Advancing Equity in Early Childhood Developmental Screening Through Item Response Theory and User-Centered Design

通过项目反应理论和以用户为中心的设计促进幼儿发展筛查的公平性

• 批准号: 10808542
• 负责人: Kendra Liljenquist
• 金额: $ 14.67万
• 依托单位: SEATTLE CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2025-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10808542
• 关键词: Advancing; Equity; Early; Childhood; Developmental

Project Summary Over one-third of all U.S. children are at-risk for negative long-term health, behavioral and emotional outcomes, due to circumstances of poverty. Beginning in early childhood, children living in low-income circumstances are twice as likely to experience developmental delay in one or more developmental domains including: 1) motor, 2) cognitive, 3) communication, and 4) social-emotional. For Black and Latino children this risk is compounded due to structural racism. Specifically, racial and ethnic minority children and children living in low-income circumstances experience severe inequities in access to appropriate developmental screening and support. These inequities result in missed opportunities to intervene at critical developmental periods, contributing to economic and racial disparities in school readiness and long-term cognitive and behavioral disabilities. A report by the American Academy of Pediatrics identified two key barriers to enhancing screening and referral practices: 1) lack of provider time to carry out more frequent screenings, and 2) difficulty accessing services once families are referred. To address these barriers, I will design specifications of a computer adaptive developmental assessment that includes contextually and culturally appropriate items, to be used by parents, clinicians, and community health workers to improve developmental assessment in primary care settings. Informed by principles of patient-centered measurement and user-centered design I will carry out the following specific aims of this project: Aim 1: Identify optimal items in English and Spanish to include in a new developmental assessment – computer adaptive test; Aim 2: Develop a prototype for a new developmental assessment – computer adaptive test informing a primary care based developmental support intervention. This project will result in 1) culturally and contextually appropriate developmental assessment items in English and Spanish ready for standardization to nationally representative samples, and 2) design specifications to inform building a high- fidelity developmental assessment - computer adaptive test for clinical integration. This research plan is part of a K01 proposal designed to provide me with scholarly training, mentorship, and support to gain skills and experience needed to be an independent investigator, conducting community-engaged research to design effective developmental assessment and response practices, to address economic and racial disparities in child development outcomes. To achieve this objective, I will pursue training in: (1) advanced Item Response Theory, (2) user centered design, (3) clinical effectiveness research.

项目摘要 超过三分之一的美国儿童对长期健康，行为和正当的负面影响很高 结果，由于贫困的情况。 环境在矿石开发领域的发展延迟的可能性是 包含：1）马达，2）认知，3）交流，4）黑人和拉丁裔儿童的社会情感。 风险由于种族主义而更加复杂。 生活在低收入情况下经历了严重的不平等 发展和支持。 发展时期，导致学校阅读和长期的经济和种族差异 认知和行为残疾。 增强筛查和推荐实践的障碍：1）缺乏提供者的时间来进行更多频繁 筛选和2）一旦将家庭推荐给这些障碍，我将获得差异。 计算机自适应发展评估的设计规范，包括上下文 和文化适当的物品，供父母，临床医生和社区卫生工作者使用 通过以患者为中心的原则来提高初级保健环境中的发育评估 测量和以用户为中心的设计我将执行该项目的以下特定目标：AIM 1 :: 确定英语和西班牙语的最佳项目，以在新的发展评估中包括 计算机自适应测试； AIM 2：开发新的开发评估原型 自适应测试告知基于初级保健的发展支持干预措施。 在1）文化和上下文中适当的英语和西班牙语中适当的发展评估项目可以供您使用。 标准化国家代表性样本，以及2）设计规范，以告知建筑高级 富达发育评估 - 计算机自适应测试临床整合。 K01提案旨在为我提供学术培训，指导和支持，以获得技能和 经验需要是一名独立调查员，进行社区参与设计 有效的发展评估和措施实践，以解决经济和种族差异 儿童发展结果。 理论，（2）以用户为中心的设计，（3）临床有效性研究。