DISPLACE: Dissemination and Implementation of Stroke Prevention Looking at the Care Environment

DISPLACE：从护理环境来看中风预防的传播和实施

基本信息

批准号：
10210281
负责人：
ROBERT J ADAMS
金额：
$ 86.03万
依托单位：
UNIVERSITY OF ALABAMA AT BIRMINGHAM
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-08-01 至 2023-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10210281
关键词：
Adoption Affect Age Assessment tool Brain Infarction Caregivers Caring Child Childhood Chronic Clinical Clinical Data Clinical Trials Clinical Trials Design Collaborations Common Data Element Communities Complication Comprehensive Health Care Computerized Medical Record Custom Data Defect Development Disease Dissemination and Implementation Education Educational Materials Eligibility Determination Enrollment Ensure Environment Erythrocytes Evaluation Face Focus Groups Funding Future Generations Geographic Distribution Goals Guidelines Health Healthcare Hematological Disease Hematology Hemoglobin Individual Information Technology Inherited Institution Interactive Systems Framework Intervention Interview Ischemic Stroke Knowledge Lead Leadership Measures Medical Methods Minority Groups Modeling Morbidity - disease rate Multi-Institutional Clinical Trial Multicenter Studies National Heart, Lung, and Blood Institute Outcome Patient Education Patient-Focused Outcomes Patients PhenX Toolkit Prevention Prevention Guidelines Prevention Protocols Prevention trial Private Sector Protocols documentation Provider Randomized Randomized Clinical Trials Recommendation Research Research Design Risk Sampling Services Sickle Cell Anemia Site Socioeconomic Factors South Carolina Specialist Specific qualifier value Standardization Stroke Stroke prevention Surveys System Third-Party Payer Time Transcranial Doppler Ultrasonography Transfusion United States Universities Vascular Endothelium base cohort compare effectiveness comparison intervention data dictionary data management design dissemination strategy effectiveness evaluation evidence base evidence based guidelines health disparity high risk hydroxyurea implementation intervention implementation science implementation strategy improved mortality multidisciplinary novel organizational readiness patient health information patient population patient screening pediatric patients screening social media stroke risk treatment strategy web site

项目摘要

Project Abstract Ischemic stroke is a potentially preventable, devastating complication of sickle cell disease (SCD), a group of inherited blood disorders that affect close to 100,000 individuals in the United States. Without intervention, stroke may occur in up to 24% of individuals with the highest risk form of SCD, sickle cell anemia. Despite improvements in comprehensive care and management of SCD in children, stroke remains a major cause of morbidity and mortality due to insufficient screening and prevention practices. Individuals living with SCD continue to face multiple health disparities cause by racial and socioeconomic factors as well as disease- specific disparities in funding and private sector support. In order to standardize and improve care, the National Heart, Lung, and Blood Institute (NHLBI) released evidence-based guidelines in 2014. These guidelines established routine transcranial Doppler ultrasound (TCD) screening as a means for identifying children at high risk of stroke and indefinite chronic red cell transfusions (CRCT) as a means of treating children at high risk for stroke based on the previous NHLBI funded, randomized controlled STOP (Stroke Prevention Trial in Sickle Cell Disease) results. This proposal, entitled DISPLACE (Dissemination and Implementation of Stroke Prevention Looking at the Care Environment) is a multi-site effort focused on enhancing the implementation and dissemination of these evidence-based stroke prevention guidelines in SCD. The research approach is guided by the Interactive Systems Framework for Dissemination and Implementation and the multilevel ecological model of health. The DISPLACE leadership core at the Medical University of South Carolina is a multidisciplinary team lead by Dr. Julie Kanter, Dr. Robert Adams and Dr. Cathy Melvin and includes specialists in multicenter clinical trial design, hematology, implementation science, qualitative analysis and statistical evaluation. The Data Coordinating Unit (DCU) at MUSC who have coordinated over 40 multicenter studies and will provide study design and information technology support and data management support the leadership core. The aims of DISPLACE are to: 1) assess the gap between current and guideline- recommended practices for stroke prevention among pediatric patients with SCD, 2) assess the multi-level patient, provider, and systems barriers and enablers to performing TCD screening and initiating CRCT, and 3) evaluate the effectiveness of a novel multi-level dissemination and implementation strategy to increase current annual TCD screening rates and CRCT initiation rates using a parallel cluster-randomized clinical trial. We have assembled a large, multi-institutional collaboration of institutions with widespread geographic distribution to best assess the feasibility and utility of the multi-level implementation strategy. The long-term goal of DISPLACE is to ensure that all children with SCD receive guideline-based care for stroke prevention for a “stroke free generation” in SCD.

