权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Enhanced Intervention to Improve Adolescent Outcomes: A Clinical Trial

加强干预以改善青少年的结局：临床试验

基本信息

批准号：
9272429
负责人：
Melissa Kristine Miller
金额：
$ 15.49万
依托单位：
CHILDREN'S MERCY HOSP (KANSAS CITY, MO)
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-05-11 至 2020-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9272429
关键词：
Accident and Emergency department Address Adolescent Affect African American Age Behavior Therapy Behavioral Research Caring Childhood Clinic Clinical Decision Support Systems Clinical Research Clinical Trials Communities Complement Consensus Counseling Data Development Plans Effect Modifiers (Epidemiology)Eligibility Determination Emergency Medicine Emergency department visit Enrollment Funding Gender Goals HIV HIV Infections Health Health Educators Health Services Health Services Accessibility Health behavior Health behavior change Health system Healthcare Systems Healthy People 2020 Hispanics Hospital Administrators Human immunodeficiency virus test Improve Access Incidence Individual Insurance Intervention Intervention Studies Intervention Trial K-Series Research Career Programs Knowledge Lead Length of Stay Location Maintenance Master of Science Measures Mentored Patient-Oriented Research Career Development Award Mentors Mentorship Methods Minority Mission Modeling Motivation Multi-Institutional Clinical Trial National Institute of Child Health and Human Development Outcome Patients Persons Physicians Pregnancy Pregnancy Rate Provider Public Health Recommendation Research Research Methodology Risk Risk Behaviors Risk Reduction Safe Sex Services Sexual Health Sexually Transmitted Diseases Source Statistical Data Interpretation Structure System Techniques Testing Theory of Change Time Training Training Activity Uninsured United States Dept. of Health and Human Services United States National Institutes of Health Visit Youth adolescent health adolescent health outcomes adolescent sexual health arm base career development child bearing condoms cost design effective intervention emergency contraception ethnic minority population evidence base follow-up health care service health disparity high risk hormonal contraception improved innovation intervention effect life time cost multidisciplinary novel patient oriented payment pilot trial point of care practical application prevent public health relevance racial and ethnic racial and ethnic disparities randomized trial responsible research conduct sexual health intervention sexually active adolescent skills skills training symposium therapy design time interval unintended pregnancy uptake

项目摘要

DESCRIPTION (provided by applicant): Limited access to care is a major contributor to sexually transmitted infections (STIs), human immunodeficiency virus (HIV) infection, and unintended pregnancy for U.S. adolescents and contributes to significant health disparities, including rates of STIs that are 6-7 times higher for uninsured youths than for insured youths. Racial/ethnic disparities also exist, with African American and Hispanic adolescents evidencing pregnancy rates that are 4 times higher than White youths. The emergency department (ED) represents an important but underutilized location for reaching large numbers of sexually at-risk adolescents with limited access to evidence-based care and there is growing support for use of the ED to improve adolescent sexual health outcomes. Because few proven interventions are available in the ED to motivate youth to safer sexual behavior and provide health services (e.g., STI testing, condoms), novel interventions are needed. Dr. Miller, a pediatric emergency medicine physician and the candidate for this Career Development Award, is committed to conducting patient-oriented behavioral research to improve adolescent health outcomes, focusing on underserved communities. Together with a strong multi-disciplinary mentorship team, Dr. Miller has created a four-year career development plan which includes structured mentoring, completion of a Master of Science in Clinical Research, and focused training in the use of health behavior change theories to develop multi-level interventions, research methods and statistical analyses for behavioral intervention trials, effective counseling strategies for health behavior change, health care system and payment models, and responsible conduct of research. Dr. Miller's training activities will be complemented by an innovative project that will facilitate practical application of these new skills. The goal of the project is to enhance and tes a previously piloted ED SexHealth intervention that uses a dedicated health educator to provide risk reduction counseling, point-of care health services, and referral for ongoing care. Following intervention refinement, Dr. Miller will conduct a randomized trial of the enhanced intervention versus a standard information arm to determine the effect size of rates of health service uptake and enhanced intervention feasibility. We hypothesize that the intervention will result in higher health service uptake and increased condom use versus a standard information arm. The rationale is that it will produce the first controlled data on an intervention designed to improve adolescent sexual health outcomes using a novel and effective method of delivering care. We expect to use these critical effect size estimates to inform the design of a larger clinical trial o evaluate efficacy. Dr. Miller's training efforts will culminate in the submission of an R01 proposa to fund this trial. This training and research plan are consistent with the mission of the National Institutes of Health and the National Institute of Child Health and Human Development, the Healthy People 2020 objectives from the United States Department of Health and Human Services, and the 2009 Academic Emergency Medicine consensus conference.

描述（由申请人提供）：获得护理的机会有限是美国青少年性传播感染（STI）、人类免疫缺陷病毒（HIV）感染和意外怀孕的主要原因，并导致了显著的健康差异，包括未投保青年的STI发病率是投保青年的6-7倍。种族/民族差异也存在，非洲裔美国人和西班牙裔青少年的证据表明，怀孕率是白色青年的4倍。急诊科（艾德）是一个重要的，但未充分利用的位置，达到大量的性风险青少年有限的循证护理，并有越来越多的支持使用艾德，以改善青少年性健康的结果。因为在艾德中很少有经证实的干预措施可以激励年轻人采取更安全的性行为并提供健康服务（例如，性传播感染检测、避孕套），需要新的干预措施。米勒，儿科急诊医生和候选人的职业发展奖，致力于开展以患者为导向的行为研究，以改善青少年健康结果，重点是服务不足的社区。米勒博士与一支强大的多学科导师团队一起，制定了一个为期四年的职业发展计划，其中包括结构化的导师，完成临床研究理学硕士学位，并重点培训使用健康行为改变理论来制定多层次的干预措施，行为干预试验的研究方法和统计分析，健康行为改变的有效咨询策略，医疗保健系统和支付模式，以及负责任的行为 research.米勒博士的培训活动将得到一个创新项目的补充，该项目将促进这些新技能的实际应用。该项目的目标是加强和测试之前试点的艾德性健康干预措施，该干预措施使用专门的健康教育工作者来提供风险降低咨询、护理点健康服务以及持续护理的转诊。干预措施完善后，米勒博士将进行一项随机试验，对比强化干预措施与标准信息组，以确定卫生服务接受率和强化干预措施可行性的效应量。我们假设，与标准信息臂相比，干预措施将导致更高的卫生服务吸收和更多的安全套使用。其理由是，它将产生第一个关于干预措施的受控数据，该干预措施旨在使用一种新颖有效的护理方法来改善青少年性健康结果。我们期望使用这些关键效应量估计值来为更大规模的临床试验设计提供信息，以评估疗效。米勒博士的培训工作将最终提交R 01提案以资助本试验。这一培训和研究计划符合国家研究所的使命，卫生研究院和儿童健康和人类发展的国家研究所，健康的人2020年的目标，从美国卫生和人类服务部，和2009年学术急诊医学共识会议。