North STAR Trial: Specialty Telemedicine Access for Referrals in Rural Alaska

North STAR 试验:阿拉斯加农村地区的转诊专业远程医疗服务

基本信息

  • 批准号:
    10490362
  • 负责人:
  • 金额:
    $ 65.54万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2021
  • 资助国家:
    美国
  • 起止时间:
    2021-09-17 至 2026-06-30
  • 项目状态:
    未结题

项目摘要

ABSTRACT Rural Alaska Native children experience a high prevalence of preventable childhood hearing loss. School-based programs provide the only access to preventive services for many underserved rural and minority children, yet loss to follow-up from school hearing screening is common and scarcity of specialists in rural areas compound barriers to care. The Alaska Tribal Health System addresses geographic barriers to care with a telehealth network, but the network is not used for school hearing screening and is only available in Tribal regions. This proposal brings a novel telehealth model directly into schools to reach underserved rural and minority children across the state of Alaska, including non-Tribal regions. The overall objective is to prospectively implement and evaluate a new virtual specialty care model in Alaska schools to reduce loss to follow-up from school hearing screening and improve access to specialty care in rural environments. This work builds on the team’s recent PCORI-funded cluster-randomized trial that translated Alaska’s existing Tribal telehealth network in village clinics to a prevention model for school hearing screening referrals. Children randomized to clinic- based telemedicine specialty referral were 2.3 (95% CI 1.4, 3.8) times more likely to receive an ear/hearing diagnosis than those receiving the standard referral of a letter home. Success of the clinic-based intervention varied substantially between communities; stakeholder interviews revealed implementation challenges that could be addressed by delivering telehealth directly in schools. The current proposal will establish a unique model of care in Tribal and non-Tribal regions across the state, bringing virtual specialty care directly into schools. Three accomplished and complementary multi-PIs, who collaborated on PCORI- and NIDCD-funded studies in rural Alaska, will lead an interdisciplinary team, and an Alaska Stakeholder Team that includes Alaska Commissioners for Education and Health and Social Services will guide study development. In Aim 1, the team will develop and pilot an implementation protocol for school-based virtual specialty care for hearing loss through focus groups and interviews with community stakeholders. In Aim 2, they will conduct a stepped wedge, cluster-randomized implementation trial of virtual specialty care in three representative regions (n=31 schools; 2,008 children). The primary outcome is proportion of hearing referrals resulting in specialty follow-up within two months of screening date. The conservative hypothesis, based on PCORI trial data, is that virtual specialty care will improve follow- up by 100%. In Aim 3, the team will evaluate sustainability of virtual specialty care in Alaska schools through a policy analysis to assess alignment between health and education sectors, identify policy and practice barriers and accelerators, and ascertain payment models for future programmatic financing. This school-based telehealth model to address preventable childhood hearing loss could be translated to other underserved rural and minority groups, bringing high-value services into rural schools to alter the paradigm of prevention nationwide.
摘要 阿拉斯加农村原住民儿童经历可预防的儿童听力损失的高患病率。校本 项目为许多服务不足的农村和少数民族儿童提供了获得预防服务的唯一途径, 从学校听力筛查中失访是常见的,农村地区缺乏专家 护理障碍。阿拉斯加部落卫生系统通过远程医疗解决了医疗保健的地理障碍 该网络不用于学校听力筛查,仅在部落地区可用。这 一项提案将一种新颖的远程保健模式直接引入学校,以覆盖服务不足的农村和少数民族儿童 阿拉斯加州,包括非部落地区。总体目标是前瞻性地实施 并评估阿拉斯加学校的一种新的虚拟专业护理模式,以减少学校后续护理的损失 听力筛查和改善农村地区获得专业护理的机会。这项工作建立在 该团队最近的PCORI资助的集群随机试验, 在村卫生室开展听力筛查转介预防模式。随机分配到诊所的儿童- 基于远程医疗专科转诊的患者接受耳/听力检查的可能性是其他患者的2.3倍(95% CI 1.4,3.8)。 诊断比那些接受标准转诊的一封家书。基于诊所的干预措施的成功 社区之间差异很大;与利益攸关方的访谈揭示了执行方面的挑战, 通过直接在学校提供远程保健来解决。目前的建议将建立一个独特的模式, 在整个国家的部落和非部落地区的护理,使虚拟专业护理直接进入学校。三 完成和互补的多个PI,他们合作进行PCRI和NIDCD资助的农村研究, 阿拉斯加,将领导一个跨学科的团队,和阿拉斯加利益相关者团队,其中包括阿拉斯加专员 教育、卫生和社会服务部将指导研究发展。在目标1中,团队将开发和 透过焦点小组,试行校本听觉损失虚拟专科护理的实施方案 与社区利益相关者的访谈。在目标2中,他们将进行一个阶梯式楔形, 在三个有代表性的地区(n=31所学校; 2 008名儿童)实施虚拟专业护理试验。的 主要结果是筛选后两个月内进行专业随访的听力转介比例 约会基于PCRI试验数据的保守假设是,虚拟专科护理将改善随访- 上升了100%在目标3中,该团队将通过一项研究评估阿拉斯加学校虚拟专业护理的可持续性。 进行政策分析,以评估卫生和教育部门之间的一致性,查明政策和实践障碍 和加速器,并确定未来计划融资的支付模式。这种基于学校的远程医疗 解决可预防的儿童听力损失的模式可以转化为其他服务不足的农村和少数民族 在农村学校提供高价值的服务,以改变全国范围内的预防模式。

