Implementation of Childhood Obesity Treatment Innovations to Improve Outcomes of Low-Income Children: The Connect for Health II Study

实施儿童肥胖治疗创新以改善低收入儿童的预后:健康连接 II 研究

基本信息

项目摘要

Project Summary/Abstract Cardiovascular disease is the leading cause of death and premature mortality in the US and worldwide. Obesity is a major contributor to cardiovascular disease and has its origins in early life. Thus, interventions to reduce obesity and adverse risk factors in childhood may set individuals on the best possible trajectories for lifelong cardiovascular health. Promising approaches for reduction of childhood obesity include interventions such as Connect for Health which demonstrated that a highly scalable, multilevel intervention package including (1) electronic health record (EHR)-based clinical decision support tools to guide pediatric clinicians in child weight management; (2) family educational materials focused on evidence-based behavioral targets; and (3) social- and community-informed text messages for parents to support behavior change, could improve family-centered outcomes for childhood obesity and child body mass index (BMI). Despite availability of proven-effective interventions such as Connect for Health, substantial gaps remain in the adoption of recommended practices by clinicians and families, particularly in settings that care for low-income children. Implementation strategies that leverage efficient health information technologies (HIT) can help support adoption of effective interventions among clinicians and families. Incorporation of HIT may be especially effective if augmented by outreach to parents and children, yet we have insufficient evidence on facilitators and barriers to the adoption of behavior change recommendations and ways to support and sustain behavior changes among diverse patient populations. Finally, few studies attempt to learn modifiable attributes of clinicians and families who demonstrate “positive deviance”, i.e. those who have succeeded in making practice and behavior changes in the context of sometimes inflexible clinical workflows and/or adverse neighborhood environments. The purpose of this study is to develop and test implementation strategies to accelerate the uptake and adoption of research evidence generated by the Connect for Health trial among pediatric primary care teams and families. Guided by the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE- AIM) and Consolidated Framework for Implementation Research frameworks, we will use mixed-methods to adapt and implement the Connect for Health intervention in two large health care systems in Massachusetts, examine generalizable and modifiable attributes and strategies associated with positive deviance (e.g. children who achieve clinically significant improvements in BMI and clinicians who adopt the program with high fidelity), and examine the costs associated with the intervention. To achieve our aims, we have assembled a research team with extensive experience in obesity interventions, implementation science, informatics, community health, biostatistics, and qualitative methods. If successful, this study will yield evidence of proven, cost- effective, sustainable, and generalizable strategies for accelerating adoption of evidence for obesity screening and management in pediatric primary care and for improving outcomes for low-income children with obesity.
项目概要/摘要 心血管疾病是美国和全世界死亡和过早死亡的主要原因。 肥胖是心血管疾病的主要原因,其起源于生命早期。因此,干预措施 减少儿童时期的肥胖和不良危险因素可能会让个人走上最佳的发展轨迹 终生心血管健康。减少儿童肥胖的有希望的方法包括干预措施 例如 Connect for Health,它证明了高度可扩展的多层次干预方案 包括(1)基于电子健康记录(EHR)的临床决策支持工具,以指导儿科临床医生 儿童体重管理; (2) 家庭教育材料侧重于基于证据的行为目标;和 (3) 向家长发送社交和社区信息短信以支持行为改变,可以改善 以家庭为中心的儿童肥胖和儿童体重指数(BMI)结果。尽管有可用的 尽管 Connect for Health 等已被证明有效的干预措施在采用方面仍存在巨大差距 临床医生和家庭推荐的做法,特别是在照顾低收入儿童的环境中。 利用高效的卫生信息技术 (HIT) 的实施策略可以帮助支持 在临床医生和家庭中采取有效的干预措施。 HIT 的合并可能尤其重要 如果通过向父母和儿童进行宣传来增强效果,但我们没有足够的证据证明促进者和 采用行为改变建议的障碍以及支持和维持行为的方法 不同患者群体之间的变化。最后,很少有研究尝试学习可修改的属性 表现出“积极偏差”的临床医生和家庭,即那些成功进行实践的人 有时在不灵活的临床工作流程和/或不利的邻里背景下的行为变化 环境。本研究的目的是制定和测试实施策略,以加速 在儿科小学中接受和采用 Connect for Health 试验产生的研究证据 护理团队和家庭。以范围、有效性、采用、实施、维护为指导(RE- AIM)和实施研究框架综合框架,我们将使用混合方法 在马萨诸塞州的两个大型医疗保健系统中调整并实施 Connect for Health 干预措施, 检查与积极偏差相关的可概括和可修改的属性和策略(例如儿童 BMI 取得临床显着改善的人以及采用高保真度计划的临床医生), 并检查与干预相关的成本。为了实现我们的目标,我们进行了一项研究 团队在肥胖干预、实施科学、信息学、社区方面拥有丰富的经验 健康、生物统计学和定性方法。如果成功,这项研究将提供经过验证的、成本低廉的证据 加速采用肥胖筛查证据的有效、可持续和可推广的策略 儿科初级保健和管理以及改善低收入肥胖儿童的结局。

