Bridging gaps in healthcare services for new families due to COVID-19

弥补新家庭因 COVID-19 造成的医疗保健服务差距

• 批准号: 10244731
• 负责人: Craig F. Garfield
• 金额: $ 90.29万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-13 至 2022-06-08
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10244731
• 关键词: Admission activity; Adult; Adverse effects; Area; Behavioral; Birth; Breast Feeding; COVID-19; COVID-19 pandemic; Caring; Child Rearing; Childhood; Climacteric; Communities; Containment; Contraceptive methods; Crowding; Depression screen; Discipline of obstetrics; Education; Ethnic Origin; Face; Family; Fathers; Feedback; Foundations; Funding; Health; Health Services; Healthcare; Home; Hospitals; Income; Individual; Infant; Infant Health Services; Internet; Intervention; Interview; Knowledge; Lead; Life; Low income; Measures; Medical; Medicine; Mental Health; Mental Health Services; Modeling; Monitor; Newborn Infant; Outcome; Paper; Parents; Patient Outcomes Assessments; Patients; Pediatrics; Postpartum Depression; Postpartum Period; Preventive Health Services; Preventive healthcare; Public Health; Race; Randomized; Randomized Controlled Trials; Reporting; Resources; Risk; Role; Self Administration; Self Efficacy; Services; Social Responsibility; Social support; Surveys; Symptoms; Testing; Touch sensation; Transportation; United States; United States Agency for Healthcare Research and Quality; Vaccination; Visit; Well Child Visits; Woman; anxiety symptoms; arm; base; birth control; child services; collaborative care; depressive symptoms; design; digital health; digital healthcare; distrust; efficacy testing; ethnic minority population; evidence base; experience; global health; health care delivery; health care service; health equity; health equity promotion; health of the mother; health service use; improved; lower income families; pandemic disease; patient oriented; perceived stress; perinatal mental health; physical conditioning; postnatal; postpartum care; primary outcome; racial and ethnic; recruit; residential segregation; response; screening; secondary outcome; service intervention; service utilization; social health determinants; socioeconomic disparity; stress symptom; substance use; success; telehealth; therapy design; transmission process; treatment arm; treatment as usual; urgent care; virtual healthcare

PROJECT SUMMARY The transition to new parenthood is marked by dramatic changes in social roles and responsibilities. To support new parents, obstetric and pediatric healthcare surrounding this transition is designed with a supportive focus to facilitate new parents' navigation of the attendant life changes. The COVID-19 pandemic has altered healthcare delivery in ways that have limited these supportive obstetrics and pediatric services provided at the beginning of new parenthood. Consequently, aspects of preventative healthcare, such as monitoring for symptoms of postpartum depression, discussing optimal birth control options, educating parents on recommended adult and pediatric vaccinations, and providing anticipatory guidance on infant wellness, are less robust. In addition, without professional guidance and support, outcomes of foundational importance to new parents, such as perceived stress, depressive and anxiety symptoms, or parenting and breast-feeding self-efficacy, are worse. Moreover, the COVID-19 pandemic has underscored the impact of the social determinants of health on new family wellness, with racial/ethnic minority and low-income families being differentially impacted by COVID-19 pandemic driven healthcare delivery changes. Recognizing the potential for longitudinal changes in healthcare delivery engendered by the COVID-19 pandemic, a scalable, patient-centered, equity-focused intervention designed to bridge gaps in healthcare services around the transition to new parenthood is needed. This due (N2H), project, “Bridging gaps in healthcare delivery to COVID-19 for parent and infants from birth through the first year of life” aims to evaluate Nursery2Home a patient-informed digital healthcare intervention that s is specifically responsive to the COVID-19 pandemic's impact on new families, with a focus on health equity for racial/ethnic minority and low income families. N2H builds upon previous digital health successes of our team while incorporating the evidence-based collaborative care model for mental health support. N2H is designed to mitigate the adverse effects of healthcare delivery changes in response to the COVID-19 pandemic and to improve health for mothers, fathers, and infants over the first year of life. Developed from feedback given by new parents who delivered during the COVID-19 pandemic, N2H provides 1) parental education about their own physical and mental health, 2) infant wellness resources and tracking of recommended healthcare services, 3) parental mental health screening and support, and 4) systematic case review to optimize the health of new families. We assigned improves In health will test the efficacy of N2H via a randomized controlle trial. In total, 640 diverse families will be randomly to either usual care or N2H intervention arm to evaluate whether, compared to usual care, N2H healt services utilization and patient reported outcomes of foundational importanc to new families. addition, we will evaluate the impact of N2H on racial/ethnic and income-based disparities observed in both services utilization and patient reported outcomes. d h e

项目摘要 向新生生的过渡以社会角色和责任的巨大变化为特征。支持 围绕此过渡的新父母，产科和儿科医疗保健的设计，以支持性的重点 促进新父母对随之而来的生活变化的导航。 COVID-19大流行改变了医疗保健 以限制这些支持的妇产科和儿科服务的方式交付 新生儿。因此，预防医疗保健的各个方面，例如监测 产后抑郁症，讨论最佳节育选择，对父母进行建议的成人教育和 小儿疫苗接种，并提供有关婴儿健康的预期指导，较不健壮。此外， 没有专业的指导和支持，对新父母的基础重要性的结果，例如 感知到的压力，抑郁症和焦虑症状，或育儿和母乳喂养的自我效能感更糟。 此外，COVID-19大流行强调了社会决定者对新的影响 家庭健康，种族/族裔少数民族和低收入家庭受到Covid-19的不同影响 大流行驱动的医疗保健提供变化。 认识到COVID-19参与医疗保健提供的纵向变化的潜力 大流行，可扩展的，以患者为中心的，以股权为中心的干预措施，旨在弥合医疗保健中的差距 需要围绕过渡到新生儿的服务。这 到期的 （N2H）， 项目，“医疗保健交付中的弥合差距 从出生到生命第一年的父母和婴儿的COVID-19 一种患者信息的数字医疗干预措施 s 特别响应Covid-19 大流行对新家庭的影响，重点是种族/族裔少数民族和低收入 家庭。 N2H建立在我们团队以前的数字健康成功的基础上，同时结合了循证 心理健康支持的协作护理模型。 N2H旨在减轻医疗保健的不利影响 响应于199年大流行的响应变化，并改善母亲，父亲和婴儿的健康状况 在生命的第一年。从新父母提供的反馈中开发 大流行，N2H提供1）关于自己身心健康的父母教育，2）婴儿健康 资源和推荐医疗服务的跟踪，3）父母心理健康筛查和支持， 4）系统案例审查以优化新家庭的健康。 我们 分配 改进 在 健康 将通过随机对照试验测试N2H的效率。总共有640个潜水员家庭将是随机的 为了通常的护理或N2H干预组，以评估与常规护理相比，N2H是否 卫生服务利用和患者报告了新家庭的基础重要性。 此外，我们将评估N2H对两者中观察到的种族/种族和基于收入的差异的影响 服务利用和患者报告的结果。 d 他