Perinatal Nurse Home Visiting Enhanced with mHealth Technology

移动医疗技术增强围产期护士上门服务

• 批准号: 9008052
• 负责人: LINDA F.C. BULLOCK
• 金额: $ 56.37万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-01 至 2018-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9008052
• 关键词: AIDS/HIV problem; Address; Afghanistan; Alcohol or Other Drugs use; Award; Baltimore; Battered Women; Benchmarking; Birth; Car Phone; Centers for Disease Control and Prevention (U.S.); Child; Child Development; Child health care; Client; Clinical; Communication Barriers; Communities; Consent; Data; Data Collection; Devices; Early Intervention; Effectiveness; Electronics; Enrollment; Ensure; Evidence based intervention; Frequencies; Funding; Grant; Health; Health Care Reform; Health education; Home Ranges; Home environment; Home visitation; House Call; Human Development; Infant Health; Institutes; Intervention; Interview; Linear Regressions; Logistic Regressions; Maternal Health; Medicaid; Mental Depression; Mental Health; Methods; Modeling; Mothers; Nurses; Outcome; Pa-11; Pamphlets; Paper; Participant; Perception; Perinatal; Perinatal Nursing; Personal Satisfaction; Phase; Pregnancy; Pregnancy Outcome; Pregnant Women; Premature Infant; Privacy; Public Health; Randomized; Recruitment Activity; Research; Resources; Rural; Safety; Sampling; Secure; Security; Sensitivity and Specificity; Severities; Site; Social Security; Technology; Testing; Time; Uganda; United States National Institutes of Health; Virginia; Wireless Technology; Woman; Work; World Health; base; community planning; compare effectiveness; design; empowerment; encryption; evidence base; experience; global health; health application; health disparity; improved; infant outcome; innovation; instrument; intimate behavior; intimate partner violence; mHealth; open source; prenatal; prevent; programs; psychologic; satisfaction; screening; sound; underserved minority

DESCRIPTION (provided by applicant): This study addresses PA-11-104 calling for Reducing Health Disparities among Minority and Underserved Children. The Institute of Medicine1, World Health Organization2 and Centers for Disease Control and Prevention3 recognize that prenatal home visitation, which improves the well-being of mother and children, presents an opportunity to provide early intervention to reduce intimate partner violence (IPV) and the impact the exposure has on the children. Major challenges for nurses and other home visitors (HV) are to accurately identify abused women and facilitate their accessing resources needed to change their situation. HVs often find it difficult to assess and intervene for IPV in the intimacy of home settings. The use of mHealth technology may increase the sensitivity of screening instruments and reduce communication barriers between HVs and clients regarding IPV, as well as enhance implementation of IPV interventions and allow for a more standard delivery of an intervention. Building on the successful trial testing the DOVE IPV intervention in prenatal home visiting programs (NR009093), we propose to test mHealth technology using an open-source application, eMOCHA, to improve assessment of IPV and to deliver the DOVE intervention. The proposed eMOCHA DOVE study will first (Specific Aim/Phase 1) compare sensitivity and specificity of two different approaches for IPV assessment; paper and pencil versus the eMOCHA mHealth technology. Phase 2 (Aim 2) will compare effectiveness of the DOVE intervention delivered in standard form (paper brochure) versus mHealth eMOCHA DOVE application. In Phase 1 women enrolled in a perinatal home visiting program and consenting to the study, will be randomized to one of the two assessment groups and assessed for IPV at enrollment, birth and 2 months post birth. Women who are IPV positive (IPV+) at any of the assessment times will be re-randomized to receive the DOVE intervention by one of the two approaches. 1600 Medicaid eligible pregnant women in a perinatal home visiting program (800 from urban Baltimore and 800 from rural Virginia) will be recruited for Phase I and 400 IPV+ women (200 from each site) for Phase II. Women participating in Phase 2 will receive 6 home visit interventions over 6 months. Maternal outcomes related to IPV and mental health and selected infant outcomes will be collected at enrollment, 3, 6, 12, and 18 months after entry into Phase 2. Specific Aim 1 will use logistic and linear regression models to examine the proportion of women experiencing IPV through mHealth technology versus paper and pencil on the same validated assessments. Specific Aim 2 (comparing effectiveness of two intervention administrations) will be assessed with logistic and linear regression models for categorical (proportion abused and premature infants) and continuous outcome variables (e.g. depression, frequency and severity of physical, psychological, sexual IPV, use of community resources) respectively. Study findings will assist nurse home visitation programs to use best approaches for routine assessment of IPV and implement empowerment interventions to reduce IPV and improve maternal infant health outcomes.

