Development of a Healthcare Navigation Intervention

医疗保健导航干预措施的开发

• 批准号: 9279214
• 负责人: Katherine M Yun
• 金额: $ 12.63万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9279214
• 关键词: Address; Anthropology; Area; Attention; Award; Bhutanese; Biometry; Career Mobility; Caring; Characteristics; Child; Child Care; Child health care; Childhood; Chronic; Communities; Community Developments; Community Health Aides; Competence; Complex; Data; Development; Discipline; Doctor of Philosophy; Eligibility Determination; Emergency Care; Enrollment; Evidence based intervention; Familiarity; Family; Funding; Future; Goals; Health; Health Services Accessibility; Health Services Research; Health system; Healthcare; Home environment; Immigrant; Individual; Insurance; Intervention; Interview; Investigation; Learning; Limited English Proficiency; Low income; Measurement; Measures; Medicaid; Medical; Mentored Patient-Oriented Research Career Development Award; Mentors; Methodology; Methods; Parents; Pediatric Hospitals; Pediatrics; Phase; Philadelphia; Population; Preventive care; Program Development; Protocols documentation; Psychometrics; Public Health; Qualitative Methods; Qualitative Research; Reading; Refugees; Reporting; Research; Research Ethics; Research Methodology; Research Personnel; Risk; Sampling; Scientist; Screening for cancer; Self Management; Services; Standardization; Surveys; Symptoms; Training; Training Programs; Trauma; United States National Institutes of Health; Work; arm; base; bilingualism; career development; comparative; control trial; experience; glycemic control; health care availability; health disparity; health service use; improved; informant; insight; instrument; member; multidisciplinary; pediatric department; professor; programs; public health relevance; skills; social; success

 DESCRIPTION (provided by applicant): This 4-year award supports career development and mentored research experience for Katherine Yun, MD MHS, a clinician-scientist focusing on health disparities and access to care for children in refugee and immigrant families, including children with special healthcare needs (SHCN). Through the K23 award, Dr. Yun will gain advanced training in qualitative research and research ethics, and she will expand her skills to include health measurement and the development of community-based interventions. This training will serve as the basis for future, large-scale interventions to promote the health of children in refugee and immigrant families. Dr. Yun proposes a comprehensive research program with the Bhutanese refugee community in Philadelphia that will allow for future comparative work across immigrant populations. The proposed research will empirically define, measure, and develop an intervention to promote healthcare navigation, meaning the skills and strategies used by parents to realize access to pediatric healthcare. Aim 1 uses the New Immigrant Survey and National Survey of Children's Health to identify parental characteristics associated with realized access to care in order to develop a purposive sampling plan for Aim 2. Aim 2 uses multiple qualitative methods to build a conceptual framework for healthcare navigation, using parents in the Bhutanese refugee community as key informants. Aim 3 uses the conceptual framework to build and evaluate an instrument to measure healthcare navigation competency and to identify areas for support to improve individuals' ability to use health services. Aim 4 uses mixed methods to adapt, pilot, and evaluate a single-arm community health worker intervention to promote mastery of these skills. The conceptual framework created in Aim 2 will be used to adapt the intervention protocol, and data on feasibility, acceptability, and effect sizes will be used to refine the intervention and power a future controlled trial. This work has the potential to impact the 30,000 children who enter the US as refugees each year; it also has significance for the 1.2 million publicly-insured, US children in immigrant families who have SHCN and continue to report difficulties obtaining necessary care. Dr. Yun is a junior investigator and Assistant Professor of Pediatrics with training in health services research, extensive experience with healthcare for refugee and immigrant children in the US, and existing partnerships with Philadelphia's Bhutanese community. She has assembled a multidisciplinary team of mentors and advisors led by David Rubin, MD MSCE (primary mentor), Frances Barg, PhD MEd (co-mentor), [and Leela Kuikel, MA (community co-mentor)]. Her career development program will include coursework; [a 1-year, NIH- supported mixed methods research training program;] directed reading; and mentored practical experience in methodologies from the disciplines of medical anthropology, biostatistics, psychometrics, and public health. The Division of General Pediatrics, the Department of Pediatrics, and the Children's Hospital of Philadelphia are committed to her success and the advancement of her career.

 描述（由申请人提供）：这个为期 4 年的奖项支持 Katherine Yun（医学博士、MHS）的职业发展和指导研究经验，她是一位临床医生科学家，专注于难民和移民家庭儿童的健康差异和获得护理的机会，包括患有特殊疾病的儿童通过 K23 奖项，云博士将获得定性研究和研究伦理方面的高级培训，她将扩展自己的技能，包括健康测量和基于社区的干预措施的开发。云博士提议与费城的不丹难民社区合作开展一项全面的研究计划，以便未来对移民人群进行比较工作。将根据经验定义、衡量和制定一项干预措施，以促进医疗保健导航，这意味着父母为实现儿科医疗保健而使用的技能和策略使用新移民调查和全国儿童健康调查来确定与实现相关的父母特征。获得护理以发展目标 2 的有目的抽样计划。目标 2 使用多种定性方法构建医疗保健导航的概念框架，以不丹难民社区的父母作为关键信息提供者，目标 3 使用概念框架构建和评估衡量医疗保健导航的工具。目标 4 使用混合方法来调整、试点和评估单臂社区卫生工作者干预措施，以促进对这些技能的掌握。 2 将用于调整干预方案，有关可行性、可接受性和效果大小的数据将用于完善干预措施并为未来的对照试验提供动力。这项工作有可能影响 30,000 名作为难民进入美国的儿童。每年，它对于 120 万患有 SHCN 的美国移民家庭儿童也具有重要意义，这些儿童继续报告难以获得必要的护理。 Yun 博士是一名初级研究员和儿科助理教授，接受过卫生服务研究培训。 ,她在美国难民和移民儿童医疗保健方面拥有丰富的经验，并与费城不丹社区建立了合作伙伴关系。她组建了一支由医学硕士大卫·鲁宾（MD MSCE）（主要导师）、医学博士弗朗西斯·巴尔格（Frances Barg）领导的多学科导师和顾问团队。 -导师），[和Leela Kuikel，MA（社区共同导师）]。她的职业发展计划将包括课程作业；[NIH 支持的为期一年的混合方法研究培训计划；]她在医学人类学、生物统计学、心理测量学和公共卫生等学科的方法学方面积累了实践经验，普通儿科、儿科和费城儿童医院致力于指导她的成功和职业发展。