CURRICULUM FOR PEDIATRIC HERBS/DIETARY SUPPLEMENTS

随着公众越来越多地转向补充和替代医学(CAM)疗法，越来越多的卫生专业人员被问及他们可能没有接受过正规教育的草药(H)和其他膳食补充剂(DS)。对于照顾儿童和青少年的临床医生来说，H/DS的使用尤其令人担忧，因为在这一脆弱人群中存在毒性风险。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、护士从业者和药剂师更多地了解儿童和青少年最常用的H/DS。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的哈佛医学院招募。感兴趣的临床医生将被随机分成立即干预组或等待名单对照组。两组都将接受知识、态度和实践(KAP)的基线测试。干预组将收到由三部分组成的课程：L)20个简短的基于病例的小插曲模块，带有一个单项选择题和关于H/DS的信息，每周两次通过电子邮件；2)访问具有相同模块的网页，以及关于相同主题的更深入的循证临床医生信息；3)主持的电子论坛，从这些模块、网页和参与者的临床经验讨论关于H/DS的信息。在20个模块分发给干预参与者后，所有参与者都将获得后续的KAP调查#L(内容评估)。然后，等待名单小组将收到课程。然后两组都将接受后续的KAP调查2和教育干预的评估(过程评估)。基线和结果内容评估将由对任务状态视而不见的研究人员使用描述性统计和“治疗意向”分析进行分析，并适当控制基线分数。这项试点研究的信息将被用于为照顾儿童和青少年的医生、护士从业者和药剂师准备有关H/DS的全国性电子教育计划。

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.