Motivational Interviewing Simulation to Prevent & Manage Pediatric Obesity

描述（由申请人提供）： 儿童肥胖是一个严重的公共卫生问题，具有重大的健康风险和高昂的医疗费用。在办公室访问的背景下使用围绕营养和身体活动的动机访谈（MI）在儿童和成人的健康行为改变和体重减轻方面显示出积极的结果。尽管研究证明 MI 作为患者和医生交流的工具的有效性，但大多数执业临床医生缺乏 MI 培训。美国儿科学会和 Kognito 正在合作研究以下假设，即虚拟现实技术是一种有效的工具：1）教授关键概念，并）在围绕儿童肥胖预防和治疗的动机性访谈和认知行为指导方面培养医疗保健专业人员的技能并提高其效率。该项目的具体目标是： 目标 1：确定利用虚拟现实技术对临床医生进行动机访谈教育的可接受性，并培养利用动机访谈和行为辅导作为护理点行为咨询一部分的技能和自我效能；目标 2：识别和分离最有效提高临床医生关于动机性访谈和行为辅导的知识和技能的关键创新技术和功能；目标 3：在目标用户样本中确定最相关的内容，将其包含在基于虚拟现实的教育模块中，该模块旨在通过使用动机访谈来改善临床医生的行为咨询和指导；目标 4：确定医疗之家和家庭/患者/从业者团队可以使用该技术来监测、评估行为目标和取得进展的潜在方式。方法：为了实现我们的目标，我们建议进行定量和定性研究相结合，使临床医生能够“测试”该技术，并在个人层面上提供即时反馈，并在互动环境中提供更具反思性的反馈。总共 35 名儿科医生将被纳入第一阶段研究的目标。样品 将反映当前 AAP 成员的年龄和性别人口统计数据；在此背景下，我们将对为肥胖风险较高人群提供服务的临床医生进行过度抽样。选定的儿科医生将被要求完成研究的两个组成部分。首先，所有 35 名参与者将独立审查测试模块，并通过前后调查以及整个模块中的弹出问题提供定量反馈。此外，将通过结构化的一对一电话访谈或小型焦点小组向参与者收集定性数据。该技术的商业应用包括能够快速传播给各种环境中的执业临床医生，包括作为继续教育活动的学分，以及通过专业学校（医学、护理、医师助理等）向学员传播的能力，以及向肥胖和肥胖相关并发症风险最高的人群进行有针对性的推广。任何拥有互联网连接或具有 CD/DVD 功能的计算机的用户都可以使用培训及其所有上述组件，因此，与面对面和团体培训相比，可以以较低的每用户成本向大量且地理上分散的人群提供培训。 （摘要完）

DESCRIPTION (provided by applicant): Childhood obesity is a serious public health issue with significant health risks and high medical costs. Using motivational interviewing (MI) around nutrition and physical activity in the context o an office visit has shown positive results in terms of health behavior change and weight lost in both the pediatric and adult populations. Despite studies demonstrating the efficacy of MI as a tool in the patient and physician encounter, most practicing clinicians lack training in MI. The American Academy of Pediatrics and Kognito are partnering to examine the following hypothesis that virtual reality technology is an effective tool to: 1) teach critical concepts and ) build skills and increase efficacy among healthcare professionals in motivational interviewing and cognitive behavioral coaching around childhood obesity prevention and treatment. Specifically the aims of this project are to: AIM 1: to ascertain the acceptability of utilizing vitual reality technology to educate clinicians on motivational interviewing and to build skills and self-efficacy in utilizing motivational interviewing and behavioral coaching as part of behavioral counseling at the point of care; AIM 2: to identify and isolate the key innovative technologies and features that will be most effective in improving clinician knowledge and skills on motivational interviewing and behavioral coaching; AIM 3: to identify, among a sample of target users, the most pertinent content to be included in a virtual reality- based educational module designed to improve clinician behavioral counseling and coaching through the use of motivational interviewing; and AIM 4: to ascertain potential ways that this technology can be used by the medical home and family/patient/practitioner team to monitor, assess, and progress on behavioral goals. Methods: To accomplish our aims, we propose conducting a blend of quantitative and qualitative research that allows clinicians to "test" the technology and provide both immediate feedback on an individual level and more reflective feedback in an interactive setting. A total of 35 pediatricians will be targeted for inclusion in Phase I research. The sample will reflect the current AAP member demographics for age and gender; within this context, we will oversample clinicians serving populations at higher risk for obesity. Pediatricians selected will be asked to complete two components of the study. First, all 35 will independently review a test module and provide quantitative feedback via pre and post surveys as well as pop-up questions throughout the module. In addition, qualitative data will be collected with participants through either a structured one on one interview over the phone or a small focus group. Commercial applications for this technology includes the capacity to be rapidly disseminated to practicing clinicians in a variety of settings, including for credit as Continuing Education activities, as well as to trainees through professional schools (medical, nursing, physician assistant, etc), and to conduct targeted outreach to those serving populations at the highest risk for obesity and obesity- related comorbities. The training and all its aforementioned components are available to any user with an internet- connected or CD/DVD capable computer and can, therefore, be delivered to large and geographically dispersed populations at low per-user costs when compared with in-person and group trainings. (End of Abstract)