Bio-behavioral chronic disease management by families of young minority children

少数民族幼儿家庭慢性病生物行为管理

• 批准号: 7817470
• 负责人: Burton L Edelstein
• 金额: $ 44.57万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-24 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7817470
• 关键词: Address; Age; Algorithms; Area; Asthma; Behavior Therapy; Behavioral; Biological; Biological Neural Networks; Caring; Child; Child Care; Chronic Disease; Classification; Clinical; Clinical Trials; Clinical and Translational Science Awards; Collaborations; Communities; Community Health; Computers; Control Locus; Cost Savings; Counseling; Data; Dental; Dental caries; Dentistry; Diabetes Mellitus; Diet; Disadvantaged; Disease; Disease Management; Early treatment; Educational Technology; Electronics; Environment; Environmental Risk Factor; Evaluation; Family; Fluorides; Funding; Future; Government; Grant; Head Start Program; Health; Health Promotion; Health Services; Health Status; Health behavior; Health education; Height; Industry; Informal Social Control; Informatics; Information Technology; Institutes; Instruction; Insurance Carriers; Intervention; Knowledge; Laboratories; Logistics; Low income; Machine Learning; Measures; Medicaid; Medical; Methods; Minority; Modeling; New York City; Obesity; Oral health; Outcome; Paper; Parents; Pathogenesis; Pediatric Dentistry; Pediatrics; Performance; Phase; Policy Research; Population; Prevalence; Preventive; Process; Professional counselor; Public Health; Public Health Nurses; Public Health Nursing; Research; Research Personnel; Resources; Risk; Risk Assessment; Role; Scientist; Secure; Self Efficacy; Site; Social Work; Stress; Testing; Therapeutic; Translational Research; Trees; United States National Institutes of Health; Universities; Validity and Reliability; Washington; base; behavioral health; college; community setting; cost; dental surgery; design; diabetes education; disorder risk; early childhood; evidence base; expectation; experience; health belief; health disparity; improved; instrument; interest; literacy; medical schools; meetings; member; new technology; nutrition; peer; programs; prototype; psychologic; repaired; research study; social; success; teacher; theories; tool

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area (09) Health Disparities and specific Challenge Topic 09-MD- 102 Trans-disciplinary Research to Integrate the Biological and Non-biological Determinants of Health to Address Health Disparities. Description "Bio-behavioral chronic disease management by families of young minority children" seeks to reduce health disparities by investigating methods to close the gap between health information and health behaviors- specifically, the gap between instruction provided by clinicians to families of young children with chronic diseases and the capacity of economically stressed families to act on that instruction. Whether addressing asthma, diabetes, obesity, or tooth decay, needed now is trans-disciplinary translational research that tailors pharmacological and behavioral interventions to care management plans that parents are able to implement successfully. Envisioned is a computer "Tool" for use in community sites that assists community health workers in collaboration with families to: (1) determine children's level of risk for chronic diseases, (2) match them to clinicians and care plans, (3) characterize a family's capacity to engage in such plans, and (4) modify care plans to meet family's capacities. Target families are those disadvantaged by low-income, low-literacy, cultural barriers and minority status. Specific research aims are to develop, pilot test, and refine two "Instruments" that are integral to this Tool: (1) a 'disease risk assessment instrument' and (2) a culturally adaptable 'family capacity assessment instrument.' Early childhood caries ("ECC") was selected as the exemplar chronic disease for this research by an existing 12-member multi-disciplinary Project Team comprised of social and behavioral scientists, clinicians, educational and informatics technologists, and health services researchers. ECC was selected because it is highly prevalent in young children, because preventive and therapeutic bio- behavioral therapies are available but underused, and because significant cost savings may accrue to governmental programs, insurers, and families if the need for dental repair can be reduced. The proposed 'disease risk assessment instrument' will experiment with inputting recognized biological (clinical, laboratory, psychological, and pharmacologic), and non biological (knowledge, logistic, socio-cultural, and environmental) risk factors into algorithm-supported "classification and regression tree analyses" and machine learning "artificial neural networks" to improve on current professionally-endorsed methods of classifying young children by risk. As the proposed 'family capacity assessment instrument' has been less developed to date by the Project Team, its ultimate form will be determined by this research. Success in developing and implementing the Tool and its two assessment Instruments can result in better oral health outcomes at lower cost through risk-based early intervention, disease suppression, individualized care, family engagement, and elimination of the need for dental surgery in children under the age of six. Findings of this research will support clinical trials of risk-based caries management in vulnerable minority child populations and is adaptable to management of other chronic diseases in young children. "Bio-behavioral chronic disease management by families of young minority children" seeks to reduce health disparities by investigating methods to close the gap between health information and health behaviors-specifically, the gap between instruction provided by clinicians to families of young children with chronic diseases and the capacity of economically stressed families to act on that instruction. Specific research aims are to develop, pilot test, and refine two "Tools" that are integral to this Instrument: (1) a 'disease risk assessment tool' and (2) a culturally adaptable 'family capacity assessment tool.'

