SBIR Phase II New Risk Assessment/Intervention For Pregnant Woman

SBIR 第二阶段针对孕妇的新风险评估/干预

• 批准号: 7188039
• 负责人: Robin Inlander
• 金额: $ 30.36万
• 依托单位: BEHAVIORAL RESEARCH, INC.
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-06-01 至 2009-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7188039
• 关键词: Accountability; Alcohol Nutrition; Alcohol consumption; Area; Arts; Back; Behavior; Birth; Clinic; Clinical; Communities; Computer software; Computers; Contracts; Data; Diagnostic; Discipline of obstetrics; Documentation; Drug usage; Elements; Feedback; Feeling; Fetus; First Pregnancy Trimester; Funding; HIV; Health Maintenance Organizations; Health Personnel; Hispanic Americans; Hour; Image; Individual; Intention; Intervention; Interview; Learning; Length; Low income; Maintenance; Marketing; Modeling; Motivation; Movement; Not Hispanic or Latino; Numbers; Online Systems; Operative Surgical Procedures; Outcome; Paper; Parents; Partner Abuse; Patient Self-Report; Patient currently pregnant; Patients; Personal Satisfaction; Pharmaceutical Preparations; Phase; Population; Pregnancy; Pregnant Women; Prenatal care; Prevention; Printing; Provider; Psychologist; Questionnaires; Race; Randomized; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Rate; Reaction; Readiness; Reporting; Research; Research Personnel; Resources; Risk; Risk Assessment; Risk Behaviors; Small Business Funding Mechanisms; Small Business Innovation Research Grant; Smoking; Staging; Standards of Weights and Measures; Stress; Structure; Substance abuse problem; Surveys; System; Testing; Text; Third Pregnancy Trimester; Time; Translating; Translations; Update; Validation; Visit; Vocabulary; Woman; base; behavior change; cigarette smoking; computerized; cost; design; follow-up; improved; instrument; maternal drug use; motivational intervention; nutrition; prenatal; prevent; programs; prototype; quality assurance; racial and ethnic; response; self reported behavior; usability; user-friendly

DESCRIPTION (provided by applicant): Drug use is common among pregnant women, yet only an estimated 32 percent to 42 percent of prenatal care providers routinely ask patients about their use of drugs. Prenatal visits afford a unique opportunity for providers to educate women about prevention, and to detect drug use during pregnancy. To facilitate efficient use of provider resources, we developed a computerized interactive survey interview, the Pregnancy Information Program (PIP) that has been extensively tested in non-Hispanic white, Hispanic, and American Indian populations. Earlier studies demonstrated that the PIP was well received in multiple ethnic/racial pregnant populations. More importantly, the PIP evoked more honest responses regarding drug use and other socially stigmatized behaviors than paper-and-pencil questionnaires. In Phase I we updated the program, integrated current diagnostic standards, added a tailored motivational intervention, and incorporated audio and video elements to the program. For this Phase II project, we propose to further enhance the software capabilities, expand the domains of use to clinicians, and develop a commercial quality CD ROM prototype of the entire instrument. We will beta test the completed instrument in 6 community women's clinics, to determine its acceptability and ease of use, through anonymous clinician surveys and rates of completion. We will also conduct a randomized, controlled clinical trial of 346 pregnant women to determine PIP's ability to promote behavior change from the initial to the third trimesters of pregnancy. Primary outcomes evaluated in this trial include self-reported changes in nutrition, drug use, alcohol use, cigarette smoking, HIV risk behavior, and partner abuse avoidance. We will also assess stages of readiness to change, where change is not yet manifest. Subjects in their first trimester will be randomized to complete the PIP or a computer questionnaire minus the educational and customized motivational feedback. Both groups also will receive printed educational information. In their third trimesters, subjects will complete a second computer-based questionnaire to determine current behaviors, and will participate in a personal interview regarding their reaction to PIP. Paired data will be analyzed using generalized linear mixed models to estimate differences between and within groups over time. This study will reveal the potential of the PIP to enhance prenatal healthy behaviors, and improve birth outcomes, while saving providers time.

描述（由申请人提供）：药物使用在孕妇中很常见，但估计只有32％至42％的产前护理提供者通常会向患者询问他们对药物的使用。产前访问为提供者提供了一个独特的机会，可以教育妇女有关预防的教育，并在怀孕期间发现吸毒。为了促进有效利用提供商资源，我们开发了一项计算机化的互动调查访谈，怀孕信息计划（PIP），该计划已在非西班牙裔白人，西班牙裔和美洲印第安人人群中进行了广泛的测试。较早的研究表明，该PIP在多个种族/种族怀孕人群中受到了良好的接受。更重要的是，与纸笔问卷相比，PIP唤起了关于吸毒和其他受到社会污名行为的更诚实的回应。在第一阶段，我们更新了该程序，集成了当前的诊断标准，添加了量身定制的动机干预，并将音频和视频元素纳入了程序。对于此II阶段项目，我们建议进一步增强软件功能，扩展到临床医生的使用域，并开发整个乐器的商业质量CD ROM原型。我们将通过匿名临床医生的调查和完成率测试了6个社区妇女诊所中完成的仪器，以确定其可接受性和易用性。我们还将对346名孕妇进行随机，对照临床试验，以确定PIP促进行为从最初的妊娠到第三个孕期的变化能力。该试验中评估的主要结果包括自我报告的营养，吸毒，饮酒，吸烟，艾滋病毒风险行为和避免伴侣滥用的变化。我们还将评估准备变化的准备阶段，而变化尚未体现出来。妊娠中期的受试者将被随机分配以完成PIP或计算机问卷减去教育和定​​制的动机反馈。这两个小组还将收到印刷的教育信息。在他们的第三个陈旧者中，受试者将完成第二份基于计算机的问卷，以确定当前行为，并将参加有关对PIP反应的个人访谈。配对数据将使用广义线性混合模型进行分析，以估计组之间和内部的差异。这项研究将揭示PIP增强产前健康行为并改善出生结果的潜力，同时节省提供者的时间。