Maternal, Clinician & Hospital Factors in Breastmilk for Premature Infants

产妇、临床医生

• 批准号: 8598488
• 负责人: Henry Chong Lee
• 金额: $ 13.01万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-01-05 至 2015-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8598488
• 关键词: Address; Adopted; Age; Applications Grants; Behavioral; Birth; Breast; Breast Feeding; California; Caring; Case Study; Clinical; Clinical Research; Clinical Trials; Counseling; Data; Data Collection; Data Set; Demographic Factors; Development; Education; Environmental Risk Factor; Epidemiology; Equipment; Failure; Goals; Growth; Health Policy; Health Services Research; Home environment; Hospitalization; Hospitals; Hour; Human Milk; Immune; Infant; Infant Care; Information Technology; Institutes; Intervention; Intervention Trial; Interview; K-Series Research Career Programs; Knowledge; Lactation; Lead; Leadership; Left; Link; Literature; Maintenance; Medical; Medicine; Mentored Patient-Oriented Research Career Development Award; Mentors; Methods; Milk; Modeling; Morbidity - disease rate; Mothers; Necrotizing Enterocolitis; Neonatal Intensive Care Units; Neonatology; Observational Study; Patients; Perinatal; Persons; Pharmaceutical Preparations; Physical activity; Physician Executives; Policies; Population; Premature Birth; Premature Infant; Procedures; Property; Publishing; Pump; Qualitative Research; Quality of Care; Race; Research; Research Methodology; Research Personnel; Resources; Retinopathy of Prematurity; Risk; San Francisco; Structure; Surveys; System; Techniques; Testing; The Sun; Time; Training; Universities; Variant; base; career; clinical practice; design; effective intervention; feeding; high risk; implementation science; improved; innovation; medically underserved; nutrition; patient safety; prevent; professor; racial and ethnic disparities; success; therapy design

DESCRIPTION (provided by applicant): This is a revised application for a K23 award for Dr. Henry Chong Lee, a neonatologist at the University of California, San Francisco. Dr. Lee is establishing himself as a young investigator in clinical research of quality improvement in neonatology. This K23 award will provide Dr. Lee with the support necessary to accomplish the following goals: (1) to become expert at survey and qualitative research methods; (2) to conduct clinical investigations of the factors influencing breast milk feeding in premature infants; (3) to gather data for the purpose of designing an intervention to promote breast milk feeding in premature infants; (4) to progress in leadership in quality improvement research in neonatology; and (5) to develop an independent clinical research career. To achieve these goals, Dr. Lee has assembled a mentoring team comprised of primary mentor Dr. R. Adams Dudley, Professor of Medicine and Health Policy at UCSF, a leader in largescale health services research; two co-mentors: Dr. Jeffrey Gould, a neonatologist and Professor at Stanford, a distinguished leader and researcher in quality improvement and Director of the California Perinatal Quality Care Collaborative, and Dr. Daniel Dohan, an expert in qualitative research methods in the Institute of Health Policy Studies at UCSF; and four scientific advisors: Dr. Jane Morton, an expert in breastfeeding and breast milk provision for premature infants, Dr. Yao Sun, Medical Director of the Division of Neonatology at UCSF and expert in information technology, who is concerned with patient safety and quality of care, Ralph Gonzales, Professor of Medicine and Epidemiology & Biostatics at UCSF, an expert in Implementation Sciences, and Dr. Anna N¿poles, an expert in ethnic and racial disparities in medical care. Breast milk is established as the optimal feeding choice for premature infants as it prevents serious morbidities such as necrotizing enterocolitis. Nevertheless, many premature infants are not being fed breast milk by the time they are discharged home from the hospital. Breast milk provision for premature infants varies by socio-demographic and medical factors and varies widely by hospital. Dr. Lee's research will focus on the maternal, clinician, and hospital factors that impact breast milk feeding of premature infants. The results of his study will inform the design of an intervention to promote breast milk feeding in premature infants. In Aim 1, Dr. Lee will perform a qualitative study using semi-structured interviews and a survey study of mothers to probe maternal factors related to pumping/feeding practices, focusing on the impact of early counseling and environmental factors. In Aim 2, Dr. Lee will use a case study approach of high-performing and low-performing hospitals to determine what hospital factors impact breast milk feeding of premature infants. In Aim 3, Dr. Lee will perform a statewide survey of more than 100 hospitals in California, in which he will study what clinical practices were associated with higher or lower rates of breast milk provision in premature infants. This research will form the basis for development of a pilot intervention to be proposed in an R03 grant application during the K award, and a subsequent multi-center intervention to promote breast milk feeding in premature infants, to be proposed in an R01 grant application at the end of the K award.

描述（由申请提供）：这是加利福尼亚大学旧金山新生儿医生亨利·钟·李博士的K23奖的修订申请。李博士正在建立自己是新生儿质量改善临床研究的年轻研究者。该K23奖将为Lee博士提供实现以下目标所需的支持：（1）成为调查和定性研究方法的专家； （2）对影响早产婴儿的母乳喂养的因素进行临床研究； （3）到 收集数据是为了设计干预措施以促进早产婴儿的母乳喂养； （4）在新生儿学质量改进研究领导力方面的进步； （5）发展独立的临床研究职业。为了实现这些目标，李博士组建了一个心理团队，完成了大型健康服务研究领导者的UCSF医学与健康政策教授R. Adams Dudley博士；两位联合官员：杰弗里·古尔德（Jeffrey Gould）博士，新生儿学家兼教授 质量改进的杰出领导者和研究员，加利福尼亚围产期质量护理合作伙伴的主任，以及UCSF卫生政策研究所定性研究方法专家Daniel Dohan博士； and four scientific advisors: Dr. Jane Morton, an expert in breastfeeding and breast milk provision for premature infants, Dr. Yao Sun, Medical Director of the Division of Neonatology at UCSF and expert in information technology, who is concerned with patient safety and quality of care, Ralph Gonzales, Professor of Medicine and Epidemiology & Biostatics at UCSF, an expert in Implementation Sciences, and Dr. Anna N¿ Poles, an医疗保健中种族和种族差异的专家。母乳被确定为早产婴儿的最佳喂养选择，因为它可以防止严重的病因，例如坏死性小肠结肠炎。然而，许多早产婴儿在从医院出院后没有喂母乳。母乳为早产婴儿提供的品种由社会人口统计学和医学因素提供，并且因医院而异。李博士的研究将重点放在影响早产儿母乳的母亲，临床和医院因素上。他的研究结果将为您提供干预的设计 在早产婴儿中促进母乳喂养。在AIM 1中，Lee博士将使用半结构化访谈和对母亲进行的调查研究进行定性研究，以探测与抽水/喂养实践有关的物质因素，重点是早期咨询和环境因素的影响。在AIM 2中，Lee博士将采用高性能和低性能医院的案例研究方法来确定哪些医院因素会影响AIM 3中的母乳喂养的母乳。 将对加利福尼亚州的100多家医院进行全州调查，在该调查中，他将研究哪些临床实践与早产儿的母乳提供较高或更低的母乳相关。这项研究将构成在K奖励期间在R03赠款申请中提出的试点干预措施的基础，以及随后的多中心干预措施，以促进早产婴儿中的母乳喂养母乳，并在K奖末期的R01赠款申请中提出。