Evaluating a mobile health tool to improve management of pediatric acute respiratory illness in Uganda

候选人：艾灵顿医生是华盛顿大学(UW)和K12医院的儿科肺病专家 威斯康星大学-实施科学培训补助金获得者(NHLBI)。年，她获得了理学硕士学位。 在威斯康星州大学公共卫生学院从事流行病学研究，并在全球 健康研究。艾灵顿博士的长期目标是成为一名独立的医生-研究员 致力于在资源有限的环境中改善儿科呼吸系统疾病的健康结果。 她的职业发展计划包括课程学习、体验式学习和导师指导，以实现 培训目标：1)复杂的定性和混合方法，2)实用的临床试验和准临床试验 实验研究，3)先进的实施科学，4)全球卫生领导地位。 环境：拟议的培训和研究活动将由现有的 国际合作、资源、基础设施和学术严谨的环境 威斯康星大学医学院和公共卫生学院以及马凯雷雷大学肺脏研究所和 计算与信息科学。研究：急性下呼吸道疾病(ALRI)是 5岁以下儿童死亡的原因，尽管有有效的预防和治疗 战略。大多数死亡病例发生在撒哈拉以南非洲地区。案例管理面临的主要挑战 存在于低收入和中等收入国家(LMIC)，包括对ALRI准则的遵守不力，缺乏 缺乏卫生工作者培训，缺乏识别喘息疾病(哮喘和哮喘)的决策支持 毛细支气管炎)，占儿童急性呼吸道感染的50%。急性下呼吸道疾病的治疗 评估(ALRITE)是一个基于指南和证据的综合ALRI临床决策支持 埃灵顿博士和她的团队共同开发了移动健康工具。阿利特已经展示了初步的 乌干达卫生中心的可接受性和可用性，但需要优化卫生系统 临床护理中的整合和中试。埃灵顿博士建议对4名乌干达人进行可行性研究 卫生中心1)确定有前景的实施战略，以优化ALRITE干预 实施，2)ALITE工具的中试研究可行性及其诊断和评估的有效性 采用间断时间管理1-59个月儿童喘息性疾病和肺炎 系列设计，以及3)评估部署后的实施结果和 使用的障碍/促进者。这些目标的成功实现将促进执行 乌干达和其他LMIC的决策支持工具提供了关键的初步数据来支持Dr。 Ellington计划的R01用于评估ALRITE干预的临床效果的群集性RCT ，并为艾灵顿博士提供过渡到研究所需的培训和经验 独立。

Candidate: Dr. Ellington is a pediatric pulmonologist at the University of Washington (UW) and K12 UW-Implementation Science Training Grant recipient (NHLBI). She completed a Master of Science in Epidemiology at the UW School of Public Health and has a long-term track record of successful global health research. Dr. Ellington’s long-term goal is to become an independent physician-investigator working to improve health outcomes of pediatric respiratory conditions in resource-constrained settings. Her career development plan includes coursework, experiential learning, and mentorship to achieve training goals in 1) complex qualitative and mixed methods, 2) pragmatic clinical trials and quasi- experimental studies, 3) advanced implementation science, and 4) global health leadership. Environment: The proposed training and research activities will be facilitated by existing strong international collaborations, resources, infrastructure, and academically rigorous environments of the UW Schools of Medicine and Public Health and the Makerere University Lung Institute and College of Computing & Information Science. Research: Acute lower respiratory illnesses (ALRI) are a leading cause of childhood mortality in children under 5 years, despite effective prevention and treatment strategies. The majority of deaths occur in sub-Saharan Africa. Major challenges in case management exist in low- and middle-income countries (LMICs), including poor adherence to ALRI guidelines, lack of health worker training, and lack of decision support to recognize wheezing illnesses (asthma and bronchiolitis), which represent up to 50% of ALRI in children. Acute Lower Respiratory Illness Treatment Evaluation (ALRITE) is a comprehensive guideline- and evidence-based ALRI clinical decision support mobile health tool Dr. Ellington developed with her team. ALRITE has demonstrated preliminary acceptability and usability in Ugandan health centers but requires optimization for health system integration and pilot-testing in clinical care. Dr. Ellington proposes a feasibility study in 4 Ugandan health centers to 1) identify promising implementation strategies for the ALRITE intervention to optimize implementation, 2) pilot-test study feasibility of the ALRITE tool and its effectiveness for diagnosis and management of wheezing illness and pneumonia in children 1-59 months using an interrupted time series design, and 3) assess the outcomes of implementation following ALRITE deployment and barriers/facilitators of ALRITE use. Successful completion of these aims will improve implementation of decision support tools in Uganda and other LMICs, provide critical preliminary data to support Dr. Ellington’s planned R01 for a cluster RCT evaluating clinical effectiveness of the ALRITE intervention in LMICs, and provide Dr. Ellington with the training and experience needed to transition to research independence.