Addressing Low-Income Families' Basic Social Needs at Pediatric Visits

在儿科就诊中满足低收入家庭的基本社会需求

• 批准号: 8298667
• 负责人: Arvin Garg
• 金额: $ 23.74万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-19 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8298667
• 关键词: Address; Alcohol or Other Drugs use; Attention; Attenuated; Baltimore; Caring; Child; Child health care; Childhood; Clinic; Collaborations; Communities; Development; Distal; Domestic Violence; Education; Effectiveness; Employment; Ensure; Environment; Family; Fellowship; Food; Goals; Guidelines; Health; Health Policy; Healthy People 2010; Housing; Human Development; Institutes; Intervention; Intervention Studies; Knowledge; Life; Low income; Mediating; Mediation; Medicine; Mental Depression; Mentors; Mission; Modeling; National Institute of Child Health and Human Development; Outcome; Parents; Personal Satisfaction; Phase; Physicians; Poverty; Preventive; Primary Health Care; Protocols documentation; Provider; Randomized Controlled Trials; Research; Resources; Risk; Role; Site; Smoking; Stress; Testing; Visit; base; career; chronic care model; depressive symptoms; design; experience; food security; health care service utilization; health disparity; improved; intimate partner violence; meetings; psychosocial; satisfaction; skills; social; theories

DESCRIPTION (provided by applicant): Low-income families often struggle to meet basic social needs such as food, housing, employment, and childcare. Children growing up in such an environment are at increased risk for poor health and development. A fundamental tenet of primary care medicine is for physicians to "practice in the context of family and community". However, few pediatric providers routinely address families' basic social needs. The candidate's long-term career goal is to reduce health disparities through theory- and research-based interventions addressing families' basic social needs in the context of pediatric primary care. His recently completed fellowship research ~ a randomized controlled trial at an urban pediatric primary care clinic in Baltimore ~ demonstrated the positive impact of a protocol for parental self-identification of family psychosocial problems, providers' discussion of family needs, and referral of families to community resources to address these needs. The mentored phase has three goals: (1) to build observational and intervention research skills pertinent to primary care-based strategies to promote child outcomes by addressing family psychosocial needs; (2) to acquire health policy skills; and (3) to gain experience developing collaborations between community social agencies and pediatric primary care. In the independent phase, the candidate will develop and test experimentally the impact of a primary care-based Basic Needs Surveillance (BNS) protocol on family, parent, and child outcomes. The BNS protocol is derived from his fellowship project's protocol; it also incorporates concepts from developmental surveillance and the Chronic Care Model to strengthen the model and enhance implementation fidelity across primary care sites. The aims for the independent study are to: (1) demonstrate the feasibility of implementing the BNS protocol in pediatric practice; (2) assess its effects on low-income families' use of community resources, basic social needs, parental well-being, and pediatric health care utilization; and (3) explore mediation and moderation of the protocol's impact on use of community resources, basic needs, parental well-being, and pediatric health care utilization. Nearly 40 percent of children in the US live in low-income families. This project will further develop primary care's role in addressing families' basic social needs as a strategy to reduce health disparities - a main goal of Healthy People 2010 - and to ensure that low-income children have "the chance to achieve their full potential for healthy and productive lives" - a stated mission of the NICHD.

描述（由申请人提供）：低收入家庭往往难以满足基本的社会需求，如食物，住房，就业和儿童保育。在这种环境中长大的儿童健康和发育不良的风险更大。初级保健医学的一个基本原则是医生“在家庭和社区的背景下执业”。然而，很少有儿科服务提供者经常解决家庭的基本社会需求。候选人的长期职业目标是通过理论和研究为基础的干预措施，解决家庭的基本社会需求，在儿科初级保健的背景下，减少健康差距。他最近完成的奖学金研究-在巴尔的摩的一家城市儿科初级保健诊所进行的随机对照试验-证明了父母自我识别家庭心理社会问题，提供者讨论家庭需求以及将家庭转介到社区资源以解决这些需求的协议的积极影响。指导阶段有三个目标：（1）建立有关的观察和干预研究技能，以初级保健为基础的战略，以促进儿童的成果，通过解决家庭心理社会需求;（2）获得卫生政策的技能;（3）获得经验，发展社区社会机构和儿科初级保健之间的合作。在独立阶段，候选人将开发和实验测试基于初级保健的基本需求监测（BNS）协议对家庭，父母和儿童结局的影响。BNS协议是从他的奖学金项目的协议派生出来的;它还结合了发展监测和慢性病护理模型的概念，以加强该模型，并提高整个初级保健站点的实施保真度。本独立研究的目的是：（1）证明在儿科实践中实施BNS方案的可行性;（2）评估其对低收入家庭使用社区资源、基本社会需求、父母幸福感和儿科卫生保健利用的影响;以及（3）探讨该方案对社区资源利用、基本需求、父母幸福感和儿科卫生保健利用的影响的中介和调节作用。美国近40%的儿童生活在低收入家庭。该项目将进一步发展初级保健在满足家庭基本社会需求方面的作用，作为一项战略，以减少健康差距-“2010年健康人”的主要目标-并确保低收入儿童“有机会充分发挥其健康和有所作为的生活潜力”-这是国家儿童与发展研究所的一项明确使命。