项目成果

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Elsie Mireya Taveras Benavidez其他文献

Elsie Mireya Taveras Benavidez的其他文献

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{{ truncateString('Elsie Mireya Taveras Benavidez', 18)}}的其他基金

Expanding the Use of Proven-Effective Pediatric Weight Management Interventions in Community Health Centers
在社区卫生中心扩大使用行之有效的儿童体重管理干预措施
  • 批准号:
    9899901
  • 财政年份:
    2019
  • 资助金额:
    $ 78.19万
  • 项目类别:
Expanding the Use of Proven-Effective Pediatric Weight Management Interventions in Community Health Centers
在社区卫生中心扩大使用行之有效的儿童体重管理干预措施
  • 批准号:
    9812578
  • 财政年份:
    2019
  • 资助金额:
    $ 78.19万
  • 项目类别:
Implementation of Childhood Obesity Treatment Innovations to Improve Outcomes of Low-Income Children: The Connect for Health II Study
实施儿童肥胖治疗创新以改善低收入儿童的预后:健康连接 II 研究
  • 批准号:
    10657489
  • 财政年份:
    2019
  • 资助金额:
    $ 78.19万
  • 项目类别:
Expanding the Use of Proven-Effective Pediatric Weight Management Interventions in Community Health Centers
在社区卫生中心扩大使用行之有效的儿童体重管理干预措施
  • 批准号:
    10266740
  • 财政年份:
    2019
  • 资助金额:
    $ 78.19万
  • 项目类别:
Implementation of Childhood Obesity Treatment Innovations to Improve Outcomes of Low-Income Children: The Connect for Health II Study
实施儿童肥胖治疗创新以改善低收入儿童的预后:健康连接 II 研究
  • 批准号:
    10199016
  • 财政年份:
    2019
  • 资助金额:
    $ 78.19万
  • 项目类别:
The Implementation Science Center for Cancer Control Equity - Implementation Lab
癌症控制公平实施科学中心 - 实施实验室
  • 批准号:
    10021629
  • 财政年份:
    2019
  • 资助金额:
    $ 78.19万
  • 项目类别:
The Implementation Science Center for Cancer Control Equity - Implementation Lab
癌症控制公平实施科学中心 - 实施实验室
  • 批准号:
    10252864
  • 财政年份:
    2019
  • 资助金额:
    $ 78.19万
  • 项目类别:
Patient Oriented Research and Mentorship in Childhood Obesity Disparities
以患者为中心的儿童肥胖差异研究和指导
  • 批准号:
    10301422
  • 财政年份:
    2015
  • 资助金额:
    $ 78.19万
  • 项目类别:
Patient Oriented Research and Mentorship in Childhood Obesity Disparities
以患者为中心的儿童肥胖差异研究和指导
  • 批准号:
    9116836
  • 财政年份:
    2015
  • 资助金额:
    $ 78.19万
  • 项目类别:
Patient Oriented Research and Mentorship in Childhood Obesity Disparities
以患者为中心的儿童肥胖差异研究和指导
  • 批准号:
    8938732
  • 财政年份:
    2015
  • 资助金额:
    $ 78.19万
  • 项目类别:

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