An open-source public domain health risk assessment for use in primary care

用于初级保健的开源公共领域健康风险评估

• 批准号: 8698766
• 负责人: JOSEPH J SUDANO
• 金额: $ 48.77万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-30 至 2016-07-16
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8698766
• 关键词: open; source; public; domain; health

DESCRIPTION (provided by applicant): Over half of all deaths before age 65 can now be attributed to lifestyle factors. In order to reduce the annual incidence of lifestyle-based causes of death, it is essential to understand the contribution of lifestyle factors that are potentially under the control of the individual and those that may be amenable to social, medical or pharmacological interventions. The health risk appraisal (HRA) can be an important tool in assessing the impact of these precursors of disease and trauma. Additionally, the 2009 National Committee for Quality Assurance (NCQA) release of their accreditation requirements for health plans, preferred provider organizations, managed care organizations and health and wellness promotion programs requires the administration of HRA's as part of the accreditation process. These new standards will stimulate broad utilization of the HRA and call for a systematic review/updating of currently available instruments. Similarly, the transformation of many primary care practices into patient centered medical homes will also stimulate the need for instruments and tools that can help facilitate provider-patient communication and patient education. However, little is known regarding the uptake, usability, acceptability and effectiveness of HRA's in diverse primary care settings. What information we do have is based on very few managed care settings, employer wellness programs and insurance plans among mostly white, middle-class, employed individuals. In short, there is no information, to our knowledge, regarding the use of HRA's among racial/ethnicity minority groups, the uninsured, the poor, or those with limited health literacy. We also know of no studies regarding provider or patient satisfaction with HRA's, yet alone the effects of HRA's on patient health outcomes or behavior/lifestyle changes. All of these are important research questions that need answered, but require one critically important tool-a proven HRA that is inexpensive and easy to field in a wide variety of primary care settings, some resource rich and others resource poor. This application is a first step in filling all of these knowledge gaps. To advance the science and knowledge regarding the use of HRA's in primary care clinical settings we propose the following aims: Aim 1: To re-engineer the Healthier People Network's Health Risk Appraisal (HPN-HRA) tool to a multi-platform, social-network-friendly, open-source code, and standards compliant software product, for use in the public domain either directly by users or indirectly by third-party applications via an Application Programmers Interface (API). Aim 2: To update current mortality risk algorithms, create new chronic disease and accidental death risk algorithms, and update the patient and provider reports in the HPN-HRA to provide estimates and recommendations based on systematic reviews of current scientific findings. Aim 3: To engage a local primary care practice based research network (PBRN) in the design and pilot testing of the new HRA as a prelude to a rigorous evaluation of the HRA in primary care to be carried out in a subsequent study.

描述（由申请人提供）：超过一半的65岁之前的死亡现在可以归因于生活方式因素。为了减少以生活方式为基础的死亡原因的年发生率，必须了解生活方式因素的作用，这些因素可能在个人控制之下，而那些因素可能需要社会、医疗或药物干预。健康风险评估（HRA）可作为评估这些疾病和创伤前体影响的重要工具。此外，2009年国家质量保证委员会（NCQA）发布了他们对健康计划、首选提供者组织、管理护理组织和健康和健康促进计划的认证要求，要求将HRA的管理作为认证过程的一部分。这些新标准将促进人类资源评估的广泛利用，并要求系统地审查/更新现有的工具。同样，许多初级保健实践向以患者为中心的医疗之家的转变也将刺激对有助于促进提供者与患者沟通和患者教育的仪器和工具的需求。然而，在不同的初级保健环境中，人们对HRA的吸收、可用性、可接受性和有效性知之甚少。我们所掌握的信息是基于很少的管理式医疗机构、雇主健康计划和保险计划，这些信息主要来自白人、中产阶级、有工作的个人。简而言之，据我们所知，没有关于种族/族裔少数群体、没有保险的人、穷人或卫生知识有限的人使用HRA的信息。我们也知道没有关于提供者或患者对HRA满意度的研究，也没有关于HRA对患者健康结果或行为/生活方式改变的影响的研究。所有这些都是需要回答的重要研究问题，但需要一个至关重要的工具——经过验证的HRA，价格低廉，易于在各种初级保健环境中使用，有些资源丰富，有些资源贫乏。这个应用程序是填补所有这些知识空白的第一步。为了推进有关HRA在初级保健临床环境中使用的科学和知识，我们提出以下目标：目标1：将健康人群网络的健康风险评估（HPN-HRA）工具重新设计为多平台、社交网络友好、开源代码和符合标准的软件产品，供用户直接或通过应用程序编程接口（API）间接地在公共领域使用。目标2：更新当前的死亡率风险算法，创建新的慢性疾病和意外死亡风险算法，并更新HPN-HRA中的患者和提供者报告，以根据当前科学发现的系统审查提供估计和建议。目标3：在新的HRA的设计和试点测试中，让一个基于当地初级保健实践的研究网络（PBRN）参与，作为对HRA在初级保健中的严格评估的前奏，该评估将在随后的研究中进行。