Project 2: OBGYN

项目2：妇产科

基本信息

批准号：
10615853
负责人：
Emily Stinnett Miller
金额：
$ 50.13万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-01 至 2025-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10615853
关键词：
Affect Age Alcohol consumption Algorithms Anxiety Behavior Therapy Caring Case Manager Cellular Phone Clinic Cluster randomized trial Communication Competence Consumption Development Plans Discipline of obstetrics Disease Disease remission Effectiveness Ethnic Origin Failure Feedback Goals High Prevalence Hybrids Impairment Income Infant Care Intake Investigational Therapies Managed Care Maternal Mortality Mediating Medicine Mental Depression Mental Health Mental Health Services Methodology Modeling Modification Online Systems Outcome Patients Perinatal Persons Physicians Postpartum Depression Postpartum Period Pregnancy Process Protocols documentation Provider Psychiatry Psychotherapy Public Health Race Recommendation Reporting Research Research Project Grants Research Proposals Resources Role Service delivery model Services Severities Suicide Symptoms Technology Time Training Translating Translations United States Woman Work adverse outcome anxiety symptoms barrier to care care burden care coordination care systems collaborative care computer human interaction cost dashboard depressive symptoms design digital mental health effectiveness outcome effectiveness/implementation trial experience follow-up health care delivery health care settings implementation evaluation implementation facilitation implementation outcomes improved innovation insight mobile application neurobehavioral novel offspring outreach patient engagement perinatal mental health population health post implementation prevent programs psychologic randomized trial response satisfaction secondary outcome social stigma substance use suicidal technology validation tool treatment as usual treatment planning treatment response user centered design

项目摘要

Abstract Post-partum depression (PPD) affects one in seven women. Untreated PPD can have devastating consequences including pregnancy-associated suicide, which has remained among the leading contributors to maternal mortality in the United States. Collaborative care (CC) has been shown in randomized trials to improve PPD outcomes. However, a major challenge in the implementation of postpartum collaborative care is the overburdened role of the care manager (CM), the lynchpin of the collaborative care model. CMs are managing many more patients than recommended targets. Additionally, the unique context of the postpartum period, including newly competing priorities when managing demands of newborn care, often requires multiple outreach attempts by the CM to promote engagement. Due to these challenges, CMs are only able to complete the core CC tasks for women with critical mental health needs, leaving most women without the active management of care or brief behavioral interventions needed to achieve remission of depression. Technology-enabled services (TES), which use web-based and mobile application supported by low-intensity coaching or care-management, represent a novel solution that would enable the CMs to more efficiently and effectively adhere to the core tenants of collaborative care that have been demonstrated to improve depression outcomes. This research project will use a comprehensive user centered design approach to engage patients, care managers (CMs) and physicians in the design of a TES—comprised of technologies, CM service protocol, and implementation plan—that can be successfully deployed in a postpartum collaborative care program. The overall TES will be designed to support the existing collaborative care model, facilitating the acquisition of ongoing depression symptom tracking from patients and improving communication with patients, both critical to informing the stepped care processes. The design innovation focus of this research project will be to design a CM dashboard that will help organize the CM workflow, promote patient engagement, facilitate communication, and automate tasks. We will leverage ongoing research efforts in our Center developing CM dashboards that help CMs better organize their work. Patient-facing tools will focus on completing psychological assessments and receiving feedback. The effectiveness and implementation of the developed TES will be evaluated in a stepped wedge cluster randomized trial across 5 perinatal clinics. This project has the potential to create and assess implementation the first fully functional TES for postpartum collaborative care.

抽象的产后抑郁症（PPD）影响七分之一的女性。未经处理的PPD可能具有毁灭性的包括怀孕相关自杀在内的后果，这仍然是主要因素的主要因素在美国的孕产妇死亡率。在随机试验中显示了协作护理（CC）改善PPD结果。但是，实施产后协作护理的主要挑战是协作护理模型的Lynchpin护理经理（CM）的负担过高。 CMS是管理比推荐目标更多的患者。此外，产后的独特背景时期，包括在管理新生儿护理需求时新竞争的优先级，通常需要多个 CM的推广尝试促进参与。由于这些挑战，CMS只能完成针对具有关键心理健康需求的女性的核心CC任务，使大多数女性没有活跃需要治疗或简短的行为干预措施来减轻抑郁症。支持技术的服务（TES），使用基于Web的和移动应用程序，由低强度支持指导或护理管理，代表了一种新颖的解决方案，可以使CMS更有效，并且有效地遵守已证明可以改善抑郁症的协作护理的核心租户结果。该研究项目将采用全面的用户以用户为中心的设计方法来吸引患者， TES设计中的护理经理（CMS）和医生 - 技术，CM服务协议，和实施计划 - 可以成功部署在产后协作护理计划中。这总体TE将旨在支持现有的协作护理模型，并支持收购正在进行的抑郁症跟踪患者并改善与患者的沟通，这既对通知阶梯护理过程。该研究项目的设计创新重点将是设计 CM仪表板将有助于组织CM工作流程，促进患者参与度，促进沟通，和自动任务。我们将利用中心正在开发CM仪表板的正在进行的研究工作，帮助CMS更好地组织他们的工作。面向患者的工具将专注于完成心理评估并收到反馈。开发的TE的有效性和实施将在A中评估在5个围产期诊所中，梯级楔形群集随机试验。该项目有可能创建和评估实施产后协作护理的第一个功能齐全的TE。