Translating Evidence-Based Developmental Screening into Pediatric Primary Care

将循证发育筛查转化为儿科初级保健

• 批准号: 7405267
• 负责人: JAMES P GUEVARA
• 金额: $ 44.9万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-30 至 2010-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7405267
• 关键词: Translating; Evidence; Based; Developmental; Screening

DESCRIPTION (provided by the applicant): Developmental problems in early childhood are common and often go undetected, leading to significant disability. Developmental screening using standardized instruments can improve the detection of developmental delays and allow for referral to early intervention services. Unfortunately, few clinicians utilize standardized screening instruments to identify developmental problems. The American Academy of Pediatrics (AAP) recently issued a recommendation that health care providers conduct developmental surveillance at all well child visits and institute developmental screening at 9, 18, and 30 months of age. This application will address the adaptability, feasibility, and effectiveness of the AAP's evidence-based policy statement regarding developmental screening in an urban primary care setting serving primarily low income African American families. The specific aims of this application are (1) to identify barriers and facilitators to the use of guideline based standardized developmental screening in primary care practice, (2) to assess the feasibility of implementation of two different developmental screening protocols compared with a control condition: standardized developmental screening at 9, 18, and 30 months with support for the implementation of the protocol (Intervention 1) vs. standardized developmental screening at 9, 18, and 30 months with no additional support for the implementation of the protocol (Intervention 2) vs. developmental surveillance alone (control condition), and (3) to determine the relative effectiveness of two different developmental screening protocols compared with a control condition: standardized developmental screening at 9, 18, and 30 months with support for the implementation of the protocol (Intervention 1) vs. standardized developmental screening at 9, 18, and 30 months with no additional support for the implementation of the protocol (Intervention 2) vs. developmental surveillance alone (control condition). The application will employ a mixed methods study design that combines qualitative and quantitative methodologies. In year 1 of the application, urban primary care pediatric practices affiliated with a large children's hospital will be recruited. Focus groups of health care providers and office staff at participating practices will be conducted to identify attitudes, social norms, and perceived behavioral controls including facilitators and barriers to developmental screening. Information obtained from these meetings will be used to adapt a developmental screening protocol for implementation. In years 2-3 of the application, health care providers will be randomized to one of three developmental screening protocols: targeted screening by primary care support staff, targeted screening by health care providers, or surveillance alone. Eligible children will be followed in the intervention for 18 months, and outcome data on identification and referral of developmental problems and enrollment in early intervention will be obtained from electronic health records and early intervention service providers. Surveys of participating health care providers and families will be used to obtain information on the feasibility of the various screening protocols.

描述（由申请人提供）：儿童早期的发育问题很常见，但往往未被发现，导致严重的残疾。使用标准化仪器进行发育筛查可以改善对发育迟缓的发现，并允许转介到早期干预服务。不幸的是，很少有临床医生使用标准化的筛查工具来识别发育问题。美国儿科学会（AAP）最近发布了一项建议，建议卫生保健提供者在所有健康儿童就诊时进行发育监测，并在9个月、18个月和30个月时进行发育筛查。本申请将解决美国儿科学会基于证据的政策声明的适应性、可行性和有效性