Integrated Clinic and Patient Technology-Enabled Program to Reduce the Risks of Cardiometabolic Disease Among Latinas with Prior Pregnancy Complications

综合临床和患者技术支持计划，以降低患有既往妊娠并发症的拉丁美洲人患心血管代谢疾病的风险

• 批准号: 10601518
• 负责人: Dharma E CORTES
• 金额: $ 32.86万
• 依托单位: ENVIRONMENT AND HEALTH GROUP, INC.
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-25 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10601518
• 关键词: Address; Adopted; Adoption; Adverse event; American Heart Association; Behavior; Behavioral; Body Weight decreased; Cardiometabolic Disease; Cardiovascular Diseases; Caring; Clinic; Community Health Aides; Cultural Diversity; Data; Diabetes Mellitus; Disease; Feedback; Future; Gestational Diabetes; Goals; Health; Health Benefit; Health Educators; Health Services Accessibility; Intervention; Latina; Latina Population; Life Style; Light; Link; Marketing; Medical; Modeling; Needs Assessment; Neighborhood Health Center; Non-Insulin-Dependent Diabetes Mellitus; Patients; Phase; Physical activity; Physician Executives; Population; Postpartum Period; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Premature Birth; Prevention; Preventive service; Primary Health Care; Public Health; Research; Research Personnel; Resources; Risk; Small Business Innovation Research Grant; Small for Gestational Age Infant; Social support; System; Technology; Testing; Training; Trust; Woman; adverse pregnancy outcome; base; behavior change; cardiometabolic risk; care providers; cost; diabetes risk; digital; digital health; experience; good diet; health disparity; healthy lifestyle; high risk; innovation; intervention delivery; intervention program; lifestyle intervention; maternal risk; member; mobile application; multidisciplinary; obstetric care; outcome prediction; patient population; payment; personalized approach; population health; pregnancy hypertension; primary care setting; programs; success; tool; trend; usability; user centered design; virtual delivery

Abstract Nearly 40% of Latinas experience an adverse pregnancy outcome (APO) that places them at significantly higher risk of developing cardiometabolic disease (CMD), including type 2 diabetes and/ or cardiovascular disease. The primary care setting has been identified as a key locus for addressing this major public health need, as primary care providers assume responsibility for the majority of care 6 weeks after delivery. Although currently not widely available, digital technologies have been recommended as a solution for expanding access to such preventive services in primary care. This lack of availability of digital technologies for women with prior APOs is a particularly noteworthy gap among primary care clinics serving large Latina populations, given the many historical disparities experienced by Latinas in health, coverage, and access to care. To the best of our knowledge, the proposed SBIR would be the first-ever effort to create and test an integrated clinic platform and patient app to enable primary care practices to deliver behavior-change programming to support Latinas in the 5 years after their APO. The integrated system will be developed using a user centered design approach incorporating feedback from both paraprofessional staff who will deliver the program and provide social support, and Latina patients, with the goal of successfully marketing the program to primary care clinics serving Latinas. The project is innovative in its comprehensive approach that addresses the 5 major APOs associated with future CMD, a clinic platform that overcomes key barriers to delivering lifestyle interventions in primary care, reliance on paraprofessionals to deliver the program, and combining an individualized approach for patients with a population health approach for primary care clinics. Specific aims are: Aim 1: Develop a clinic platform to integrate with our existing patient application to promote healthy behaviors among Latinas with recent APOs predictive of CMD; Aim 2: Develop and test digital tools and digital training toolkit for the new clinic platform for use by paraprofessionals (e.g. CHWs, medical assistants, health educators) and test the new features incorporated in the existing patient app; and, Aim 3: Evaluate feasibility, usability, and acceptability of the integrated clinic and patient application. The team includes a multicultural and multidisciplinary group of clinicians and researchers who have collaborated on prior technology-based interventions for women in the postpartum years. Hola Bebé, Hola Salud addresses a large unmet public health need with significant commercial potential among primary care clinics serving Latina populations. Our B2B approach is consistent with emerging trends on population health and value-based payment in primary care.

抽象的 近 40% 的拉丁裔女性经历过不良妊娠结局 (APO)，这使她们的妊娠结局显着降低。 患心脏代谢疾病 (CMD) 的风险较高，包括 2 型糖尿病和/或心血管疾病 初级保健机构已被确定为解决这一重大公共卫生问题的关键场所。 需要，因为初级保健提供者在分娩后 6 周承担大部分护理责任。 目前尚未广泛使用，但已建议将数字技术作为扩大访问范围的解决方案 初级保健中缺乏此类预防性服务。 鉴于 APO 是为大量拉丁裔人口提供服务的初级保健诊所中特别值得注意的差距 拉丁裔在健康、保险覆盖和获得医疗服务方面经历了许多历史性的差异。 据了解，拟议的 SBIR 将是创建和测试综合临床平台的首次尝试 患者应用程序使初级保健实践能够提供行为改变计划，以支持拉丁美洲人 APO 发布 5 年后，将使用以用户为中心的设计方法来开发集成系统。 纳入将提供该计划并提供社会服务的专业辅助人员的反馈 支持和拉丁裔患者，目标是将该计划成功推广到初级保健诊所 该项目的创新之处在于其全面的方法，解决了 5 个主要 APO 相关问题。 未来的 CMD 是一个临床平台，可克服在初级人群中提供生活方式干预的主要障碍 护理、依靠辅助专业人员来提供计划以及结合个性化方法 初级保健诊所的人口健康方法的具体目标是： 目标 1：建立诊所。 平台与我们现有的患者应用程序集成，以促进拉丁裔的健康行为 最近 APO 预测 CMD 目标 2：开发和测试新的数字工具和数字培训工具包； 供辅助专业人员（例如社区卫生工作者、医疗助理、健康教育工作者）使用的诊所平台并测试新的 目标 3：评估现有患者应用程序的可行性、可用性和可接受性； 该团队包括一个多文化和多学科的团队。 此前曾合作开展针对妇女的技术干预措施的牧师和研究人员 Hola Bebé、Hola Salud 解决了巨大的未满足的公共卫生需求。 为拉丁裔人群提供服务的初级保健诊所的商业潜力是一致的。 随着人口健康和初级保健基于价值的支付的新趋势。