Improving Pediatric Developmental Screening and Communications: A CME

描述（由申请人提供）：发育迟缓在幼儿期很常见，影响至少10%的儿童，是后来发育状况的标志。众所周知，大脑在生命的前三年具有巨大的适应性，这意味着早期治疗延迟会导致改善的结果，而后期干预则效果较差。为了提供治疗以改善儿童的结果，在生命的头三年早期发现发育迟缓和感觉障碍至关重要。 有一个巨大的需要和兴趣在早期识别儿童的风险发展问题，证明了广泛关注这一主题的主要组织儿科健康（AAP建议，NICHD的早期识别和干预婴幼儿的风险智力迟钝，和AHRQ特别强调通知诊断错误的研究）。一个一致的关注是，有必要在不同的观众筛选策略，并翻译有效的，以证据为基础的筛选方法，用于初级保健的做法。有许多不同的筛选工具可用，但在实践中最好使用哪些筛选方面没有达成共识。然而，筛查越来越多地被从业者采用，并且将结果翻译给父母的不适程度很高。因此，有必要的教育材料，汇集信息，以帮助初级保健提供者选择最佳的工具，提供指导，在实践中实施筛选，并沟通这些屏幕的目的和结果在实践中。 该资源将告知提供者进行发育筛查的重要性和挑战;帮助提供者理解并向父母传达这些结果，并确定和承认筛查策略和结果交付中的文化差异。具体目标是：目标1：为CME/CE项目制定临床内容大纲，重点关注两个主要领域：1）了解并适当实施初级保健中的发育筛查。2)改善与父母沟通发育筛查测试的目的和结果。目标2：开发基于Web的CME/CE课程的原型模块的临床内容/交互性。目标3：通过基于视频的讲故事小插曲，开发一种独特的网络学习方法。这个在线继续医学教育计划将通过“真实的世界”的故事，儿科医生和家长谁处理过这样的问题（用他们自己的话）。该课程将说明与父母沟通结果并寻求适当的下一步护理的技术。因为拍摄高质量的视频是这样一个计划的核心成本组成部分，我们还建议使用视频为父母创建一个网站。目标4：进行一系列定性访谈，为课程的发展提供信息，并对课程进行评估。 公共卫生相关性：在这个第一阶段计划中，我们将开发一个基于网络的CME/CE课程的原型，以帮助医疗保健提供者了解发育筛查的目的和方法，并更有效地与父母沟通结果。该计划将汇集现有的研究，并为儿科医生提供一个易于获得的筛查来源。通过提供创新的内容，通过一个既定的媒体，我们的目标是，通过这个产品，达到初级保健提供者面临这一重要问题，以改善结果，通过早期识别和干预。

DESCRIPTION (provided by applicant): Developmental delays are common in early childhood, affecting at least 10 percent of children and are markers for later developmental conditions. It is well established that the tremendous adaptability of the brain in the first three years of life means that early treatment of delays leads to improved outcomes, whereas later intervention is less effective. In order to provide treatment to improve children's outcomes, early identification of delays and sensory impairments during the first three years of life are critical. There is a tremendous need for and interest in early identification of children at risk for development problems, as is evidenced by the vast attention to this topic by the leading organizations for pediatric health (AAP recommendations, NICHD's Early Identification and Interventions for Infants and Young Children at Risk for Mental Retardation, and AHRQ Special Emphasis Notice for research on diagnostic errors). A consistent concern is that there is the need for screening strategies in diverse audiences, and for translating effective, evidence-based screening approaches for use in primary care practices. There are a number of different screening tools available, but no consensus on which screens are best used in practice. However, screening is being increasingly adopted by practitioners and there is a high level of discomfort translating the results to parents. Thus, there is a need for educational materials that brings together information to assist primary care providers in choosing the best tools; provides guidance on implementation of screening in practice; and communicates the purpose and results of these screens in practice. This resource will inform providers about the importance and challenges of conducting developmental screening; assist providers in understanding and communicating those results to parents, and identifying and acknowledging cultural differences in screening strategies and delivery of results. The specific aims are: Aim 1: To develop a clinical content outline for a CME/CE program that will focus on two major areas: 1) Understanding and appropriate implementation of development screeners in primary care. 2) Improving communication of the purpose and results of developmental screening tests with parents. Aim 2: Develop clinical content/interactivity for a prototype module of the Web-based CME/CE course. Aim 3: Develop a unique approach to learning on the web through video-based storytelling vignettes. This online CME program will speak through "real world" stories of pediatricians and parents who have dealt with such issues (in their own words). The course will illustrate techniques for communicating results to parents and seeking appropriate next steps for care. Because capturing high quality video is a core cost component of such a program, we also propose to use the video to create a web site for parents. Aim 4: Conduct a set of qualitative interviews to inform development and evaluate the course. PUBLIC HEALTH RELEVANCE: In this Phase I program we will develop a prototype of a CME/CE Web-based course to assist health care providers understand the purpose and approach to developmental screening, and more effectively communicate results with parents. This program will bring together existing research and provide an easily accessible source for pediatricians on screening. By providing innovative content via an established medium, we aim, through this product, to reach primary care providers facing this important issue to improve outcomes through early identification and intervention.