描述（由申请人提供）：本研究涉及PA-11-104呼吁减少少数民族和服务不足的儿童的健康差异。医学研究所，世界卫生组织2和疾病控制与预防中心3认识到，改善母亲和儿童福祉的产前家庭探视，为减少亲密伴侣暴力（IPV）提供了早期干预的机会，以及暴露对儿童的影响。护士和其他家庭访客（HV）面临的主要挑战是准确确定受虐待的妇女，并促进其改变其处境所需的访问资源。 HVS经常发现在家庭环境的亲密关系中很难评估和干预IPV。 MHealth技术的使用可能会提高筛选工具的敏感性，并减少HVS和客户在IPV方面的沟通障碍，并增强IPV干预措施的实施，并允许更标准地提供干预措施。在成功测试产前家庭访问计划（NR009093）的Dove IPV干预的成功试验的基础上，我们建议使用开源应用程序EMOCHA测试MHealth技术，以改善对IPV的评估并提供Dove干预。拟议的EMOCHA DOVE研究将首先（特定目标/第1阶段）比较两种不同的IPV评估方法的灵敏度和特异性；纸和铅笔与Emocha MHealth技术相比。第2阶段（AIM 2）将比较以标准形式（纸手册）与MHealth Emocha Dove应用程序进行的鸽子干预的有效性。在第1阶段，妇女参加了围产期家庭访问计划并同意该研究，将随机分为两个评估组之一，并在入学率，出生和出生后2个月进行IPV评估。在任何评估时间中，IPV阳性（IPV+）的妇女都将通过两种方法之一重新获得鸽子干预。在围产期家庭访问计划中，有1600名符合医疗补助的孕妇（来自巴尔的摩城市的800名，弗吉尼亚州的800名）将被招募到第一阶段和400次IPV+女性（每个站点200次）的II期。参加第2阶段的妇女将在6个月内接受6次家庭访问干预措施。进入第2阶段后的3、6、12和18个月，将收集与IPV和心理健康相关的孕产妇结局，并且将在入学率中收集一些婴儿结果。具体的AIM 1将使用Logistic和Linear Repression模型来检查通过MHealth Technology与Coper和Pencil在相同验证的评估中通过MHealth技术经历IPV的妇女的比例。特定目标2（比较两个干预管理的有效性）将通过分类（滥用和早产的婴儿和早产儿）和连续的结果变量（例如，身体，心理，性，性，性IPV的抑郁症和严重性，社区资源的使用）进行评估。研究结果将帮助护士家庭探视计划使用最佳方法来常规评估IPV并实施赋权干预措施，以减少IPV并改善孕产妇的健康状况。

项目成果

"It Doesn't Freak Us Out the Way It Used to": An Evaluation of the Domestic Violence Enhanced Home Visitation Program to Inform Practice and Policy Screening for IPV.

“它不会像以前那样让我们感到害怕”：对家庭暴力加强家访计划的评估，为 IPV 的实践和政策筛选提供信息。

• DOI: 10.1177/0886260519827161
• 发表时间: 2021
• 期刊: Journal of interpersonal violence
• 影响因子: 2.5
• 作者: Burnett,Camille;Crowder,Jolie;Bacchus,LoraineJ;Schminkey,Donna;Bullock,Linda;Sharps,Phyllis;Campbell,Jacquelyn
• 通讯作者: Campbell,Jacquelyn