Improving Pediatric Developmental Screening and Communications: A CME

描述（由申请人提供）：发育迟缓在儿童早期很常见，影响至少10%的儿童，是后期发育状况的标志。众所周知，大脑在生命的头三年具有巨大的适应性，这意味着早期治疗迟缓会改善结果，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识别迟缓和感觉障碍至关重要。儿童健康的主要组织对这一主题的广泛关注（美国儿科学会的建议，NICHD对有智力迟钝风险的婴幼儿的早期识别和干预，以及AHRQ对诊断错误研究的特别强调通知）证明了对早期识别有巨大的需求和兴趣。一个一贯关注的问题是，有必要针对不同的受众制定筛查策略，并将有效的、基于证据的筛查方法转化为用于初级保健实践的方法。有许多不同的筛查工具可供使用，但对于哪种筛查方法在实践中使用效果最佳尚无共识。然而，筛查越来越多地被从业者采用，并且将结果传递给父母时存在高度的不适。因此，有必要提供教育材料，汇集信息，以帮助初级保健提供者选择最佳工具；为在实践中实施筛查提供指导；并在实践中传达了这些筛选的目的和结果。该资源将告知提供者进行发育筛查的重要性和挑战；协助提供者理解并与家长沟通这些结果，识别和承认在筛查策略和结果交付方面的文化差异。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)理解并适当实施初级保健中的发育筛查。2)加强与家长对发育筛查试验目的和结果的沟通。目标2：为基于web的CME/CE课程的原型模块开发临床内容/交互性。目标3：开发一种独特的方法，通过基于视频的讲故事的小插曲在网络上学习。这个在线继续教育项目将通过儿科医生和父母的“真实世界”故事来讲述他们处理这些问题的故事（用他们自己的话）。本课程将说明如何将结果传达给父母，并寻求适当的后续护理步骤。因为拍摄高质量的视频是这样一个项目的核心成本组成部分，我们也建议使用视频为家长创建一个网站。目标4：进行一系列定性访谈，为开发和评估课程提供信息。

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.