Helping gEnerations Identify Risks (Heirs) to Health

帮助几代人识别健康风险（继承人）

• 批准号: 9795308
• 负责人: Jennifer E DeVoe
• 金额: $ 39.65万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-01 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9795308
• 关键词: Helping; gEnerations; Identify; Risks; Heirs

Project Summary Preventive and acute healthcare are essential to ensure child health, yet, many children do not receive adequate care. Research shows the factors associated with receipt of healthcare for children are having health insurance coverage and/or a usual source of care and parental factors such as health conditions and health insurance coverage. Additionally, social determinants of health (SDH) (e.g., neighborhood social deprivation, poverty rate, food availability) are likely another burden on families' healthcare utilization, therefore, it is important to take them into account to improve children's receipt of recommended healthcare. The parental and/or SDH factors most strongly associated with children's receipt of recommended care are largely unknown. Further, the pathways between and among these different factors are not clearly defined. Additionally, it is essential to understand parents' perspectives on what prevents receipt of recommended healthcare for their children and what they believe primary care can do to intervene. Without this information, effective interventions to improve children's receipt of recommended healthcare cannot be devised. Therefore, this study aims to examine the relationships between parental factors (i.e., receipt of healthcare, burden of disease), SDH, and children's receipt of recommended healthcare. We will use comprehensive, outpatient primary care electronic health record (EHR) data from OCHIN's (not an acronym) network of community health centers on >2 million patients (n=354,915 children) from 18 states. In addition, we will interview about 30-40 parents to understand the factors facilitating or hindering children's receipt of recommended care. The specific aims are: Aim 1. Identify the parental healthcare and health factors most strongly associated with children's access to and utilization of recommended healthcare. Aim 2. Explore the influence of SDH on family healthcare access and utilization. Aim 3. Discover additional barriers and facilitators of accessing children's recommended healthcare and assess parental beliefs about how primary care could help them overcome these barriers. We will employ a sequential mixed-methods approach to iteratively learn from the qualitative interviews and conduct additional quantitative analyses based on important qualitative insights. Aims 1 and 2 identify EHR-based parental healthcare and health factors and SDH most strongly associated with children's receipt of recommended care, while Aim 3 explores “real-life” parent perceptions of what helps or hinders receipt of recommended care and identifies the barriers that parents believe primary care can intervene on. The proposed work will be the first to understand the complex relationship of parental healthcare and health factors and SDH and children's receipt of recommended healthcare and to identify the barriers that parents believe primary care can intervene on. This formative work will propel potential interventions to improve children's recommended care receipt. We will capitalize on unique data resources that provide information about healthcare and health of vulnerable families.

项目摘要 预防和急性医疗保健对于确保儿童健康至关重要，但是，许多儿童没有接受 足够的护理。研究表明，与儿童获得医疗保健相关的因素是健康 保险范围和/或通常的护理来源和父母因素，例如健康状况和健康 保险范围。此外，卫生的社会决定者（SDH）（例如，社区社会剥夺， 贫困率，粮食利用率）可能是家庭医疗保健利用的另一个燃烧，因此，这是 重要的是要考虑到改善儿童收到建议的医疗保健。父母 和/或SDH因素与儿童收到推荐护理最密切相关的因素很大程度上是 未知。此外，这些不同因素之间和之间的途径尚未明确定义。 此外，必须了解父母对什么防止推荐收到的观点 为孩子的医疗保健以及他们认为初级保健可以干预的事情。没有这些信息， 无法设计有效改善儿童收到建议医疗保健的干预措施。所以， 这项研究旨在检查父母因素之间的关系（即，医疗保健，燃烧 疾病），SDH和儿童收到建议的医疗保健。我们将使用全面的门诊 Ochin（不是首字母缩写）社区健康网络的初级保健电子健康记录（EHR）数据 以18个州的> 200万患者（n = 354,915名儿童）为中心。此外，我们将面试大约30-40 父母了解促进或阻碍儿童收到建议护理的因素。具体 目的是：目标1。确定父母的医疗保健和与儿童最密切相关的健康因素 获得和利用推荐的医疗保健。目标2。探索SDH对家庭的影响 医疗保健访问和利用。目标3。发现进入儿童的其他障碍和促进者 建议医疗保健和评估父母关于如何帮助他们克服的信念 这些障碍。我们将采用连续的混合方法方法来迭代从定性中学习 根据重要的定性见解进行访谈并进行其他定量分析。目标1和2 确定基于EHR的父母医疗保健和健康因素以及与儿童最密切相关的SDH 收到推荐的护理，而AIM 3则探讨了对有助于或阻碍的“现实生活”父母的看法 收到建议的护理，并确定父母认为初级保健可以干预的障碍。 拟议的工作将是第一个了解父母医疗保健与健康的复杂关系的工作 因素，SDH和儿童收到推荐的医疗保健，并确定父母的障碍 相信初级保健可以进行干预。这项形成性的工作将推动潜在的干预措施以改善 儿童推荐的护理收据。我们将利用提供信息的独特数据资源 关于弱势家庭的医疗保健和健康。