Technology-Enhanced Asthma Care in Children at Clinic and Home (TEACCCH) Study

技术增强的儿童哮喘护理诊所和家庭 (TEACCCH) 研究

• 批准号: 10580783
• 负责人: Kristin Kan
• 金额: $ 18.98万
• 依托单位: LURIE CHILDREN'S HOSPITAL OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10580783
• 关键词: 11 year old; Absenteeism; Acute; Address; Adherence; Administrator; Adrenal Cortex Hormones; Advisory Committees; Affect; Asthma; Breathing; Caregiver support; Caregivers; Caring; Child; Child Care; Child Support; Childhood; Childhood Asthma; Chronic; Chronic Disease; Clinic; Clinical; Clinical Investigator; Clinical Trials Design; Communication; Communities; Competence; Data; Data Analyses; Dedications; Detection; Development Plans; Diabetes Mellitus; Educational workshop; Emergency department visit; Enhancement Technology; Environment; Evaluation; Feasibility Studies; Feedback; Funding; Future; Goals; Guidelines; Health Personnel; Health Technology; Health system; Healthcare; Home; Hospitalization; Household; Inhalation; Inhalators; Integrated Health Care Systems; Intervention; Interview; Learning; Literature; Low income; Mentored Clinical Scientist Development Program; Mentors; Mentorship; Methods; Monitor; Outcome; Outpatients; Patients; Pediatric Hospitals; Pharmaceutical Preparations; Physicians; Population; Population Study; Preventive; Process; Quality of Care; Randomized; Randomized, Controlled Trials; Recommendation; Reporting; Research; Research Infrastructure; Research Methodology; Research Personnel; Risk; Schools; Scientist; Self Management; Series; Services; Signal Transduction; Symptoms; Techniques; Technology; Testing; Training; United States National Institutes of Health; Universities; World Health; acceptability and feasibility; asthmatic patient; care burden; career development; clinical care; clinical decision support; design; digital; effective intervention; effectiveness/implementation study; effectiveness/implementation trial; electronic sensor; evidence base; experience; feasibility testing; feasibility trial; health care delivery; health care service; health care settings; high risk; high risk population; implementation design; implementation science; implementation strategy; improved; improved outcome; informant; longitudinal analysis; mHealth; medication compliance; mobile application; mobile sensor; patient oriented; patient-clinician communication; pilot trial; population health; reduce symptoms; research and development; sensor; skill acquisition; skills; socioeconomics; statistical learning; tool; urban children; user centered design; wireless

PROJECT SUMMARY/ABSTRACT Candidate: Kristin Kan, MD MPH MSc is a pediatric physician and clinical investigator focused on designing and implementing evidence-based, health-system interventions to support children with asthma. Dr. Kan’s long-term goal is to be an independent physician-investigator and leading expert in implementation science and health system interventions that improve the outcomes and quality of care for children with asthma. Research Context: Of the 5.5 million US children with pediatric asthma, over half have uncontrolled symptoms due in part to poor asthma self-management, leading to high rates of acute unscheduled care and activity limitations. Supporting guideline-based preventive asthma care, especially adherence to medications, is a critical step in reducing uncontrolled symptoms among high-risk asthma populations. There is evidence suggesting that mobile health (mHealth) technologies can be part of an effective intervention to improve adherence and symptom control. However, data from our previous mHealth asthma trial and other studies suggest that limitations in mHealth use in real-world health care are partly attributable to the lack of optimizing health system integration of the mHealth tool and the implementation strategy. Specific Aims: (1) Optimize a mHealth pediatric asthma intervention and implementation plan with caregivers and health system stakeholders through user-centered design workshops and interviews. (2) Conduct a feasibility study of an adaptive, mHealth asthma intervention and multi-stakeholder implementation plan to improve asthma symptom control and medication adherence. Research Plan: To accomplish these aims, Dr. Kan will engage caregivers of children with asthma, clinical staff, and health system administrators to refine the design of an existing mHealth asthma intervention, identify health care services to integrate the intervention in health care delivery, and design an implementation strategy. Dr. Kan will then conduct a feasibility trial with caregiver-child dyads, whom will be randomized to an adaptive mHealth asthma intervention. Findings will help prepare for a future, full-scale hybrid implementation- effectiveness trial. Career Development Plan: Dr. Kan’s training goals include: (1) acquire experience in user-centered design (UCD) methods, (2) develop expertise in clinical trial design & evaluation in health care settings, (3) increase competencies in implementation science research methods, and (4) learn statistical techniques for analyzing longitudinal data. Dr. Kan’s career development goals will be well-supported by an interdisciplinary mentorship team, a planned series of didactic learning, and implementation of her research plan. Environment: Dr. Kan has a NIH-funded core mentorship and advisory team, who are dedicated to mentoring her to independence, and is also supported by Northwestern University and Lurie Children’s Hospital, both with outstanding research infrastructures and commitments to supporting junior investigators.

项目概要/摘要 候选人：Kristin Kan，医学博士、公共卫生硕士、儿科医师和临床研究者，专注于设计 实施基于证据的卫生系统干预措施来支持菅直人的哮喘儿童。 长期目标是成为一名独立的医师研究员和实施科学领域的领先专家 以及改善哮喘儿童护理结果和质量的卫生系统干预措施。 研究背景：在美国 550 万患有小儿哮喘的儿童中，超过一半的哮喘未得到控制 部分原因是哮喘自我管理不善，导致急性非计划护理和 支持基于指南的预防性哮喘护理，特别是坚持药物治疗， 有证据表明，这是减少高危哮喘人群不受控制症状的关键一步。 表明移动医疗（mHealth）技术可以成为有效干预措施的一部分，以改善 然而，我们之前的 mHealth 哮喘试验和其他研究的数据。 表明移动医疗在现实世界医疗保健中使用的局限性部分归因于缺乏优化 移动医疗工具和实施策略的卫生系统整合。 具体目标：（1）与护理人员一起优化 mHealth 小儿哮喘干预和实施计划 通过以用户为中心的设计研讨会和访谈与卫生系统利益相关者进行交流 (2) 开展 适应性移动健康哮喘干预和多利益相关者实施计划的可行性研究 改善哮喘症状控制和药物依从性。 研究计划：为了实现这些目标，菅博士将让哮喘儿童的护理人员、临床 工作人员和卫生系统管理员改进现有移动医疗哮喘干预措施的设计，确定 医疗保健服务将干预措施整合到医疗保健提供中，并设计实施方案 然后，菅直人博士将对看护者与儿童二人组进行可行性试验，将他们随机分配到一组 适应性移动健康哮喘干预措施将有助于为未来的全面混合实施做好准备。 有效性试验。 职业发展计划：阚博士的培训目标包括：（1）获得以用户为中心的设计经验 (UCD) 方法，(2) 发展医疗保健环境中临床试验设计和评估的专业知识，(3) 增加 科学研究方法的能力，以及（4）学习用于分析的统计技术 纵向数据将得到跨学科指导的大力支持。 团队、计划的一系列教学学习以及她的研究计划的实施。 环境：菅博士拥有一支由NIH资助的核心导师和顾问团队，致力于 指导她独立，并得到西北大学和卢里儿童医院的支持 医院均拥有出色的研究基础设施并致力于支持初级研究人员。