Development of a provider centered intervention for Non-Traumatic Dental Condition management in the Emergency Department

开发以提供者为中心的急诊科非创伤性牙科疾病管理干预措施

基本信息

批准号：
10597326
负责人：
Tumader Khouja
金额：
$ 10.31万
依托单位：
UNIVERSITY OF FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-22 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10597326
关键词：
Accident and Emergency department Acute Adult Allergic Reaction Antibiotics Area Award Behavior Therapy Behavioral Caring Clinical Trials Clostridium difficile Data Data Set Dental Dental Care Dentists Development Diagnosis Doctor of Philosophy Education Educational Curriculum Effectiveness Effectiveness of Interventions Electronic Health Record Emergency Department Physician Emergency department visit Endodontics Ensure Evidence based intervention Fostering Goals Guidelines Health Health Services Health system Hospitalization Hospitals Hour Individual Infection Inflammation Insurance Intervention Interview Knowledge Life Medicaid Medical Medical center Medicare Mentorship Methods Minority Mission Modeling Myocardial Infarction National Institute of Dental and Craniofacial Research Nurse Practitioners Opioid Oral health Pain management Palliative Care Pathway interactions Patient Care Patients Persons Pharmacists Physician Assistants Physicians Preventive dental care Provider Psychologist Public Health Qualitative Methods Research Research Methodology Research Personnel Rural Science Scientist Serious Adverse Event Smiling Source Surgeon System Talents Testing Toothache Training Uninsured United States National Institutes of Health Universities Variant Visit Work acceptability and feasibility bacterial resistance biomedical informatics career clinical decision support cohort design effectiveness testing experience health care settings human centered design improved indexing opioid use pilot test prescription opioid programs skills success support tools symposium tool urgent care

项目摘要

PROJECT ABSTRACT This NIDCR Dual Dentist Scientist Pathway to Independence Award (K99/R00) for Tumader Khouja BDS MPH PhD, will establish Dr. Khouja as an independent oral health services researcher developing and implementing evidence-based interventions that integrate dental care into medical settings utilizing both qualitative and quantitative research methods. This long-term goal will be achieved via a 5-year training and research plan that will launch Dr. Khouja’s independent program of research and academic career and support the NIDCR’s mission to increase and maintain a strong cohort of new and talented independent dual degree dentist scientists. The career goals of this program are: (1) training in intervention sciences [and biomedical informatics]; (2) gain expertise in qualitative methods to inform, design, and evaluate theoretically based behavioral interventions, and (3) professional development as an independent researcher. These career goals will be achieved via formal coursework, trainings, national conferences, mentorship, and research experience. The overall objective of this proposal is to understand the barriers and facilitators to non-traumatic dental condition (NTDC) management in the emergency department (ED) through quantitative and qualitative methods. The first aim will determine the national variation in NTDC prescribing in the ED and subsequent ED/urgent care revisits and hospitalizations within 30-days of an index ED visit. Using national electronic health records and integrated claims datasets and a random effects model, we will identify factors associated with prescribing for NTDC and variation at the patient, provider, hospital and state levels. The second aim identifies ED providers’ perceived barriers and facilitators to the management of NTDC in the ED. Using individual in depth interviews, ED providers (physicians, advanced practice providers) will identify the facilitators and barriers to management and prescribing for NTDC in the ED. The third aim will pilot and refine a multifaceted approach for NTDC prescribing in the ED and assess the acceptability and feasibility of the implementation of this strategy in ED settings. We will develop a 2-level interventional strategy [using human centered design methods] that will aid ED providers in NTDC prescribing and refine it based on our findings from the previous aims and field experience. As we test the intervention in an ED, we will use [EHR data from the University of Pittsburgh Medical Center (UPMC) to] evaluate appropriate treatment and clinician experience with ED use for NTDC before and during the intervention. Further trials will test the effectiveness of the intervention in U- and/or R-level proposals. An outstanding interprofessional team comprised of a public health dentist, pharmacist, ED physician, behavioral psychologist, biostatistician [and biomedical infromatician] will provide mentorship to ensure the success of this project. The long-term goal of this program of research is to develop a generalizable and sustainable intervention to improve NTDC management in ED and other medical settings. [This work supports priorities of the U.S. Surgeon General, NIH Director, and NIDCR to integrate oral health and general health through collaborative alliances and creating a diverse pipeline of clinician oral health researchers.]

项目摘要 Tumader Khouja BDS MPH 获得 NIDCR 双牙医科学家独立之路奖 (K99/R00) 博士，将使 Khouja 博士成为一名独立的口腔健康服务研究员，开发和实施基于证据的干预措施，利用两者将牙科护理纳入医疗环境这一长期目标将通过为期 5 年的培训和研究来实现。研究计划将启动 Khouja 博士的独立研究和学术生涯及支持计划 NIDCR 的使命是增加和维持一支强大的新的、有才华的独立双学位队伍该计划的职业目标是：（1）干预科学[和生物医学]培训。 (2) 获得基于理论的定性方法的专业知识、设计和评估行为干预，以及（3）作为独立研究员的职业发展这些职业目标。将通过正式课程、培训、全国会议、指导和研究经验来实现。该提案的总体目标是了解非创伤性牙科治疗的障碍和促进因素通过定量和定性方法对急诊科 (ED) 的病情 (NTDC) 进行管理。第一个目标将确定 NTDC 在急诊室和随后的急诊室/紧急护理中处方的国家差异在索引急诊就诊后 30 天内再次就诊和住院使用国家电子健康记录和综合索赔数据集和随机效应模型，我们将确定与处方相关的因素 NTDC 以及患者、提供者、医院和州层面的变化第二个目标是确定 ED 提供者的情况。 ED 中 NTDC 管理的认知和促进者使用个人深度访谈，急诊提供者（医生、高级实践提供者）将确定管理的促进因素和障碍第三个目标是试点和完善 NTDC 的多方面方法。在急诊室开处方并评估在急诊室实施该策略的可接受性和可行性我们将制定一个二级干预策略（使用以人为本的设计方法），以提供帮助。 NTDC 的 ED 提供者根据我们之前的目标和现场经验的发现来制定处方并对其进行完善。当我们测试急诊科的干预措施时，我们将使用[来自匹兹堡大学医学中心的 EHR 数据 (UPMC)] 评估 NTDC 之前和期间使用 ED 的适当治疗和临床医生经验进一步的试验将测试 U 级和/或 R 级建议的干预效果。杰出的跨专业团队，由公共卫生牙医、药剂师、急诊医生、行为医生组成心理学家、生物统计学家[和生物医学信息学家]将提供指导，以确保这一项目的成功该项目的长期目标是开发一个可推广且可持续的项目。干预以改善 ED 和其他医疗机构中的 NTDC 管理[这项工作支持优先事项。美国卫生局局长、NIH 主任和 NIDCR 通过以下方式整合口腔健康和一般健康：合作联盟并创建多样化的临床口腔健康研究人员渠道。]