Multi-modal physician intervention to detect amblyopia

多模式医师干预检测弱视

• 批准号: 7281189
• 负责人: WENDY L MARSH-TOOTLE
• 金额: $ 35.2万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-22 至 2010-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7281189
• 关键词: Academy; Alabama; Amblyopia; American; Americas; Attitude; Awareness; Blindness; Caring; Child; Childhood; Code; Collaborations; Communication; Condition; Control Groups; Current Procedural Terminology Codes; Data; Diagnosis; Diagnostic; Evaluation; Eye; Eye diseases; Family Practice; Fostering; Future; Gatekeeping; Goals; Guidelines; Health Communication; Health Status; Healthcare; Healthcare Systems; Immunization; Individual; Internet; Intervention; Knowledge; Link; Managed Care; Maternal and Child Health; Measures; Medicaid; Methods; Names; Nursery Schools; Optometry; Outcome Measure; Patients; Pediatrics; Performance; Physicians; Play; Population; Preschool Child; Primary Care Physician; Primary Health Care; Provider; Randomized Controlled Clinical Trials; Range; Recruitment Activity; Research; Research Personnel; Risk Factors; Role; Screening procedure; Source; Specialist; Strabismus; Testing; Time; Training; Translating; Universities; Vision; Vision Screening; Visit; Visual Acuity; Work; base; communication theory; continuing medical education; design; experience; forging; improved; novel; pediatrician; prevent; relating to nervous system; skills

DESCRIPTION (provided by applicant): Despite decades of research showing adverse neural consequences of abnormal vision, little has changed for amblyopic children. Data have shown that approximately half the cases of amblyopia are detected late, and this finding has remained stable during the past 40 years. In our health care system, primary care physicians play a pivotal role in translating findings about amblyopia into practice. But, our experience with the Maternal and Child Health Bureau (MCHB) / NEI expert panel on Vision Screening in the Preschool Child and the CHB/American Academy of Pediatrics (AAP) Project Universal Preschool Vision Screening revealed that primary care physicians get very little training about amblyopia and risk factors. Consequently, many do not screen aggressively for these conditions. The University of Alabama Departments of Optometry, Pediatrics and Continuing Medical Education, in collaboration with the AAP, MCHB, Prevent Blindness America, the Pediatric Eye Disease Investigators Group, the Vision in Preschoolers Study Group, and the Alabama Medicaid Agency, propose to develop a novel, internet-based, multi-modal strategy to increase the understanding and recognition of amblyopia and its risk factors by pediatricians and primary care physicians in office based settings. We propose a randomized, controlled clinical trial to test whether our intervention results in improved performance by "intervention" physicians compared to control physicians (exposed to an immunization intervention). Our design, along with pre- and post-intervention performance measures, will evaluate changes in practice attributable to the intervention versus those occurring from other sources over time. Our final analysis will show whether preschool patients of intervention physicians are more likely to be identified with strabismus or amblyopia. This research forges a critical link between the truly phenomenal body of amblyopia research fostered by the NEI and the health care offered to American children.

描述(由申请人提供)：尽管几十年的研究表明视力异常会造成不良的神经后果，但弱视儿童的情况几乎没有改变。数据显示，大约一半的弱视病例发现较晚，这一发现在过去40年中一直保持稳定。在我们的医疗保健系统中，初级保健医生在将弱视的研究成果转化为实践方面发挥着关键作用。但是，我们与母婴健康局(MCHB)/NEI学龄前儿童视力筛查专家小组和CHB/美国儿科学会(AAP)项目普遍学龄前视力筛查的经验表明，初级保健医生几乎没有接受过关于弱视和危险因素的培训。因此，许多人不会积极筛查这些情况。阿拉巴马大学验光、儿科和继续医学教育系与AAP、MCHB、预防失明美国、儿科眼病调查小组、学龄前儿童视力研究小组和阿拉巴马州医疗补助机构合作，提议开发一种新颖的、基于互联网的多模式策略，以增加儿科医生和初级保健医生在办公室环境下对弱视及其危险因素的理解和认识。我们提出了一项随机对照临床试验，以测试我们的干预是否会导致“干预”医生比对照医生(接受免疫干预)的表现有所改善。我们的设计，以及干预前和干预后的绩效衡量，将评估可归因于干预的实践变化与随时间推移来自其他来源的变化。我们的最终分析将显示干预医生的学龄前患者更有可能被确定为斜视或弱视。这项研究在NEI培育的真正非凡的弱视研究机构和为美国儿童提供的医疗保健之间建立了关键联系。