Shared Decision Making in ADHD

多动症的共同决策

• 批准号: 8119420
• 负责人: Alexander Gabriel Fiks
• 金额: $ 12.61万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8119420
• 关键词: Accident and Emergency department; Adherence; African American; Attention deficit hyperactivity disorder; Award; Child; Child health care; Childhood; Complement; Computer Systems; Conduct Clinical Trials; Conflict (Psychology); Country; Data; Decision Aid; Decision Making; Device or Instrument Development; Doctor of Medicine; Educational workshop; Effectiveness; Ethnic Origin; Evidence based treatment; Family; Goals; Grant; Health; Impairment; Institute of Medicine (U.S.); Intervention; K-Series Research Career Programs; Knowledge; Language; Length; Link; Longitudinal Studies; Measurement; Measures; Mentorship; Outcome; Parents; Patients; Population; Prevalence; Primary Health Care; Principal Investigator; Process; Race; Reporting; Research; Research Personnel; Role; Sampling; Schools; Severities; Socioeconomic Status; Structure; Subgroup; Symptoms; System; Training; Treatment outcome; Uncertainty; Validity and Reliability; Visit; Work; base; career; cohort; cultural values; effective intervention; functional disability; health information technology; improved; instrument; pediatrician; practice-based research network; preference; prototype; public health relevance; shared decision making; skills; symposium; treatment as usual

DESCRIPTION (provided by applicant): Alexander Fiks, M.D., MSCE is an urban primary care pediatrician who studies health information technology (HIT) to improve child health outcomes. Dr. Fiks' research has found that although clinician-focused HIT interventions are effective, their impact could be increased by facilitating information exchange between clinicians and families in order to clarify treatment preferences and goals, a process called shared decision making (SDM). Although Dr. Fiks' long-term career goal is to become an independent investigator expert in the large-scale implementation of SDM using HIT for multiple pediatric conditions, this career development award will focus on Attention-Deficit/Hyperactivity Disorder (ADHD). ADHD is an ideal prototype condition for SDM: families choose between multiple evidence-based treatments; personal/cultural values influence their selection; treatment disparities exist; and little work has so far been done to untangle these effects to support decision making. During this award, Dr. Fiks will: (1) assess the prevalence, determinants, and impact of SDM in primary care for a nationally representative sample of children with ADHD, (2) develop an instrument to measure families' preferences and goals for ADHD treatment, and (3) assess the feasibility and acceptability, and explore the outcomes of an ADHD, HIT-based SDM pilot intervention in primary care. The hypothesis of this application is that use of an instrument to capture families' ADHD treatment preferences and goals within an HIT-based system will facilitate SDM and improve adherence to and outcomes from treatment. This research, utilizing a pediatric practice-based research network, will complement formal coursework, workshop/conference participation, and skilled mentorship to train Dr. Fiks to achieve his career goals. Dr. Fiks' specific educational aims are to (1) develop expert skills to evaluate the effectiveness of HIT-enabled SDM including the study of longitudinal/clustered data and the conduct of clinical trials, (2) develop advanced skills in health measurement and instrument development, and (3) advance his knowledge of approaches to encourage SDM including the use of decision aids and HIT. This 5 year award will provide Dr. Fiks with the training and pilot data needed to launch an R01-level trial of SDM for ADHD. PUBLIC HEALTH RELEVANCE: Prioritized by the Institute of Medicine, shared decision making (SDM) promises to match families to acceptable treatments and improve child health outcomes. By capturing, transferring, and processing health information, computer systems can support SDM on a large-scale. This grant explores the role of these systems to facilitate SDM for ADHD, a condition impairing more than 4 million children in this country.

描述（由申请人提供）：MSCE Alexander Fiks，医学博士是一位城市初级保健儿科医生，研究健康信息技术（HIT）以改善儿童健康成果。 Fiks博士的研究发现，尽管以临床医生为中心的命中干预措施有效，但可以通过促进临床医生和家庭之间的信息交换来增加其影响，以澄清治疗偏好和目标，这一过程称为共享决策（SDM）。尽管Fiks博士的长期职业目标是成为用于多种儿科状况的HIT的大规模实施SDM实施的独立研究者，但该职业发展奖将集中于注意力缺陷/多动症障碍（ADHD）。多动症是SDM的理想原型条件：家庭在多种基于证据的治疗之间进行选择；个人/文化价值影响他们的选择；存在治疗差异；到目前为止，几乎没有做一些工作来解开这些效果以支持决策。 During this award, Dr. Fiks will: (1) assess the prevalence, determinants, and impact of SDM in primary care for a nationally representative sample of children with ADHD, (2) develop an instrument to measure families' preferences and goals for ADHD treatment, and (3) assess the feasibility and acceptability, and explore the outcomes of an ADHD, HIT-based SDM pilot intervention in primary care.该应用的假设是，在基于命中的系统中使用仪器来捕获家庭的ADHD治疗偏好和目标将有助于SDM并提高对治疗的依从性和结果。这项利用基于儿科实践的研究网络的研究将补充正式课程，研讨会/会议参与以及熟练的指导，以培训Fiks博士以实现其职业目标。 Fiks博士的具体教育目的是（1）发展专家技能，以评估示威SDM的有效性，包括研究纵向/群集数据和临床试验的进行，（2）发展健康测量和仪器开发方面的高级技能，以及（3）提高他的方法来鼓励他鼓励使用SDM的知识，包括使用决策AID和打击。该5年奖将为Fiks博士提供启动SDM的R01级试验所需的培训和试点数据。 公共卫生相关性：由医学研究所优先考虑，共享决策（SDM）有望与家庭相匹配，以接受可接受的治疗并改善儿童健康结果。通过捕获，转移和处理健康信息，计算机系统可以在大规模上支持SDM。该赠款探讨了这些系统为促进SDM的ADHD的作用，ADHD的疾病损害了该国超过400万儿童。