Personal Health Record for Youth Emancipating from Foster Care

摆脱寄养青少年的个人健康记录

• 批准号: 9764486
• 负责人: JUDITH W. DEXHEIMER
• 金额: $ 34.58万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-14 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9764486
• 关键词: Activities of Daily Living; Address; Adolescent; Adult; Age; Caregivers; Caring; Child; Child Custody; Child Health; Child Welfare; Childhood; Chronic; Collaborations; Communities; County; Data; Databases; Diagnosis; Disease; Education; Electronic Health Record; Ensure; Family; Fostering; Foundations; Future; Goals; Grant; Health; Health Personnel; Health Promotion; Health Resources; Health behavior; Healthcare; Healthcare Systems; Housing; Independent Living; Infrastructure; Institution; Knowledge; Lead; Link; Measures; Medical; Medical History; Medical Records; Mental Health Services; Modeling; Monitor; Occupations; Outcome; Patient-Focused Outcomes; Personal Health Records; Persons; Pharmaceutical Preparations; Positioning Attribute; Preparation; Primary Health Care; Process; Provider; Recommendation; Reporting; Research; Self Management; Services; Source; System; Teenagers; Time; United States; Vulnerable Populations; Work; Youth; administrative database; care coordination; care outcomes; child protective service; design; electronic data; experience; foster care; health care service utilization; health data; health knowledge; health record; health service use; improved; portability; programs; recruit; research study; satisfaction; user centered design

Project Summary There are 427,000 children in the custody of child protective services (i.e., foster care) in the United States. Children remain in foster care an average 19 months, with 26% of children in foster care for 2 years or longer. Adolescents experience an average of 7 placement changes during their time in foster care, and approximately 5,000 youth emancipate from foster care annually. States provide independent living programs prior to emancipation to help with the transition, which includes housing and utilities, assistance with education, classes about activities of daily living, and monitoring. However, support for health care self-management is not provided, and teens in or emancipating from foster care are generally unable to access their medical records. While in custody, access to medical records is managed by caseworkers; foster youth report limited access to health information and caseworkers and caregivers report not having sufficient health information for the children in their care. This lack of health information results in foster youth reporting no knowledge of how to access primary care, poor management of chronic conditions, and increased preventable disease. Providing health data from the electronic health record could improve health knowledge, care coordination, and patient outcomes in this vulnerable population. However, no sustainable system to provide personal health records (PHRs) to this vulnerable population has been developed. The objective of our research is to improve health outcomes and promote health behaviors in foster youth experiencing a transition from pediatric to adult health care systems and are emancipating from foster care. As a critical step toward accomplishing this goal, this project will create and distribute a PHR for foster youth to be distributed at age 18. The execution of the aims described below will position us to scale providing portable health records to other communities where child welfare administrative databases can be linked with the electronic health record. Our project will create and distribute a PHR to foster youth, a vulnerable population, and lay the necessary foundation to assess feasibility. This is essential for future studies seeking to examine whether providing PHR changes health service utilization once youth have emancipated. With foster youth and caseworker involvement, we will create a model PHR. We will extend existing collaborations with Hamilton County Jobs and Family Services to add designed PHRs to our existing data-sharing processes, and we will work with the community and providers to ensure that foster youth receive a PHR upon emancipation from foster care. This project will have meaningful impact on child health outcomes by delivering health information when youth need it most; we believe this will ultimately lead to improved healthcare utilization and provide infrastructure to support additional grants to improve the health and wellbeing of children in and emancipating from foster care.

项目摘要 在美国，有427,000名儿童保管儿童保护服务（即寄养）。 儿童平均保留19个月的寄养，其中26％的寄养儿童在2年或更长时间内。 青少年在寄养期间平均经历7个位置变化，大约 每年有5,000名青年从寄养护理中解放出来。国家在之前提供独立的生活计划 解放以帮助过渡，包括住房和公用事业，教育协助， 有关日常生活和监测活动的课程。但是，支持医疗保健自我管理是 未提供，寄养者的青少年通常无法获得医疗 记录。 在被拘留的过程中，案件工作者管理医疗记录；寄养青年报告有限的访问权限 健康信息和案例工作者和看护人报告没有足够的健康信息 孩子们照顾的。缺乏健康信息导致培养青年不了解如何 访问初级保健，慢性病的管理不佳以及可预防疾病的增加。提供 电子健康记录的健康数据可以改善健康知识，护理协调和患者 这个脆弱人群的结果。但是，没有可持续系统来提供个人健康记录 （PHR）已经开发了这一脆弱人群。 我们研究的目的是改善健康成果并促进寄养青年的健康行为 从小儿到成人医疗保健系统过渡，并从寄养护理中解放出来。作为 朝着实现这一目标的关键一步，该项目将创建和分发一个PHR，以使寄养青年成为 在18岁时分发。下面描述的目的的执行将使我们定位于规模提供便携式 儿童福利行政数据库可以与其他社区的健康记录 电子健康记录。 我们的项目将创建和分发一个PHR，以培养青年，脆弱的人群，并构成必要的 评估可行性的基础。这对于未来的研究至关重要，试图检查是否提供PHR 一旦青年解放，更改卫生服务利用率。与寄养青年和案例工作者 参与，我们将创建一个模型PHR。我们将扩展与汉密尔顿县工作的现有合作 和家庭服务将设计的PHR添加到我们现有的数据共享流程中，我们将与 社区和提供者，以确保寄养青年在寄养后解放后获得博士学位。 该项目将通过在青年时提供健康信息来对儿童健康成果产生有意义的影响 最需要它；我们认为，这最终将导致改善医疗保健利用，并提供基础设施 支持额外的赠款，以改善寄养儿童的健康和福祉。