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

评估移动医疗工具以改善乌干达儿科急性呼吸道疾病的管理

• 批准号: 10426760
• 负责人: Laura E Ellington
• 金额: $ 18.68万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-15 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10426760
• 关键词: Active Learning; Acute; Address; Adherence; Adoption; Africa South of the Sahara; Antibiotics; Asthma; Breathing; Bronchiolitis; Bronchodilator Agents; Case Management; Categories; Cessation of life; Chest; Child; Childhood; Chronic Disease; Clinical effectiveness; Collaborations; Community Health Aides; Complex; Consolidated Framework for Implementation Research; Coughing; Data; Development Plans; Diagnosis; Disease; Effectiveness; Environment; Epidemiology; Evaluation; Feasibility Studies; Focus Groups; Goals; Grant; Guideline Adherence; Guidelines; Health; Health system; Impact evaluation; Information Sciences; Infrastructure; Institutes; International; Interruption; Intervention; Interview; Leadership; Lung; Maps; Master of Science; Measures; Mentorship; Methods; Morbidity - disease rate; National Heart, Lung, and Blood Institute; Outcome; Outcome Measure; Penetration; Physicians; Pneumonia; Pragmatic clinical trial; Prevention strategy; Process; Public Health; Public Health Schools; Quasi-experiment; Recommendation; Research; Research Activity; Research Personnel; Resource-limited setting; Resources; Running; SECTM1 gene; Series; Surveys; Symptoms; Systems Integration; Testing; Time; Training; Training Activity; Triage; Uganda; Universities; Washington; Wheezing; World Health Organization; aged; base; care delivery; career development; clinical care; clinical decision support; college; cost effective; design; evidence base; experience; global health; implementation determinants; implementation facilitation; implementation outcomes; implementation research; implementation science; implementation strategy; improved; improved outcome; low and middle-income countries; mHealth; medical schools; mortality; participant retention; pediatric health outcomes; pilot test; point of care; pragmatic trial; preference; primary outcome; prototype; respiratory; smartphone Application; support tools; tool; treatment strategy; trial design; usability

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.

候选人：Ellington博士是华盛顿大学（UW）和K12的儿科肺病学家 UW-实施科学培训补助金获得者（NHLBI）。她在年完成了理学硕士学位。 在华盛顿大学公共卫生学院流行病学，并有一个成功的全球长期跟踪记录， 健康研究。艾灵顿博士的长期目标是成为一名独立的医学研究者 致力于在资源有限的环境中改善儿科呼吸疾病的健康结果。 她的职业发展计划包括课程，体验式学习和导师制，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 实验研究，3）先进的实施科学，以及4）全球卫生领导力。 环境：拟议的培训和研究活动将由现有的强有力的 国际合作，资源，基础设施和严谨的学术环境 华盛顿大学医学和公共卫生学院和马凯雷雷大学肺研究所和肺学院 计算机与信息科学.研究：急性下呼吸道疾病（ALRI）是一种主要的 尽管有有效的预防和治疗， 战略布局大多数死亡发生在撒哈拉以南非洲。案件管理方面的主要挑战 低收入和中等收入国家（LMIC）存在的问题，包括对ALRI指南的遵守情况不佳，缺乏 卫生工作者培训不足，缺乏识别喘息性疾病（哮喘和 细支气管炎），其占儿童ALRI的高达50%。急性下呼吸道疾病治疗 评估（ALRITE）是一个全面的指南和循证ALRI临床决策支持 艾灵顿博士和她的团队开发的移动的健康工具。ALRITE已经初步证明了 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试点测试。艾灵顿博士建议在4乌干达进行可行性研究 卫生中心1）确定有希望的实施战略，为ALRITE干预，以优化 2）ALRITE工具的可行性及其诊断效果的试点测试研究， 使用中断时间管理1-59个月儿童的喘息性疾病和肺炎 系列设计，3）评估ALRITE部署后的实施结果， 使用ALRITE的障碍/促进因素。成功地完成这些目标将改善 在乌干达和其他低收入国家的决策支持工具，提供关键的初步数据，以支持博士。 Ellington计划的R 01用于评价ALRITE干预的临床有效性的群集RCT 并为Ellington博士提供过渡到研究所需的培训和经验 独立