于指南和证据的 ALRI 临床决策支持 Ellington 博士与她的团队开发的移动健康工具 ALRITE 已进行了初步展示。乌干达卫生中心的可接受性和可用性，但需要优化卫生系统 Ellington 博士提议在乌干达开展一项可行性研究。卫生中心 1) 确定有前景的 ALRITE 干预实施策略，以优化实施，2) ALRITE 工具的可行性及其诊断和有效性的试点研究使用中断时间管理 1-59 个月儿童的喘息疾病和肺炎系列设计，3) 评估 ALRITE 部署后的实施结果成功完成这些目标将改善 ALRITE 使用的障碍/促进因素。乌干达和其他中低收入国家的决策支持工具提供了关键的初步数据来支持博士。 Ellington 计划进行 R01 集群随机对照试验，评估 ALRITE 干预的临床效果中低收入国家，并为艾灵顿博士提供过渡到研究所需的培训和经验独立。