项目摘要缺血性中风是镰状细胞疾病（SCD）的潜在预防，毁灭性的并发症，一组在美国影响近100,000人的遗传血液疾病。没有干预， SCD，镰状细胞贫血的风险最高的个体中，中风可能会发生。尽管改善儿童SCD的综合护理和管理，中风仍然是导致的主要原因由于筛查和预防实践不足而导致的发病率和死亡率。与SCD一起生活的人继续面对种族和社会经济因素以及疾病 - 资金和私营部门支持方面的特定分布。为了标准化和改善护理，国家心脏，肺和血液研究所（NHLBI）于2014年发布了基于证据的指南。建立的常规trancranial多普勒超声（TCD）筛查作为识别高儿童的手段中风和无限期慢性红细胞输血（CRCT）的风险是治疗高风险的一种手段基于先前的NHLBI资助的随机控制停止（镰刀中的中风试验）的中风细胞疾病）结果。该提议，标题为“流离失所”（中风的传播和实施）预防护理环境）是一项旨在增强实施的多站点的努力并在SCD中传播这些基于循证的中风指南。研究方法是在传播和实施的交互式系统框架和多级别的指导下健康的生态模型。南卡罗来纳州医科大学的取代领导核心是由朱莉·坎特（Julie Kanter），罗伯特·亚当斯（Robert Adams）博士和凯茜·梅尔文（Cathy Melvin）博士领导的多学科团队多中心临床试验设计，血液学，实施科学，定性分析和统计评估。 MUSC的数据协调单元（DCU）超过40个多中心研究并将提供研究设计和信息技术支持和数据管理支持领导力核心。位移的目的是：1）评估当前和指南之间的差距 - SCD儿科患者中预防中风的建议做法，2）评估多层次患者，提供商以及系统障碍和促成者可以执行TCD筛查和启动CRCT，3）评估新型多层次传播和实施策略的有效性以增加当前使用平行群集随机临床试验的年度TCD筛选率和CRCT启动率。我们已经组建了与宽度分布的机构的大型，多机构的合作为了最好地评估多层次实施策略的可行性和效用。长期目标位移是为了确保所有患有SCD的儿童都接受基于指南的护理，以预防中风 SCD中的“自由季节”。

项目成果

期刊论文数量（11）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Changes in Care Delivery for Children With Sickle Cell Anemia During the COVID-19 Pandemic.

DOI：
10.1097/mph.0000000000002008
发表时间：
2021-11-01
期刊：
Journal of pediatric hematology/oncology
影响因子：
0
作者：
Noisette ML;Phillips S;Schlenz AM;Mueller M;Kanter J
通讯作者：
Kanter J

Transcranial Doppler Screening in a Current Cohort of Children With Sickle Cell Anemia: Results From the DISPLACE Study.

DOI：
10.1097/mph.0000000000002103
发表时间：
2021-11-01
期刊：
Journal of pediatric hematology/oncology
影响因子：
0
作者：
Kanter J;Phillips S;Schlenz AM;Mueller M;Dooley M;Sirline L;Nickel R;Brown RC;Hilliard L;Melvin CL;Adams RJ
通讯作者：
Adams RJ

Practice patterns for neuroimaging and transfusion therapy for management of neurologic complications in sickle cell anemia: DISPLACE consortium.

DOI：
10.1002/pbc.28569
发表时间：
2020-11
期刊：
Pediatric blood & cancer
影响因子：
3.2
作者：
Phillips S;Schlenz AM;Mueller M;Melvin C;Adams RJ;Kanter J;(on behalf of the DISPLACE investigators)
通讯作者：
(on behalf of the DISPLACE investigators)

Identified barriers and facilitators to stroke risk screening in children with sickle cell anemia: results from the DISPLACE consortium.