Peer mentor training to reduce hospitalizations for children with asthma

同伴导师培训可减少哮喘儿童的住院治疗

• 批准号: 9044017
• 负责人: Ashwin R Patel
• 金额: $ 69.12万
• 依托单位: INQUISITHEALTH, INC.
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-11 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9044017
• 关键词: Accounting; Address; Age; Area; Asthma; Automation; Back; Child; Clinical; Clinical Trials; Communication; Communities; Computer software; Consensus; Development; E-learning; Education; Educational Intervention; Emergency department visit; Evaluation; Feedback; Focus Groups; Foundations; Goals; Health Insurance Portability and Accountability Act; Health Planning; Health system; Healthcare; Hospitalization; Hospitals; Individual; Internet; Intervention; Interview; Life; Mentors; Methods; Online Systems; Outpatients; Parents; Patients; Persons; Phase; Procedures; Process; Process Measure; Protocols documentation; Randomized Clinical Trials; Recruitment Activity; Research; Schools; Self Management; Small Business Innovation Research Grant; System; Telephone; Testing; Training; Training Programs; Translating; Visit; Work; Writing; arm; asthmatic; base; cost; cost effective; evidence base; experience; improved; insight; interest; meetings; peer; programs; prototype; public health relevance; success; tool; web services

DESCRIPTION (provided by applicant): The overall goal of this SBIR Fast-Track application is to develop a web-based program to train peer mentors to guide parents of children with asthma on methods to reduce ED visits and hospitalizations. There are 7.1 million children with asthma. Asthma is the cause of 10.5 million missed days of school, 7.5 million outpatient visits, 640,000 ED visits, and 157,000 hospitalization visits in 2008. Recent work by Fisher et al. (2009) has shown in a 2-year randomized clinical trial that trained peers mentors (lay individuals from the community) can be effective in reducing hospitalizations for asthmatic children from 59.1 percent to 36.5 percent (p<0.01). The training protocol used in the clinical trial involved 3 months of in-person training. In-person training is too slow and expensive to allow for general dissemination of this effective method for reducing hospitalizations in children with asthma. To overcome this barrier to dissemination, we are developing a web-based training program. In Phase I, our Specific Aim is to develop a web-based tool for training peer mentors such that the mentors meet the same qualification standards achieved in the study. Following training, we will use Mentor1to1" (developed by InquisitHealth) to allow the peer mentors to coach parents of children with asthma. Mentor1to1" allows for HIPAA-compliant phone conversations between a parent and a peer mentor that are easily managed, tracked, and integrated into clinical workflow. The proposed platform (web-training plus Mentor1to1") should allow for the creation of a scalable, cost-effective peer mentor workforce to meet the challenge of reducing asthma-related hospitalizations. In Phase II, our Specific Aim is to test this software with a health plan and a health system in a randomized clinical trial. To achieve our Phase I Specific Aim, we will carry out the following three Tasks: Task 1: Conduct Focus Groups. Task 2: Iterative Development of our Web-based Training Program Prototype for Peer Mentors. Task 3. Evaluate Peer Training Efficacy with 40 Peer Mentor-Trainees. Phase I Test of Feasibility: (1) 70 percent+ of mentors should meet the threshold set for both passing the written (80 percent correct) and simulated patient exams (80 percent of objectives met). (2) 70 percent+ of mentors should be satisfied with the Process Measure Tests (score at 3 or 4 on a 0-4 Likert scale, with 4 being completely satisfied). To achieve our Phase II Specific Aim, we will carry out the following four Tasks: Task 1. Gather and Utilize Feedback to Improve Training System. Task 2. Develop Easy-Access Material for Peer Mentors. Task 3. Develop Systems and Automation to Support Peer Mentoring Deployment. Task 4. Evaluate Efficacy of our Web-Trained Peer Mentors. Phase II Criteria for Success: Reduce hospitalizations by at least 30 percent, as in Fisher et al. (2009).

描述（由申请人提供）：该SBIR快速通道应用程序的总体目标是开发一个基于网络的计划，以培训同伴导师，指导哮喘儿童的父母减少艾德就诊和住院的方法。有710万儿童患有哮喘。2008年，哮喘是造成1050万人缺课、750万人门诊、64万人艾德就诊和157,000人住院的原因。Fisher等人（2009）最近的研究表明，在一项为期2年的随机临床试验中，经过培训的同伴导师（来自社区的非专业人士）可以有效地将哮喘儿童的住院率从59.1%降低到36.5%（p<0.01）。临床试验中使用的培训方案包括3个月的面对面培训。面对面的培训太慢，太昂贵，无法广泛传播这种减少哮喘儿童住院的有效方法。为了克服这一传播障碍，我们正在开发一个基于网络的培训方案。在第一阶段，我们的具体目标是开发一个基于网络的工具，用于培训同伴导师，使导师符合研究中达到的相同资格标准。在培训之后，我们将使用Mentor 1 to 1”（由InquisitHealth开发），让同伴导师指导哮喘儿童的父母。Mentor 1 to 1”允许父母和同伴导师之间的符合HIPAA的电话对话，易于管理、跟踪并集成到临床工作流程中。拟议的平台（网络培训加Mentor 1 to 1”）应允许创建一个可扩展的，具有成本效益的同行导师队伍，以应对减少哮喘相关住院的挑战。在第二阶段，我们的具体目标是测试这个软件与健康计划 和健康系统的随机临床试验。为了实现第一阶段的具体目标，我们将开展以下三项任务：任务1：开展焦点小组。任务2：为同伴导师迭代开发基于网络的培训计划原型。任务3.以40名同伴导师-受训者评估同伴训练的有效性。第一阶段可行性测试：（1）70%以上的导师应达到通过书面（80%正确）和模拟患者考试（80%达到目标）的阈值。(2)70%以上的导师应该对过程测量测试感到满意（在0-4 Likert量表上得分为3或4，4表示完全满意）。为了实现第二阶段的具体目标，我们将开展以下四项任务：任务1。收集和利用反馈意见，改进培训系统。任务2.为同伴导师开发易于获取的材料。任务3.开发系统和自动化，以支持同行指导部署。任务4.评估我们的网络培训同侪导师的功效。II期成功标准：减少至少30%的住院治疗，如Fisher et al.（2009）。