Disparities in Disability after Traumatic Brain Injury for Hispanic Children

西班牙裔儿童脑外伤后残疾的差异

• 批准号: 9096854
• 负责人: Nathalia Jimenez
• 金额: $ 12.98万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-11 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9096854
• 关键词: Acute; Adult; Anesthesiology; Appointment; Area; Award; Brain Injuries; Caring; Cause of Death; Centers for Disease Control and Prevention (U.S.); Characteristics; Child; Child Care; Child health care; Communication; Communities; Data; Databases; Decision Making; Education; Ethnic Origin; Ethnic group; Family; Focus Groups; Funding; Goals; Government; Health; Health Personnel; Health Services Accessibility; Hispanics; Injury; Inpatients; Instruction; Insurance; Intervention; Intervention Trial; Interview; Knowledge; Language; Literature; Measures; Medicaid; Medical Records; Mentored Patient-Oriented Research Career Development Award; Minority; Minority Groups; Modeling; Multicenter Studies; Not Hispanic or Latino; Outcome; Outcome Study; Outcomes Research; Outpatients; Parents; Patient-Focused Outcomes; Pattern; Pediatric Hospitals; Phase; Prevention Research; Qualitative Methods; Qualitative Research; Recruitment Activity; Rehabilitation Outcome; Rehabilitation therapy; Reporting; Research; Research Methodology; Research Personnel; Research Proposals; Research Training; Resources; Risk; Risk Factors; Role; Schedule; Self Care; Services; Severities; Socioeconomic Factors; Source; TBI Patients; Testing; Training; Traumatic Brain Injury; Universities; Vulnerable Populations; Washington; cohort; community based participatory research; disability; ethnic minority population; experience; faculty mentor; follow-up; functional outcomes; health related quality of life; improved; injury prevention; minority children; mortality; parental involvement; pediatric patients; pediatric trauma; prevent; professor; racial minority; rehabilitation service; rehabilitative care; skills; socioeconomics

DESCRIPTION (provided by applicant): Traumatic brain injury (TBI) is the leading cause of death and disability for children in the U.S. Disability after TBI is higher among children with no or government insurance, poor family functioning and lower levels of parental education. In a preliminary study, we documented disparities in long term disability after TBI for Hispanic children; Hispanic compared to non-Hispanic White (NHW) children experience significantly larger reductions in health related quality of life, participation in activities, and ability to communicate and care for themselves 3 years after injury. It is unclear if use of rehabilitation services and/or cultural and language barriers contributed to the documented differences. We propose a three-phase research plan to compare patterns and determinants of utilization of rehabilitation services and its association with disability outcomes between Hispanic, NHW and non-Hispanic Black (NHB) children. We will also develop and pilot-test the feasibility and acceptability of a culturally tailored intervention to reduce barriers for use of rehabilitation services by Hispanic children with TBI. The long term goal of this K23 award is for the candidate to develop as an independent researcher in the area of patient outcomes in vulnerable populations and pediatric trauma disparities research. The K23 candidate is an Assistant Professor in the Department of Anesthesiology at the University of Washington. The candidate proposes a five-year training plan with the support of faculty mentors who have expertise in injury outcomes research, community based participatory research, qualitative methods, and intervention trials in minority communities. The University of Washington, Seattle Children's Hospital, and Harborview Injury Prevention and Research Center provide excellent institutional support and resources for this award. The research involves three studies. Study 1 will compare use of inpatient and outpatient rehabilitation services between Hispanic, NHB and NHW pediatric patients with TBI, and its association with disability. Study 2 will compare predisposing enabling and need factors for use of outpatient rehabilitation services between the three ethnic groups. Study 3 will develop and pilot-test a culturally tailored intervention to reduce barriers fr use of rehabilitation services by Hispanic children with TBI. These studies will expand our understanding of the potential reasons for disparities in the provision of care for children with TBI. It will clarify the role of Hispanic ethnicity in the receipt of rehabilitation care and highe risk of disability after TBI, independent of socioeconomic and minority status. It will lay the groundwork for a multicenter study to evaluate a culturally tailored intervention to reduce barriers for use of rehabilitation services by Hispanic families, which can also serve as a model for other vulnerable populations.

描述（由申请人提供）：创伤性脑损伤（TBI）是美国儿童死亡和残疾的主要原因