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）是美国残疾儿童在TBI之后的死亡和残疾的主要原因 或政府保险，家庭功能不佳和父母教育水平较低。在一项初步研究中，我们记录了TBI在西班牙裔儿童中长期残疾的差异。与非西班牙裔白人（NHW）的儿童相比，西班牙裔儿童的生活质量，活动的参与以及受伤后三年的沟通和照顾能力明显更大。目前尚不清楚使用康复服务和/或文化和语言障碍是否有助于有记录的差异。我们提出了一项三相研究计划，以比较利用康复服务的模式和决定因素及其与西班牙裔，NHW和非西班牙裔黑人（NHB）儿童之间残疾结果的关联。我们还将开发和试点测试文化量身定制的干预措施的可行性和可接受性，以减少西班牙裔儿童TBI使用康复服务的障碍。该K23奖的长期目标是候选人成为脆弱人群和小儿创伤差异研究的患者结果领域的独立研究人员。 K23候选人是华盛顿大学麻醉学系的助理教授。候选人提出了一项为期五年的培训计划，并在少数民族社区的损伤结果研究，基于社区的参与性研究，定性方法和干预试验方面具有专业知识的教师导师的支持。华盛顿大学，西雅图儿童医院和Harbourview伤害预防和研究中心为该奖项提供了出色的机构支持和资源。该研究涉及三项研究。研究1将比较西班牙裔，NHB和NHW儿科患者TBI及其与残疾的关联之间的住院和门诊康复服务。研究2将比较三个族裔之间使用门诊康复服务的倾向和需要的因素。研究3将开发和试点测试文化量身定制的干预措施，以减少西班牙裔儿童TBI对康复服务的障碍。这些研究将扩大我们对为TBI儿童提供护理的潜在差异原因的理解。它将阐明西班牙族在收到康复护理和TBI之后残疾的高风险中的作用，与社会经济和少数群体地位无关。它将为多中心研究奠定基础，以评估一项文化量身定制的干预措施，以减少西班牙裔家庭使用康复服务的障碍，这也可以作为其他脆弱人群的模型。