Addressing Social Determinants of Health in Disadvantaged Children with Asthma

解决患有哮喘的弱势儿童健康的社会决定因素

• 批准号: 10321174
• 负责人: Lisa Cicutto
• 金额: $ 3.95万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-10 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10321174
• 关键词: 11 year old; Address; Adoption; Age; Area; Asthma; Caregivers; Characteristics; Child; Childhood; Childhood Asthma; Chronic Disease; Clinical Nurse Specialists; Colorado; Communication; Communities; Companions; Complex; Counseling; Data; Disadvantaged; Dissemination and Implementation; Enrollment; Evaluation; Exploration, Preparation, Implementation, and Sustainment; Family; Future; Grant; Healthcare; Hospitalization; Hot Spot; Intervention; Interview; Knowledge; Learning; Link; Low income; Mentorship; Methodology; Methods; Minority; Parents; Pediatric Hospitals; Phase; Play; Primary Health Care; Provider; Public Health; Pulmonology; Questionnaires; Randomized; Research; Research Design; Research Methodology; Research Personnel; Resources; Risk; Role; School Nursing; Schools; Self Assessment; Site; Source; Students; System; Training; Universities; Visit; Work; asthma exacerbation; base; career; career development; community engagement; design; disparities in morbidity; dissemination trial; evidence base; experience; follow-up; global health; health disparity; health equality; high risk population; implementation framework; implementation strategy; improved; improved outcome; interest; lower income families; medical schools; metropolitan; mortality; parent grant; programs; research study; school district; screening; skill acquisition; social health determinants; urgent care

PROJECT SUMMARY / ABSTRACT Our diversity supplement proposal, “Addressing Social Determinants of Health in Disadvantaged Children with Asthma,” seeks to provide Mfonobong Udoko, MD, experience in conducting qualitative methodology research to assess and manage social determinants of health (SDOH). Dr. Udoko will utilize our UG3 parent grant to evaluate the role of SDOH in children with asthma, ages 5 to 12 years, from low-income communities. We are applying community-based participatory methods with high risk populations and communities to contextualize dissemination and implementation (D&I) of our Colorado school-based asthma program (Col- SBAP) that reduces asthma exacerbations and missed school days, while also addressing SDOH which our pilot identified as a major driver of asthma disparities. Our dissemination trial will include two interventions: our evidence-based Col-SBAP and an approach to key SDOH. This two-step level of intervention, called Stop Asthma Attacks (SAA), is designed for sustainable delivery by school asthma navigators and school nurses who coordinate with primary care and community resources. In partnership with our community stakeholders, the Exploration, Preparation, Implementation, Sustainment (EPIS) D&I framework is being applied during the UG3 planning phase to iteratively adapt our current implementation guide to tailored implementation plans that meet local community and site-specific needs, resources and priorities (EPIS Phases 1 & 2). We will then conduct a UH3 dissemination trial with a randomized stepped-wedge study design in asthma “hot spot” school systems across five Colorado regions to evaluate implementation strategies across these school systems (EPIS phase 3, UH3 trial) and to apply the work from EPIS phases 1-3 to develop a “dissemination playbook” to guide future program adoption by other school systems (EPIS Phase 4). Dr. Udoko will obtain input from various stakeholders on assessing and providing resources to address SDOH. This information will be used to develop our DECIPHeR dissemination playbook for our staff to obtain information on SDOH, enhance their ability to refer families to appropriate resources and then follow up on these referrals. The following Specific Aims will support our parent UG3 grant: Supplement Aim 1a and 1b. Compare the strengths and limitations of 2 different approaches for SDOH screening + intervention from multiple stakeholders: a) self-assessment by caregivers using a printed questionnaire; b) navigator led interview of caregivers based on a questionnaire. Supplement Aim 1c. Across stakeholder groups, identify characteristic features of current SDOH screening + intervention that leads to successful management of SDOH needs. Dr. Udoko will provide important information as a companion to our DECIPHeR “dissemination playbook” on methods to obtain information on SDOH and to link families to the appropriate resources, assure their follow-up, and improve communication within our parent grant DECIPHeR communities.

项目摘要/摘要 我们的多样性补充提案，“解决弱势儿童健康的社会决定因素” 寻求为医学博士Mfonobong Udoko提供进行定性方法的经验 评估和管理健康的社会决定因素的研究(SDOH)。Udoko博士将利用我们的UG3家长 GRANT评估SDOH在低收入社区5至12岁哮喘儿童中的作用。 我们正在对高危人群和社区应用以社区为基础的参与式方法 科罗拉多州校本哮喘计划的传播和实施(D&I)(COL- SBAP)，以减少哮喘恶化和缺课，同时还解决了我们的 飞行员被确定为哮喘差异的主要驱动因素。我们的传播试验将包括两项干预措施：我们的 基于证据的COL-SBAP和密钥SDOH的方法。这种干预分为两步，称为停止 哮喘发作(SAA)，专为学校哮喘导航员和学校护士可持续提供而设计 他们与初级保健和社区资源进行协调。与我们的社区利益相关者合作， 探索、准备、实施、可持续(EPIS)D&I框架在 UG3规划阶段，反复调整我们当前的实施指南以适应量身定制的实施计划 满足当地社区和特定地点的需求、资源和优先事项(EPIS阶段1和2)。到时候我们会的 在哮喘“热点”学校采用随机阶梯楔形研究设计进行UH3传播试验 科罗拉多州五个地区的系统，以评估这些学校系统的实施策略 (EPIS阶段3，UH3试验)，并应用EPIS阶段1-3的工作来开发一本“传播手册” 指导其他学校系统未来采用计划(EPIS阶段4)。Udoko博士将从以下方面获得意见 关于评估和提供资源以解决SDOH问题的各利益攸关方。这些信息将被用于 为我们的员工开发我们的解密传播手册，以获取有关SDOH的信息，增强他们的 有能力将家庭转介给适当的资源，然后跟进这些转介。以下是具体的 AIMS将支持我们的母公司UG3赠款：补充目标1a和1b。比较以下各项的优势和局限性 2种不同的SDOH筛选方法+多个利益相关者的干预：a)通过以下方式进行自我评估 护理员使用打印的调查问卷；b)导航员根据问卷对护理员进行访谈。 补充目标1c.跨利益相关群体，确定当前SDOH筛选+的特征 能够成功管理SDOH需求的干预措施。Udoko博士将提供重要的 信息作为我们关于获取信息的方法的破译《传播攻略》的伴奏 并将家庭与适当的资源联系起来，确保他们的后续行动，并改善沟通 在我们的父母授权破译社区内。