SBIR Phase II New Risk Assessment/Intervention For Pregnant Woman

SBIR 第二阶段针对孕妇的新风险评估/干预

• 批准号: 7577135
• 负责人: Robin Inlander
• 金额: $ 5万
• 依托单位: BEHAVIORAL RESEARCH, INC.
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-06-01 至 2009-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7577135
• 关键词: Accountability; Alcohol Nutrition; Alcohol consumption; Area; Arts; Back; Behavior; Birth; Clinic; Clinical; Communities; Computer software; Computers; Contracts; Data; Diagnostic; Discipline of obstetrics; Documentation; Drug usage; Elements; Feedback; Feeling; Fetus; First Pregnancy Trimester; Funding; HIV; Health Maintenance Organizations; Health Personnel; Hispanic Americans; Hour; Image; Individual; Intention; Intervention; Interview; Learning; Length; Low income; Maintenance; Marketing; Modeling; Motivation; Movement; Not Hispanic or Latino; Numbers; Online Systems; Operative Surgical Procedures; Outcome; Paper; Parents; Partner Abuse; Patient Self-Report; Patient currently pregnant; Patients; Personal Satisfaction; Pharmaceutical Preparations; Phase; Population; Pregnancy; Pregnant Women; Prenatal care; Prevention; Printing; Provider; Psychologist; Questionnaires; Race; Randomized; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Rate; Reaction; Readiness; Reporting; Research; Research Personnel; Resources; Risk; Risk Assessment; Risk Behaviors; Small Business Funding Mechanisms; Small Business Innovation Research Grant; Smoking; Staging; Standards of Weights and Measures; Stress; Structure; Substance abuse problem; Surveys; System; Testing; Text; Third Pregnancy Trimester; Time; Translating; Translations; Update; Validation; Visit; Vocabulary; Woman; base; behavior change; cigarette smoking; computerized; cost; design; follow-up; improved; instrument; maternal drug use; motivational intervention; nutrition; prenatal; prevent; programs; prototype; quality assurance; racial and ethnic; response; self reported behavior; usability; user-friendly

Drug use is common among pregnant women, yet only an estimated 32% to 42% of prenatal care providers routinely ask patients about their use of drugs. Prenatal visits afford a unique opportunity for providers to educate women about prevention, and to detect drug use during pregnancy. To facilitate efficient use of provider resources, we developed a computerized interactive survey interview, the Pregnancy Information Program (PIP) that has been extensively tested in non-Hispanic white, Hispanic, and American Indian populations. Earlier studies demonstrated that the PIP was well received in multiple ethnic/racial pregnant populations. More importantly, the PIP evoked more honest responses regarding drug use and other socially stigmatized behaviors than paper-and-pencil questionnaires. In Phase I we updated the program, integrated current diagnostic standards, added a tailored motivational intervention, and incorporated audio and video elements to the program. For this Phase II project, we propose to further enhance the software capabilities, expand the domains of use to clinicians, and develop a commercial quality CD ROM prototype of the entire instrument. We will beta test the completed instrument in 6 community women's clinics, to determine its acceptability and ease of use, through anonymous clinician surveys and rates of completion. We will also conduct a randomized, controlled clinical trial of 346 pregnant women to determine PIP's ability to promote behavior change from the initial to the third trimesters of pregnancy. Primary outcomes evaluated in this trial include self-reported changes in nutrition, drug use, alcohol use, cigarette smoking, HIV risk behavior, and partner abuse avoidance. We will also assess stages of readiness to change, where change is not yet manifest. Subjects in their first trimester will be randomized to complete the PIP or a computer questionnaire minus the educational and customized motivational feedback. Both groups also will receive printed educational information. In their third trimesters, subjects will complete a second computer-based questionnaire to determine current behaviors, and will participate in a personal interview regarding their reaction to PIP. Paired data will be analyzed using generalized linear mixed models to estimate differences between and within groups over time. This study will reveal the potential of the PIP to enhance prenatal healthy behaviors, and improve birth outcomes, while saving providers time.

孕妇吸毒很常见，但产前护理人员中只有 32% 至 42% 吸毒 定期询问患者用药情况。产前检查为提供者提供了独特的机会 对妇女进行预防教育，并发现怀孕期间吸毒的情况。为了方便高效使用 提供者资源，我们开发了计算机化交互式调查访谈，怀孕信息 计划 (PIP) 已在非西班牙裔白人、西班牙裔和美洲印第安人中进行了广泛测试 人口。早期研究表明，PIP 在多个民族/种族的孕妇中受到好评 人口。更重要的是，PIP 引发了有关吸毒和其他社会问题的更诚实的反应。 比纸笔问卷调查更能减少污名化行为。在第一阶段，我们更新了程序，集成了 当前的诊断标准，添加了量身定制的动机干预，并纳入了音频和视频 程序的要素。对于这个二期项目，我们建议进一步提升软件能力， 扩大临床医生的使用领域，并开发整个系统的商业质量 CD ROM 原型 乐器。我们将在6个社区妇女诊所对完成的仪器进行beta测试，以确定其效果 通过匿名临床医生调查和完成率来确定可接受性和易用性。我们也会 对 346 名孕妇进行了一项随机对照临床试验，以确定 PIP 的促进能力 从怀孕初期到妊娠晚期的行为变化。本试验评估的主要结果 包括自我报告的营养、吸毒、饮酒、吸烟、艾滋病毒危险行为的变化，以及 避免伴侣虐待。我们还将评估变革的准备阶段（尚未变革的阶段） 显现。妊娠早期的受试者将被随机分配以完成 PIP 或计算机问卷 减去教育和定​​制的动机反馈。两组也将收到打印的 教育信息。在妊娠晚期，受试者将完成第二次基于计算机的测试 调查问卷以确定当前的行为，并将参加有关他们的个人访谈 对 PIP 的反应。将使用广义线性混合模型分析配对数据以估计差异 随着时间的推移，组之间和组内。这项研究将揭示 PIP 增强产前能力的潜力 健康的行为，改善出生结果，同时节省提供者的时间。