Evidence Standards for Child Health Promotion

描述（由申请人提供）：美国对儿童的现代医疗保健包括疾病的识别和治疗以及促进儿童的健康和福祉。该提案支持召开一次会议，使不同的利益攸关方参与者能够对由英联邦基金和内穆尔健康信托基金资助的一个更大的方案有实质性的投入，以制定和传播促进儿童健康政策和实践的证据标准。最近的调查表明，父母重视健康促进活动，并期望将其作为子女保健的一部分。初级保健临床医生向他们的专业组织和其他决策组织寻求政策来指导这些健康促进和疾病预防活动的内容。决策者可以依靠专家指导，或已发表的研究报告，或两者兼而有之。不幸的是，通常用于确定卫生服务的证据标准在促进儿童健康方面的应用有限，导致对政策的分歧。调查人员已经开始制定促进儿童健康的证据标准，以便进行更知情的讨论。这一进程始于2006年3月与美国预防服务工作队会议一起召开的规划会议。在那次会议上，出现了三个主要概念：(1)促进儿童健康的成果主要与儿童的发展轨迹有关，而不是与预防特定疾病或医疗状况有关；(2)目前使用证据为政策和实践提供信息的方法往往低估了随机临床试验以外的科学方法的价值，尽管这些其他方法通常提供有关儿童健康促进的最合理信息；(3)在考虑的建议类型与告知和支持这种建议所需的数据之间应该有更好的匹配。一项解决这些问题的方案正在取得进展，并将这些问题纳入制定、评估和使用科学信息的新方法，以决定促进儿童健康的政策和做法。本次会议将邀请代表不同观点的专家积极参与：研究人员、政策制定者、从业者和消费者。会议将以介绍和讨论关键技术问题开始，然后进行一系列精心设计的会议活动，以发展一种新的方法模式。然后，与会者将参加旨在征求对其结果的评论和制定计划以传播和执行最后结果的练习。寻求AHRQ资金是为了使大批利益攸关方能够与我们合作，制定证据标准，使临床医生能够更有效地为改善美国儿童的健康和福祉而工作。

DESCRIPTION (PROVIDED BY APPLICANT): Modern medical care for children in the United States includes both identification and treatment of disease and promotion of the child's health and well-being. This proposal supports a conference that will allow diverse stakeholder participants to have substantive input into a larger program, funded by the Commonwealth Fund and the Nemours Health Trust, to develop and disseminate evidence standards for child health promotion policy and practice. Recent surveys have demonstrated that parents value health promotion activity and have come to expect it as part of their children's healthcare. Primary care clinicians turn to their professional organizations and other policymaking organizations for policies to guide the content of these health promotion and disease prevention activities. Policy-makers may rely on expert guidance, or on published studies, or on a combination. Unfortunately, the evidence standards typically used in determining health services have only limited application in child health promotion, resulting in disagreements about policies. The investigators have begun a process to develop evidence standards for child health promotion that would allow for more informed discussions. This process began with a planning conference held March 2006, in conjunction with a meeting of the United States Preventive Service Task Force. At that meeting, three main concepts emerged: (1) The outcomes of child health promotion relate primarily to the child's developmental trajectory, rather than the prevention of specific diseases or medical conditions; (2) Current methods of using evidence to inform policy and practice tend to discount the value of scientific methods other than randomized clinical trials, although these other methods often provide the most reasonable information about child health promotion; and (3) There should be a better match between the type of recommendation under consideration and the data necessary to inform and support such a recommendation. Work is progressing on a program to address these concerns and incorporate them into new ways of developing, assessing, and using scientific information in making decisions on child health promotion policies and practices. This conference will solicit the active participation of experts representing different perspectives: researchers, policymakers, practitioners and consumers. The conference will begin with presentations and discussions of key technical issues, and proceed through a series of carefully designed conference activities to develop a new methodological model. Conference participants will then participate in exercises designed to obtain comments on their results and to develop a plan to disseminate and implement the final results. AHRQ funds are sought to enable the large group of stakeholders to work with us to develop evidence standards that will allow clinicians to work more effectively towards improving the health and well being of American children.