描述（由申请人提供）：本申请涉及广泛的挑战领域 (09) 健康差异和具体挑战主题 09-MD-102 整合健康的生物和非生物决定因素以解决健康差异的跨学科研究。说明“少数民族儿童家庭的生物行为慢性病管理”旨在通过调查缩小健康信息和健康行为之间差距的方法来减少健康差距，特别是临床医生向慢性病幼儿家庭提供的指导之间的差距疾病以及经济困难的家庭按照该指示采取行动的能力。无论是解决哮喘、糖尿病、肥胖还是蛀牙，现在都需要跨学科的转化研究，根据父母能够成功实施的护理管理计划量身定制药理学和行为干预措施。 Envisioned 是一种在社区场所使用的计算机“工具”，可帮助社区卫生工作者与家庭合作：(1) 确定儿童患慢性病的风险水平，(2) 将其与临床医生和护理计划相匹配，(3) 描述儿童的慢性病风险水平。家庭参与此类计划的能力，以及 (4) 修改护理计划以满足家庭的能力。目标家庭是那些因低收入、识字率低、文化障碍和少数民族身份而处于不利地位的家庭。具体研究目标是开发、试点测试和完善该工具不可或缺的两种“工具”：(1)“疾病风险评估工具”和(2)具有文化适应性的“家庭能力评估工具”。由社会和行为科学家、临床医生、教育和信息学技术专家以及卫生服务研究人员组成的现有 12 名多学科项目团队选择早期儿童龋齿 (“ECC”) 作为本研究的慢性疾病范例。选择 ECC 是因为它在幼儿中非常普遍，因为预防性和治疗性生物行为疗法可用但未得到充分利用，并且因为如果可以减少牙齿修复的需求，可以为政府计划、保险公司和家庭节省大量成本。拟议的“疾病风险评估工具”将尝试将公认的生物（临床、实验室、心理和药理学）和非生物（知识、逻辑、社会文化和环境）风险因素输入到算法支持的“分类和回归”中树分析”和机器学习“人工神经网络”，以改进当前专业认可的按风险对幼儿进行分类的方法。由于迄今为止项目组尚未开发出拟议的“家庭能力评估工具”，其最终形式将由本次研究确定。成功开发和实施该工具及其两个评估工具可以通过基于风险的早期干预、疾病抑制、个性化护理、家庭参与以及消除 15 岁以下儿童的牙科手术需求，以更低的成本实现更好的口腔健康结果。六岁。这项研究的结果将支持针对弱势少数民族儿童群体进行基于风险的龋齿管理的临床试验，并适用于幼儿其他慢性疾病的管理。 “少数民族儿童家庭的生物行为慢性病管理”旨在通过研究缩小健康信息和健康行为之间差距的方法来减少健康差距，特别是临床医生向患有慢性病的幼儿家庭提供的指导之间的差距以及经济困难的家庭按照该指示采取行动的能力。具体研究目标是开发、试点测试和完善该工具不可或缺的两个“工具”：(1)“疾病风险评估工具”和(2)具有文化适应性的“家庭能力评估工具”。