CURRICULUM FOR PEDIATRIC HERBS/DIETARY SUPPLEMENTS

随着公众越来越多地转向补充和替代医疗（CAM）疗法，越来越多的卫生专业人员被问及草药(H)和其他膳食补充剂（DS），他们可能没有接受过正规教育。由于儿童和青少年易受伤害的人群存在毒性风险，因此使用H/DS尤其引起照顾儿童和青少年的临床医生的关注。该项目将评估提供基于互联网的电子教育干预的可行性，以帮助照顾儿童的医生、执业护士和药剂师更多地了解儿童和青少年最常用的卫生保健/保健服务。参与者将从儿童医院、马萨诸塞州药学与健康科学学院和波士顿哈佛医学院招募。感兴趣的临床医生将随机分配到立即干预组或等待名单对照组。两组都将在基线上进行知识、态度和实践（KAP）测试。干预组将接受由三部分组成的课程：l) 20个基于案例的简短模块，其中包含一个选择题和每周两次通过电子邮件发送的关于H/DS的信息；2)访问具有相同模块和相同主题的更深入的循证临床医生信息的网页；3)举办电子论坛，讨论各模块、网页和参与者的临床经验。20个模块分发给干预参与者后，所有参与者将接受后续KAP调查# 1（内容评估）。然后，等候名单组将收到课程。然后，两组都将接受后续的KAP调查#2和教育干预评估（过程评估）。基线和结果内容评估将由对分配状态不知情的研究人员使用描述性统计和“治疗意向”分析进行分析，并酌情控制基线评分。这项试点研究的信息将用于为照顾儿童和青少年的医生、护士从业人员和药剂师准备关于健康/死亡的国家电子教育计划。

As the public increasingly turns to complementary and alternative medical (CAM) therapies, more and more health professionals are asked about herbs (H) and other dietary supplements (DS) about which they may not have received formal education. The use of H/DS is particularly concerning to clinicians caring for children and adolescents because of the risks of toxicity in this vulnerable population. This project will evaluate the feasibility of providing an Internet-based, electronic educational intervention to help physicians, nurse practitioners and pharmacists who care for children learn more about the H/DS most often used by children and adolescents. Participants will be recruited from the Children's Hospital, the Massachusetts College of Pharmacy and Health Sciences and the Harvard Medical School in Boston. Interested clinicians will be randomized to an immediate intervention or a wait list comparison group. Both groups will be tested at baseline for knowledge, attitudes and practices (KAP). The intervention group will receive a 3-part curriculum: l) 20 brief modules of case-based vignettes with a single multiple choice question and information about H/DS via e-mail twice weekly; 2) access to Web pages with the same modules and more in-depth evidence-based clinician information on the same topics; 3) a moderated electronic forum to discuss the information about H/DS from the modules, the Web page and the participants' clinical experiences. After the 20 modules have been distributed to intervention participants, all participants will receive follow-up KAP survey #l (content evaluation). The wait list group will then receive the curriculum. Both groups will then receive follow-up KAP survey #2 and an assessment of the educational intervention (process evaluation). Baseline and outcome content evaluations will be analyzed by researchers blinded to assignment status using descriptive statistics and an "intention to treat" analysis, controlling for baseline scores as appropriate. Information from this pilot study will be used to prepare national electronic educational programs about H/DS for physicians, nurse practitioners and pharmacists who care for children and adolescents.