Development and Implementation of Optimal Rehabilitation Care Pathways to Reduce Disparities in Rehabilitation Outcomes after Joint Replacement

制定和实施最佳康复护理途径，以减少关节置换后康复结果的差异

• 批准号: 10722471
• 负责人: Allyn M Bove
• 金额: $ 13.8万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-25 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10722471
• 关键词: Acute; Address; Adherence; Administrator; Adoption; Affect; Area; Black race; Caring; Clinical Practice Guideline; Clinical Services; Collaborations; Communities; Control Groups; Data; Degenerative polyarthritis; Development; Disparity; Effectiveness; Equity; Evidence based practice; Focus Groups; Foundations; Funding; Future; Glean; Goals; Grant; Health; Health Sciences; Health Services; Health Services Research; Health system; Hip region structure; Home; Home Health Agency; Hospitalization; Hospitals; Household; Improve Access; Income; Individual; Insurance; Insurance Coverage; Intervention; Interview; K-Series Research Career Programs; Knee; Knowledge; Low income; Medicaid; Mentored Clinical Scientist Development Program; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methods; Musculoskeletal; National Institute on Minority Health and Health Disparities; Operative Surgical Procedures; Orthopedic Surgery; Outcome; Outcome Measure; Outpatients; Pain; Pathway interactions; Patient-Focused Outcomes; Patients; Patterns of Care; Phase; Physical Function; Physical therapy; Population; Positioning Attribute; Preparation; Provider; Qualitative Research; Quality of Care; Quality of life; Race; Recovery of Function; Rehabilitation Centers; Rehabilitation Outcome; Rehabilitation therapy; Replacement Arthroplasty; Reporting; Research; Research Methodology; Research Personnel; Research Project Grants; Sampling; Schools; Scientist; Structure; Surgeon; System; Testing; Time; Training; United States; Universities; Work; black patient; design; disparity reduction; effectiveness/implementation trial; evidence base; functional outcomes; health care disparity; health care settings; health disparity; health equity; hip replacement arthroplasty; implementation science; improved; improved outcome; income disparities; interest; knee replacement arthroplasty; novel; outcome disparities; pilot test; professor; racial disparity; rehabilitation science; rehabilitation service; rehabilitative care; sociodemographic disparity; systematic review

PROJECT SUMMARY/ABSTRACT This NIMHD Mentored Research Scientist Career Development Award (K23) for Dr. Allyn Bove, an Assistant Professor of Physical Therapy at the University of Pittsburgh School of Health and Rehabilitation Sciences, will establish Dr. Bove as an independent health equity investigator with expertise in health disparities in musculoskeletal rehabilitation and use of implementation science methods to trial strategies to mitigate disparities. The proposed research aligns with several of NIMHD’s research interests related to clinical and health services research. This multi-level health services research project aligns with NIMHD’s goals to pursue “multilevel interventions” that seek to “increase health equity” and “improve access to or quality of care for populations affected by health disparities”. It also aligns with NIMHD’s pursuit of “research to understand barriers and facilitators to the adoption of and adherence to evidence-based practices and interventions in healthcare settings”. The research proposed in this four-year K23 award will occur in three phases. In the first aim, we will engage with provider and patient partners to identify barriers and facilitators to implementing optimal post-arthroplasty rehabilitation care pathways designed to improve outcomes and mitigate outcomes disparities based on patient race and income/insurance status. In the second stage, we will combine our preliminary data with information from Aim 1 to develop an evidence-based approach for equitable implementation of optimal rehabilitation care pathways to reduce disparities in community-based rehabilitation and physical function after arthroplasty. In the final step, we will pilot test implementation of these evidence-based novel rehabilitation care pathways. This work is important because it will progress rehabilitation disparities research beyond simply identifying differences toward designing and implementing novel interventions to reduce disparities and improve patient outcomes. The proposed work draws on Dr. Bove’s prior research on health disparities, qualitative research methodology, and rehabilitation for individuals with osteoarthritis and joint arthroplasty. This work will extend Dr. Bove’s work into the development and implementation of multi-level interventions to address health disparities in this population. Upon conclusion of the proposed research, formal training and mentorship outlined in this K23 application, Dr. Bove will be well- positioned to seek R01 funding for a large hybrid effectiveness/implementation trial of these care pathways that are designed to maximize function and promote equity in outcomes after hip and knee arthroplasty surgery.

项目概要/摘要 NIMHD 指导研究科学家职业发展奖 (K23) 授予 Dr. Allyn Bove，匹兹堡大学物理治疗学助理教授 健康与康复科学，将把 Bove 博士建立为独立的健康股权公司 具有肌肉骨骼康复和使用健康差异方面的专业知识的调查员 实施科学方法来尝试缩小差距的策略。 该研究与 NIMHD 的临床和健康相关研究兴趣相一致 这个多层次的卫生服务研究项目符合 NIMHD 的目标： 推行“多层次干预措施”，旨在“提高健康公平”和“改善获得或 受健康差异影响的人群的护理质量”也符合 NIMHD 的追求。 “研究以了解采用和遵守的障碍和促进因素 医疗机构中基于证据的实践和干预措施”。 这个为期四年的 K23 奖项提出的研究将分三个阶段进行。 目标，我们将与提供者和患者合作伙伴合作，找出障碍和促进因素 实施最佳的关节置换术后康复护理途径，旨在改善 基于患者种族和收入/保险的结果和缓解结果差异 在第二阶段，我们将把我们的初步数据与目标 1 的信息结合起来。 制定基于证据的方法，以公平实施最佳康复护理 减少社区康复和身体功能差异的途径 在最后一步，我们将试点实施这些循证小说。 这项工作很重要，因为它将促进康复。 差异研究不仅仅是简单地识别设计和实施方面的差异 减少差异并改善患者治疗结果的新颖干预措施。 拟议的工作借鉴了 Bove 博士之前关于健康差异、定性研究的研究成果 研究方法以及骨关节炎和关节置换术患者的康复。 这项工作将把 Bove 博士的工作扩展到多层次的开发和实施 在建议结束后采取干预措施解决这一人群的健康差异。 此 K23 申请中概述的研究、正式培训和指导，Bove 博士将很好地- 准备为这些项目的大型混合有效性/实施试验寻求 R01 资金 旨在最大限度地发挥功能并促进髋关节术后结果公平的护理途径 和膝关节置换手术。