项目成果

期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ monograph.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ sciAawards.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ conferencePapers.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ patent.updateTime }}

Denise A Dillard其他文献

Open to misuse? A brief investigation into the lacking safeguards of open-source LLMs
容易被滥用?
  • DOI:
  • 发表时间:
  • 期刊:
  • 影响因子:
    0
  • 作者:
    Kristine L Rhodes;Abigail Echo;Jordan P Lewis;Vanesscia L Cresci;Delight E Satter;Denise A Dillard
  • 通讯作者:
    Denise A Dillard

Denise A Dillard的其他文献

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

{{ truncateString('Denise A Dillard', 18)}}的其他基金

Research Education Component
研究教育部分
  • 批准号:
    10730133
  • 财政年份:
    2023
  • 资助金额:
    $ 65.54万
  • 项目类别:
Administrative Core
行政核心
  • 批准号:
    10494080
  • 财政年份:
    2021
  • 资助金额:
    $ 65.54万
  • 项目类别:
North STAR Trial: Specialty Telemedicine Access for Referrals in Rural Alaska
North STAR 试验:阿拉斯加农村地区的转诊专业远程医疗服务
  • 批准号:
    10340829
  • 财政年份:
    2021
  • 资助金额:
    $ 65.54万
  • 项目类别:
Building Capacity for Dissemination and Implementation Research in a Tribal Healthcare System
部落医疗保健系统传播和实施研究的能力建设
  • 批准号:
    10223700
  • 财政年份:
    2021
  • 资助金额:
    $ 65.54万
  • 项目类别:
Researcher Career Enhancement Project
研究员职业提升项目
  • 批准号:
    10223702
  • 财政年份:
    2021
  • 资助金额:
    $ 65.54万
  • 项目类别:
Administrative Core
行政核心
  • 批准号:
    10223701
  • 财政年份:
    2021
  • 资助金额:
    $ 65.54万
  • 项目类别:
North STAR Trial: Specialty Telemedicine Access for Referrals in Rural Alaska
North STAR 试验:阿拉斯加农村地区的转诊专业远程医疗服务
  • 批准号:
    10616296
  • 财政年份:
    2021
  • 资助金额:
    $ 65.54万
  • 项目类别:
Marshallese: Alternate Surveillance for COVID-19 in a Unique Population
马绍尔语:对特殊人群中的 COVID-19 进行替代监测
  • 批准号:
    10540229
  • 财政年份:
    2020
  • 资助金额:
    $ 65.54万
  • 项目类别:
Population-based Interventions to Improve Behavioral Health in a Tribal Healthcare System
以人群为基础的干预措施,以改善部落医疗保健系统中的行为健康
  • 批准号:
    9983087
  • 财政年份:
    2017
  • 资助金额:
    $ 65.54万
  • 项目类别:
Diet and the CPT1A arctic variant: Impact on the Health of Alaska Native Children
饮食和 CPT1A 北极变异:对阿拉斯加原住民儿童健康的影响
  • 批准号:
    9214253
  • 财政年份:
    2017
  • 资助金额:
    $ 65.54万
  • 项目类别:

