A Parent Coach-Led Model of Well-Child Care for Young Children in Low-Income Communities: Protocol for a Cluster Randomized Controlled Trial.
A Parent Coach-Led Model of Well-Child Care for Young Children in Low-Income Communities: Protocol for a Cluster Randomized Controlled Trial.
复制标题
DOI：
10.2196/27054
复制
发表时间：
2021-11-25
影响因子：
1.7
通讯作者：
Coker TR
中科院分区：
文献类型：
--
作者：
Hurst R;Liljenquist K;Lowry SJ;Szilagyi PG;Fiscella KA;Weaver MR;Porras-Javier L;Ortiz J;Sotelo Guerra LJ;Coker TR
以父母为中心的新生儿到幼儿接触再设计（PARENT）干预措施是作为一种基于团队的幼儿健康护理（WCC）方法而创建的，该方法依靠健康教育者（PARENT Coach）提供大部分的WCC服务，解决低收入社区家庭面临的特定需求，并减少对临床医生作为WCC服务主要提供者的依赖。本研究旨在采用整群随机对照试验评估PARENT的影响。本研究在华盛顿州塔科马市和加利福尼亚州洛杉矶的两家联邦合格医疗中心的10个临床站点测试了PARENT的有效性。我们进行了一项集群随机对照试验，包括916个家庭，在基线调查时儿童年龄≤12个月。家长将在入学后6个月和12个月进行随访。家长教练是Parent的主要组成部分，在每次WCC访问时提供预期指导，心理筛查和转诊，发育和行为监测，筛查和指导。该教练的支持包括以家长为中心的会诊前筛查和就诊优先排序，针对身体检查和任何需要临床医生关注的问题，与临床医生进行简短的、以问题为中心的会面，以及自动短信家长提醒和教育服务，定期发送针对特定年龄的信息，以加强光明未来国家指南推荐的关键健康相关信息。我们将检查父母报告的护理质量（接受国家推荐的WCC服务、以家庭为中心的护理和父母的护理经历）和医疗保健使用（WCC、紧急护理、急诊科和住院），进行成本分析，并对临床医生的时间分配进行单独的时间运动研究，以评估效率。我们还将收集关于父母和以父母为中心的结果的探索性措施的数据。我们的主要结果是接受预期指导和急诊科使用。参与者招募于2019年3月开始。招募结束后，将进行6个月和12个月的随访调查。截至2021年8月30日，我们共招募了916名参与者。PARENT与联邦政府认可的卫生中心合作开展的这项大型实用试验将评估其作为一种循证和财务上可持续的模式，为低收入社区的儿童提供预防性保健服务的效用。ClinicalTrials.gov: NCT03797898;https://clinicaltrials.gov/ct2/show/NCT03797898 derr1 - 10.2196/27054
The Parent-focused Redesign for Encounters, Newborns to Toddlers (PARENT) intervention was created as a team-based approach to well-child care (WCC) that relies on a health educator (Parent Coach) to provide the bulk of WCC services, address specific needs faced by families in low-income communities, and decrease reliance on the clinician as the primary provider of WCC services. This study aims to evaluate the impact of PARENT using a cluster randomized controlled trial. This study tested the effectiveness of PARENT at 10 clinical sites in 2 federally qualified health centers in Tacoma, Washington, and Los Angeles, California. We conducted a cluster randomized controlled trial that included 916 families with children aged ≤12 months at the time of the baseline survey. Parents will be followed up at 6 and 12 months after enrollment. The Parent Coach, the main element of PARENT, provides anticipatory guidance, psychosocial screening and referral, developmental and behavioral surveillance, screening, and guidance at each WCC visit. The coach is supported by parent-focused previsit screening and visit prioritization, a brief, problem-focused clinician encounter for a physical examination and any concerns that require a clinician’s attention, and an automated text message parent reminder and education service for periodic, age-specific messages to reinforce key health-related information recommended by Bright Futures national guidelines. We will examine parent-reported quality of care (receipt of nationally recommended WCC services, family-centeredness of care, and parental experiences of care), and health care use (WCC, urgent care, emergency department, and hospitalizations), conduct a cost analysis, and conduct a separate time-motion study of clinician time allocation to assess efficiency. We will also collect data on exploratory measures of parent-and parenting-focused outcomes. Our primary outcomes were receipt of anticipatory guidance and emergency department use. Participant recruitment began in March 2019. After recruitment, 6- and 12-month follow-up surveys will be completed. As of August 30, 2021, we enrolled a total of 916 participants. This large pragmatic trial of PARENT in partnership with federally qualified health centers will assess its utility as an evidence-based and financially sustainable model for the delivery of preventive care services to children in low-income communities. ClinicalTrials.gov: NCT03797898; https://clinicaltrials.gov/ct2/show/NCT03797898 DERR1-10.2196/27054
登录
查看更多内容
影响因子：
8
作者：
Bethell, Christina;Reuland, Colleen;Halfon, Neal
通讯作者：
Halfon, Neal
影响因子：
3.1
作者：
Jones, Kai A.;Do, Stephanie;Coker, Tumaini R.
通讯作者：
Coker, Tumaini R.
影响因子：
8
作者：
Coker, Tumaini;Casalino, Lawrence P.;Lantos, John
通讯作者：
Lantos, John
影响因子：
3.1
作者：
Freeman, Brandi K.;Coker, Tumaini R.
通讯作者：
Coker, Tumaini R.
影响因子：
2.4
作者：
Garbutt, Jane M.;Highstein, Gabrielle;Strunk, Robert C.
通讯作者：
Strunk, Robert C.