OFFICE SYSTEMS TO IMPROVE PREVENTIVE CARE FOR CHILDREN

改善儿童预防保健的办公系统

• 批准号: 6081450
• 负责人: Peter A Margolis
• 金额: $ 20.48万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-09-30 至 2000-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6081450
• 关键词: anemia; child (0-11); clinical research; disease /disorder prevention /control; health care service evaluation; human subject; immunization; lead; mass screening; patient care management; pediatrics

DESCRIPTION: This application from the University of North Carolina at Chapel Hill. It proposes a four-year randomized trial to be conducted in 48 sites. The study has two primary hypotheses: 1) private pediatric practices implementing an "office system for prevention" will have higher rates of four core preventive services (immunizations and screening for anemia, tuberculosis, and lead) than those which do not implement the system; and 2) practices implementing a greater number of office systems components will have larger increases in rates of preventive care than practices using fewer components. Outcome measures are the levels of immunizations and screening for anemia and lead in all infants one year of age. In secondary analysis, the investigators will assess: 1) the impact of the system on rates of preventive services among socially disadvantaged children; 2) to what extent practices provide counseling services more effectively (provision of a diet with adequate amounts of iron, use of a car seat, insuring adequate amounts of fluoride among infants over 6 months); 3) rates of vision and blood pressure screening in children four years of age; 4) the impact of the system on parents' knowledge and behavior regarding prevention; 5) impact on providers' documentation of preventive services; 6) what practice characteristics are associated with pre-intervention performance; 7) whether practices that implement an office system continue to use it after the end of the intervention; and 8) what the impact is on changes over time on: a. physician and staff knowledge about prevention systems b. activities used in providing services c. attitudes towards ease of providing preventive care.

描述：这份来自北卡罗来纳大学的申请 在教堂山。 它建议进行一项为期四年的随机试验 在 48 个地点进行。 该研究有两个主要假设：1) 私人儿科诊所实施“儿科办公室系统” 预防”将提高四项核心预防服务的比率 （免疫接种和贫血、肺结核和铅筛查） 未实施该制度的； 2）实践实施 更多的办公系统组件将有更大的增长 与使用较少组件的实践相比，预防性护理的比率更高。 结果衡量标准是免疫接种和筛查的水平 所有一岁婴儿均患有贫血和铅。 在二次分析中，研究人员将评估： 1) 该系统对预防服务率的影响 社会弱势儿童； 2）实践在多大程度上更有效地提供咨询服务 （提供含有足够铁质的饮食、使用汽车座椅、 确保 6 个月以上的婴儿摄入足够量的氟化物）； 3) 儿童四年视力和血压筛查率 年龄； 4）系统对家长认知和行为的影响 预防; 5) 对提供者预防性服务记录的影响； 6) 哪些实践特征与预干预相关 表现; 7）实施办公系统的做法是否继续使用它 干预结束后；和 8) 随着时间的推移，变化对以下方面有何影响： 一个。 医生和工作人员有关预防系统的知识 b. 用于提供服务的活动 c. 对易于提供预防性护理的态度。

项目成果

A randomized trial of practice-based education to improve delivery systems for anticipatory guidance.

一项基于实践的教育随机试验，旨在改进预期指导的交付系统。

• DOI: 10.1001/archpedi.159.5.456
• 发表时间: 2005
• 期刊: Archives of pediatrics & adolescent medicine
• 作者: Rosenthal,MarjorieS;Lannon,CaroleM;Stuart,JayneM;Brown,Laura;Miller,WilliamC;Margolis,PeterA
• 通讯作者: Margolis,PeterA