相似海外基金

Transcriptional assessment of haematopoietic differentiation to risk-stratify acute lymphoblastic leukaemia
造血分化的转录评估对急性淋巴细胞白血病的风险分层
  • 批准号:
    MR/Y009568/1
  • 财政年份:
    2024
  • 资助金额:
    $ 65.54万
  • 项目类别:
    Fellowship
Combining two unique AI platforms for the discovery of novel genetic therapeutic targets & preclinical validation of synthetic biomolecules to treat Acute myeloid leukaemia (AML).
结合两个独特的人工智能平台来发现新的基因治疗靶点
  • 批准号:
    10090332
  • 财政年份:
    2024
  • 资助金额:
    $ 65.54万
  • 项目类别:
    Collaborative R&D
Acute senescence: a novel host defence counteracting typhoidal Salmonella
急性衰老:对抗伤寒沙门氏菌的新型宿主防御
  • 批准号:
    MR/X02329X/1
  • 财政年份:
    2024
  • 资助金额:
    $ 65.54万
  • 项目类别:
    Fellowship
Cellular Neuroinflammation in Acute Brain Injury
急性脑损伤中的细胞神经炎症
  • 批准号:
    MR/X021882/1
  • 财政年份:
    2024
  • 资助金额:
    $ 65.54万
  • 项目类别:
    Research Grant
KAT2A PROTACs targetting the differentiation of blasts and leukemic stem cells for the treatment of Acute Myeloid Leukaemia
KAT2A PROTAC 靶向原始细胞和白血病干细胞的分化,用于治疗急性髓系白血病
  • 批准号:
    MR/X029557/1
  • 财政年份:
    2024
  • 资助金额:
    $ 65.54万
  • 项目类别:
    Research Grant
Combining Mechanistic Modelling with Machine Learning for Diagnosis of Acute Respiratory Distress Syndrome
机械建模与机器学习相结合诊断急性呼吸窘迫综合征
  • 批准号:
    EP/Y003527/1
  • 财政年份:
    2024
  • 资助金额:
    $ 65.54万
  • 项目类别:
    Research Grant
FITEAML: Functional Interrogation of Transposable Elements in Acute Myeloid Leukaemia
FITEAML:急性髓系白血病转座元件的功能研究
  • 批准号:
    EP/Y030338/1
  • 财政年份:
    2024
  • 资助金额:
    $ 65.54万
  • 项目类别:
    Research Grant
STTR Phase I: Non-invasive focused ultrasound treatment to modulate the immune system for acute and chronic kidney rejection
STTR 第一期:非侵入性聚焦超声治疗调节免疫系统以治疗急性和慢性肾排斥
  • 批准号:
    2312694
  • 财政年份:
    2024
  • 资助金额:
    $ 65.54万
  • 项目类别:
    Standard Grant
ロボット支援肝切除術は真に低侵襲なのか?acute phaseに着目して
机器人辅助肝切除术真的是微创吗?
  • 批准号:
    24K19395
  • 财政年份:
    2024
  • 资助金额:
    $ 65.54万
  • 项目类别:
    Grant-in-Aid for Early-Career Scientists
Acute human gingivitis systems biology
人类急性牙龈炎系统生物学
  • 批准号:
    484000
  • 财政年份:
    2023
  • 资助金额:
    $ 65.54万
  • 项目类别:
    Operating Grants
{{ showInfoDetail.title }}

作者:{{ showInfoDetail.author }}

知道了