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OurChild: A Health IT Solution to Reduce Minority Health Disparities

OurChild：减少少数族裔健康差异的健康 IT 解决方案

基本信息

批准号：
10355466
负责人：
Simona Kwon
金额：
$ 70.44万
依托单位：
NEW YORK UNIVERSITY SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-02-17 至 2024-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10355466
关键词：
6 year old Address Adolescent Psychiatry Adoption Adult Age Caring Child Child Mental Health Child Psychiatry Child Rearing Childhood Chinese Chinese American Chinese population Clinic Clinical Clinical Services Cohort Studies Communities Community Health Systems Community Services Consolidated Framework for Implementation Research Consultations Data Data Reporting Development Digital Libraries Early identification Effectiveness Electronic Health Record Evaluation Family Family health status Focus Groups Goals Health Health Disparities Research Health Resources Health Services Accessibility Healthcare Home Immigrant Immigrant community Immigrant family Impairment Improve Access Incubators Individual Knowledge Language Libraries Life Limited English Proficiency Link Mental Health Mental Health Services Mental disorders Metadata Methodology Methods National Institute on Minority Health and Health Disparities New York City Outcome Parents Performance Population Poverty Prevalence Provider Reach Effectiveness Adoption Implementation and Maintenance Reduce health disparities Research Resources Self Efficacy Testing Time Translating cohort design design-build-test developmental disease digital digital health early childhood evidence base health care availability health disparity health disparity populations health knowledge health literacy high school human centered design improved innovation insight iterative design mHealth minority health disparity patient health information patient portal post implementation prototype response safety net smartphone Application social stigma tool usability

项目摘要

Project Summary/Abstract Mental health and developmental disorders begin early in life, are prevalent, impairing, and predict mental health and health challenges in later childhood and in adulthood. One in nine preschoolers has an impairing mental health disorder, yet less than 15% receive any treatment. In immigrant communities, the disparity between mental health needs and care is greater because of cultural and language barriers, limited mental health literacy, and decreased use of health IT solutions, like Electronic Health Record (EHR) patient portals. Chinese American immigrant families are a fast-growing immigrant group with unmet early childhood mental health needs. We propose to design, build, and implement OurChild, an integrated mHealth/EHR solution to increase access to early childhood mental health knowledge and mental health services and resources for Chinese American children ages 2-6 years old and their parents in Sunset Park, Brooklyn. Our proposal unites our longstanding partnership with the Chinese American community in Sunset Park and the safety-net clinics serving it with our team's 1) clinical and scientific expertise in health disparities, participatory research and early childhood mental health and 2) the digital health/health IT expertise of the WonderLab, a digital incubator in the NYU Langone Department of Child and Adolescent Psychiatry. Our goal is to reduce health disparities by explicitly designing a digital solution that facilitates connection and bidirectional exchange of information across the cultural, contextual, language, and setting differences that are key barriers to early childhood mental health knowledge and access to care for this immigrant population. Our first aim is to iteratively design, build, and test OurChild. To do this we will 1) collaborate with our family, clinical, and community stakeholders to conduct an early childhood mental health context/needs analysis and participatory design and discovery activities; 2) use these insights to adapt and user-test iterative prototypes; 3) evaluate the usability and acceptability of a beta version of OurChild in a mixed-methods pilot with 20 Chinese American parents and their 2- to 6-year-old children who receive care at the Sunset Park 7th Avenue Family Health Center; and 4) optimize the design, features, and performance to create OurChild 1.0.Our second aim it to evaluate the Reach, Effectiveness, Adoption, and Implementation of OurChild 1.0 with a 6- month longitudinal implementation cohort study with 200 parent/child dyads. We will use a mixed-methods approach using metadata collected with the OurChild app, parent-reported data from the app, EHR data, and post-implementation focus groups with providers to determine whether use of Our Child increases referrals of young children for a mental health consultation or evaluation (Primary Aim). Our secondary aims will examine whether use of OurChild 1) increases parent self-efficacy; 2) parent–provider engagement; and 3) linkage with community early childhood resources. Both OurChild and our digital methodology will be designed to be scaled to other Chinese populations and efficiently adapted for other health disparity populations.

项目总结/摘要精神健康和发育障碍开始在生命的早期，是普遍的，损害，并预测心理儿童后期和成年期的健康和健康挑战。九分之一的学龄前儿童精神健康障碍，但不到15%的人得到任何治疗。在移民社区，由于文化和语言障碍，心理健康需求和护理之间的差距更大，健康素养，以及减少使用健康IT解决方案，如电子健康记录（EHR）患者门户网站。华裔美国移民家庭是一个快速增长的移民群体，健康需求。我们建议设计，构建和实施OurChild，一个集成的mHealth/EHR解决方案增加获得幼儿心理健康知识和心理健康服务的机会，为2-6岁的美国华裔儿童和他们的父母在日落公园提供资源，布鲁克林我们的提案将我们与日落的华裔美国人社区的长期伙伴关系结合起来公园和安全网诊所服务与我们的团队的1）临床和科学专业知识的健康差距，参与性研究和幼儿心理健康，2）数字健康/健康IT专业知识 WonderLab是纽约大学Langone儿童和青少年精神病学系的数字孵化器。我们的目标是通过明确设计一种促进联系的数字解决方案来减少健康差距，跨文化、语境、语言和环境差异的双向信息交换，这一移民群体获得幼儿心理健康知识和护理的主要障碍。我们第一个目标是迭代地设计、构建和测试OurChild。为了做到这一点，我们将1）与我们的家庭合作，临床和社区利益相关者进行幼儿心理健康背景/需求分析，参与式设计和发现活动; 2）使用这些见解来适应和用户测试迭代原型; 3)在混合方法试点中评估OurChild测试版的可用性和可接受性，在日落公园第七大道接受照顾的华裔美国父母和他们2至6岁的孩子家庭健康中心;以及4）优化设计、功能和性能以创建OurChild 1.0。我们的第二个目标是评估OurChild 1.0的覆盖范围、有效性、采用和实施情况，一个月的纵向实施队列研究，有200个父母/孩子对。我们将使用混合方法使用OurChild应用程序收集的元数据、来自应用程序的家长报告数据、EHR数据以及实施后与提供者的焦点小组，以确定使用我们的孩子是否会增加幼儿心理健康咨询或评估（主要目的）。我们的第二个目标是研究是否使用OurChild 1）提高父母的自我效能; 2）父母-供应商参与; 3）与社区幼儿资源。OurChild和我们的数字方法都将被设计成可扩展的并有效地适应其他健康差异人群。