Ready and Healthy for Kindergarten: A Primary Care Innovation to Promote a 360-degree View of Child Health

为幼儿园做好准备和健康：促进 360 度儿童健康视角的初级保健创新

• 批准号: 10480854
• 负责人: Manuel E Jimenez
• 金额: $ 36.59万
• 依托单位: RBHS-ROBERT WOOD JOHNSON MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10480854
• 关键词: Ready; Healthy; Kindergarten; Primary; Care

PROJECT SUMMARY/ABSTRACT Education is a critical social determinant of health (SDOH). Low-income, Latino dual language learners face large gaps in school readiness, which perpetuate inequities in academic achievement and subsequent health. Primary care is an ideal setting to promote school readiness for at-risk children given its frequent near universal contact with children and the opportunity to build on established relationships with their families. In fact, school readiness is a Bright Futures priority topic at the 4 and 5-year well child visits. However, the current structure of well child visits, which seeks to address a growing list of topics during 10-15 minute appointments, is limited in its ability to achieve this goal. To date, primary care innovations to address SDOH have largely missed an opportunity to promote 360-degree child health by simultaneously addressing academic and physical readiness for school. To address this gap, we developed an online family wellness program that uses anticipatory guidance on health topics intrinsically important to school readiness (e.g., nutrition, physical activity) to introduce basic language and literacy skills to low-income, Latino dual language learners, a fast- growing and particularly high-risk group, and their families (AHRQ priority populations). The online family wellness program was developed through a cross-sector partnership between educators and pediatric professionals and consists of parent-child workshops led by bilingual educators and reminder text messages. The program occurs during the transition into Kindergarten, a critical developmental stage, and uses promising approaches such as group structure, strategic use of technology, and partnerships with non- medical professionals. The yearlong program tightly integrates Bright Futures anticipatory guidance with the Kindergarten curriculum. During pilot testing, our team found that the family wellness program was feasible, well attended, and highly acceptable. We now propose testing the effect of the family wellness program on child and parenting outcomes using a rigorous mixed methods and community-engaged approach. In aim 1, we will conduct a developmental evaluation to refine the family wellness program and optimize the likelihood of successful implementation. In aim 2, we will conduct a randomized controlled trial testing the effects of the family wellness program on child language, literacy, and social-emotional outcomes as well parent health routines, learning activities, and self-efficacy. In aim 3, we will conduct a mixed methods process evaluation, which will provide insight into reach and implementation as well as user experience. The current proposal will yield insight into how primary care innovations can address education, which responds directly to AHRQ's interest in primary care innovations that address SDOH (NOT-HS-19-011). If effective, the online format will allow us to work with local, state, and national partners to disseminate the program rapidly to promote high- quality healthcare for vulnerable populations.

项目摘要/摘要 教育是健康的关键社会决定因素（SDOH）。低收入，拉丁裔双语言学习者面对 学校准备就绪的巨大差距，这使学业成就和随后健康的不平等永存。 初级保健是促进高危儿童准备就绪的理想场所 与儿童的普遍接触，并有机会建立与家人建立关系的机会。在 事实，在4岁和5岁的儿童访问中，学校准备是一个光明的未来优先主题。但是，电流 儿童探访的结构，旨在解决10-15分钟约会期间越来越多的主题清单 实现这一目标的能力有限。迄今为止，针对SDOH的初级保健创新在很大程度上已经 错过了通过同时解决学术和 学校的身体准备。为了解决这一差距，我们制定了一个在线家庭健康计划，该计划使用 关于健康主题的预期指南对学校准备就在本质上重要（例如，营养，身体 活动）将基本语言和扫盲技能引入低收入，拉丁裔双语语言学习者，快速 成长，特别是高风险群体及其家人（AHRQ优先人群）。在线家庭 健康计划是通过教育者与儿科之间的跨部门合作伙伴关系开发的 专业人士和由双语教育者领导的亲子讲习班和提醒短信组成。 该程序发生在过渡到幼儿园的过程中，这是一个关键的发展阶段，并使用了有希望的 诸如群体结构，技术的战略使用以及与非医学的合作伙伴关系等方法 专业人士。为期一年的计划将明亮的未来预期指导与 幼儿园课程。在试点测试中，我们的团队发现家庭健康计划是可行的， 参加会议良好，高度可接受。现在，我们建议测试家庭健康计划对 使用严格的混合方法和社区参与方法的儿童和育儿结果。在AIM 1中， 我们将进行发展评估，以完善家庭健康计划并优化 成功实施。在AIM 2中，我们将进行一项随机对照试验，以测试 关于儿童语言，识字和社会情感成果的家庭健康计划以及父母健康 常规，学习活动和自我效能感。在AIM 3中，我们将进行混合方法过程评估， 这将提供有关覆盖范围和实施以及用户体验的见解。当前的建议将 对初级保健创新如何解决教育产生洞察力，这直接对AHRQ做出了回应 对解决SDOH的初级保健创新的兴趣（非HS-19-011）。如果有效，在线格式将 允许我们与地方，州和国家合作伙伴一起迅速传播该计划，以促进高级 脆弱人群的优质医疗保健。