A Scalable mHealth Resource to Facilitate Behavioral and Emotional Recovery after Pediatric Traumatic Injury

可扩展的移动医疗资源，促进小儿创伤后行为和情绪恢复

• 批准号: 10436831
• 负责人: Leigh E. Ridings
• 金额: $ 14.8万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-15 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10436831
• 关键词: Accidental Injury; Address; Adult; Affect; Age; Animals; Area; Award; Behavioral; Bite; Caregivers; Caring; Child; Child Traumatic Stress; Childhood; Clinical; Clinical Services; Clinical Trials; Clinical Trials Design; Communication; Consultations; Critical Illness; Data; Data Analyses; Development; Distress; Education; Elements; Emotional; Endowment; Enhancement Technology; Ensure; Environment; Equilibrium; Evaluation; Family; First Aid; Goals; Grant; Health; Health Status; Health Technology; Hospitalization; Improve Access; Individual; Injury; International; Intervention; Interview; Mental Depression; Mental Health; Mentors; Mentorship; Methodology; Modeling; Monitor; National Institute of Child Health and Human Development; Outcome; Patients; Population; Post-Traumatic Stress Disorders; Preparation; Prevention Research; Protocols documentation; Publications; Quality of Care; Quality of life; Race; Reaction; Recovery; Research; Research Training; Resources; Risk; Risk Assessment; Risk Reduction; Role; Self Care; Services; Site; Structure; Symptoms; Technology; Testing; Time; Training; Trauma; Traumatic injury; United States National Institutes of Health; Vehicle crash; Work; Writing; barrier to care; base; behavioral health; behavioral outcome; career; career development; coping; cost; cost effective; cost efficient; design; effectiveness implementation study; effectiveness implementation trial; evidence base; experience; falls; follow-up; functional disability; implementation evaluation; implementation science; innovation; iterative design; longitudinal analysis; mHealth; pediatric emergency; pediatric trauma; pilot test; post-traumatic stress; programs; public health priorities; resilience; screening; screening guidelines; skills; societal costs; statistics; success; trauma care; trauma centers; treatment research; usability

PROJECT SUMMARY/ABSTRACT Pediatric traumatic injury (PTI) is a public health priority, with nearly 300,000 children incurring injuries so severe that they require hospitalization each year. PTI is associated with annual individual and societal costs of $87 billion and elevates risk for posttraumatic stress, depression, and other health risk consequences that affect quality of life, physical recovery, emotional and behavioral outcomes, family roles and routines, and academic functioning. Follow-up care for affected children and caregivers is critical to support behavioral and emotional recovery, but few trauma centers provide these services and established, scalable models of care are lacking. Cost-effective, sustainable interventions are needed to reduce barriers to care and reach families that need it most. Pilot data collected by the candidate suggest that a technology-enhanced model of care is appealing to caregivers and has high potential to address service barriers by providing real-time assistance to help caregivers manage their own distress and their children’s behavioral and emotional recovery. The candidate proposes to develop and systematically evaluate CAARE (Caregivers’ Aid to Accelerate Recovery after pediatric Emergencies), an intervention informed by our ongoing clinical initiatives together with results of qualitative semi-structured interviews with caregivers of young children after PTI. CAARE will consist of education, self-monitoring, and coping resources. Specific aims include: 1) finalize the CAARE model and research protocol with ~15 caregivers after PTI; 2) pilot test CAARE via an open trial (n=60); and 3) assess CAARE implementation feasibility with families (n~20), trauma center directors (n~15), and program managers (n~15). The research environment, facilities, and resources at MUSC are ideally suited for mentored career development in child traumatic stress research. Dovetailing with the research aims, K23 training objectives are to: 1) develop proficiency in clinical trial design, implementation, and evaluation; 2) enhance proficiency in the use of iterative-design technology-based solutions; 3) develop expertise in implementation science; 4) enhance statistical training in clinical trials, longitudinal analyses, and qualitative data analysis; and 5) expand skills in scientific communication, including grant writing, presentations, and publications. Mentorship and consultation from experts in pediatric trauma, health technology solutions, implementation science, and advanced statistics will ensure training goals are met. The candidate’s long-term career goal is to establish a research portfolio that develops, rigorously tests, and scales innovative, cost-efficient, evidence-based health technology resources to improve access and quality of care for trauma-impacted families in real-world settings. These research and training goals directly correspond with priorities detailed in NICHD’s Pediatric Trauma and Critical Illness Branch, and will allow the candidate to become an internationally recognized leader in child and family trauma prevention and treatment research. The training proposed herein is designed to develop expertise in this area, represents a clear progression from prior training, and would not be possible without this K23.

项目摘要/摘要 小儿创伤损伤（PTI）是公共卫生的优先事项，近30万儿童受伤，因此 严重的是他们每年需要住院。 PTI与年度个人和社会成本有关 870亿美元，并提高了创伤后压力，抑郁和其他健康风险后果的风险 影响生活质量，身体恢复，情感和行为成果，家庭角色和惯例，以及 学术功能。对受影响儿童和看护人的后续护理对于支持行为和 情感恢复，但很少有创伤中心提供这些服务并建立了可扩展的护理模型 缺乏。需要采取成本效益，可持续的干预措施，以减少护理障碍和接触家庭 最需要它。候选人收集的试验数据表明，技术增强的护理模型是 吸引护理人员，并通过提供实时帮助来解决服务障碍的潜力很高 帮助护理人员管理自己的困扰以及孩子的行为和情感康复。这 候选提议开发和系统地评估Caare（护理人员的援助以加速恢复 在小儿紧急情况之后），我们正在进行的临床举措告知的干预措施以及 PTI之后，对幼儿的照料者进行了定性的半结构化访谈。 caare将包括 教育，自我监控和应对资源。具体目的包括：1）最终确定Caare模型和 PTI后与约15名护理人员进行研究协议； 2）通过开放试验（n = 60）进行试验测试CAARE； 3）评估 与家庭（n〜20），创伤中心董事（n〜15）和计划经理实施可行性（n〜20） （n〜15）。 MUSC的研究环境，设施和资源非常适合指导职业 儿童创伤性压力研究的发展。与研究目的相吻合，K23培训目标是 至：1）提高临床试验设计，实施和评估的熟练程度； 2）提高熟练程度 使用基于技术设计的解决方案； 3）实施科学方面的发展专业知识； 4）增强 临床试验，纵向分析和定性数据分析中的统计培训； 5）扩大技能 科学沟通，包括赠款写作，演讲和出版物。指导和咨询 来自儿科创伤，卫生技术解决方案，实施科学和高级统计的专家 将确保实现培训目标。候选人的长期职业目标是建立研究组合 这会发展，严格测试并扩展创新，成本效益，基于证据的卫生技术 改善现实环境中受创伤受损家庭的访问和护理质量的资源。这些 研究和培训目标直接与NICHD儿科创伤中详细介绍的优先级相对应 疾病分支机构，并将允许候选人成为儿童和家庭的国际认可的领导者 创伤预防和治疗研究。本文提出的培训旨在发展 该区域是从先前训练中明确的进步，没有该K23是不可能的。