Ready and Healthy for Kindergarten: A Primary Care Innovation to Promote a 360-degree View of Child Health

为幼儿园做好准备和健康：促进 360 度儿童健康视角的初级保健创新

• 批准号: 10653505
• 负责人: Manuel E Jimenez
• 金额: $ 5.02万
• 依托单位: RBHS-ROBERT WOOD JOHNSON MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10653505
• 关键词: Ready; Healthy; Kindergarten; Primary; Care

PROJECT SUMMARY/ABSTRACT Education is a critical social determinant of health (SDOH). Low-income, Latino dual language learners face large gaps in school readiness, which perpetuate inequities in academic achievement and subsequent health. Primary care is an ideal setting to promote school readiness for at-risk children given its frequent near universal contact with children and the opportunity to build on established relationships with their families. In fact, school readiness is a Bright Futures priority topic at the 4 and 5-year well child visits. However, the current structure of well child visits, which seeks to address a growing list of topics during 10-15 minute appointments, is limited in its ability to achieve this goal. To date, primary care innovations to address SDOH have largely missed an opportunity to promote 360-degree child health by simultaneously addressing academic and physical readiness for school. To address this gap, we developed an online family wellness program that uses anticipatory guidance on health topics intrinsically important to school readiness (e.g., nutrition, physical activity) to introduce basic language and literacy skills to low-income, Latino dual language learners, a fast- growing and particularly high-risk group, and their families (AHRQ priority populations). The online family wellness program was developed through a cross-sector partnership between educators and pediatric professionals and consists of parent-child workshops led by bilingual educators and reminder text messages. The program occurs during the transition into Kindergarten, a critical developmental stage, and uses promising approaches such as group structure, strategic use of technology, and partnerships with non- medical professionals. The yearlong program tightly integrates Bright Futures anticipatory guidance with the Kindergarten curriculum. During pilot testing, our team found that the family wellness program was feasible, well attended, and highly acceptable. We now propose testing the effect of the family wellness program on child and parenting outcomes using a rigorous mixed methods and community-engaged approach. In aim 1, we will conduct a developmental evaluation to refine the family wellness program and optimize the likelihood of successful implementation. In aim 2, we will conduct a randomized controlled trial testing the effects of the family wellness program on child language, literacy, and social-emotional outcomes as well parent health routines, learning activities, and self-efficacy. In aim 3, we will conduct a mixed methods process evaluation, which will provide insight into reach and implementation as well as user experience. The current proposal will yield insight into how primary care innovations can address education, which responds directly to AHRQ's interest in primary care innovations that address SDOH (NOT-HS-19-011). If effective, the online format will allow us to work with local, state, and national partners to disseminate the program rapidly to promote high- quality healthcare for vulnerable populations.

项目总结/摘要 教育是健康的关键社会决定因素（SDOH）。低收入的拉丁裔双语学习者面临着 在入学准备方面存在巨大差距，这使学习成绩和随后的健康方面的不平等长期存在。 初级保健是一个理想的环境，以促进学校准备的风险儿童，因为其频繁的近 与儿童的普遍接触以及在与其家庭建立关系的基础上再接再厉的机会。在 事实上，在4岁和5岁的好孩子访问中，学校准备是光明未来的优先主题。但目前 健康儿童访问的结构，旨在在10-15分钟的约会中解决越来越多的主题， 它实现这一目标的能力有限。迄今为止，解决SDOH的初级保健创新在很大程度上 错过了一个机会，以促进360度儿童健康，同时解决学术和 为上学做好身体准备为了弥补这一差距，我们开发了一个在线家庭健康计划， 关于对入学准备具有内在重要性的健康主题的预期指导（例如，营养、身体的 活动），介绍基本的语言和识字技能，低收入，拉丁美洲双语学习者，一个快速- 不断增长的特别高风险群体及其家庭（AHRQ优先人群）。在线家庭 健康计划是通过教育工作者和儿科医生之间的跨部门合作开发的。 这是一个由专业人员组成的小组，包括由双语教育工作者领导的亲子讲习班和提醒短信。 该计划发生在过渡到幼儿园，一个关键的发展阶段，并使用有前途的 方法，如集团结构，战略性使用技术，并与非医疗合作伙伴关系 专业人士这项为期一年的计划将光明未来的预期指导与 幼儿园课程。在试点测试中，我们的团队发现家庭健康计划是可行的， 出席率很高，而且很受欢迎。我们现在建议测试家庭健康计划对 使用严格的混合方法和社区参与的方法来评估儿童和养育结果。在目标1中， 我们将进行发展评估，以完善家庭健康计划，并优化以下可能性： 成功实施。在目标2中，我们将进行随机对照试验， 关于儿童语言、识字和社会情感结果以及父母健康的家庭健康计划 常规，学习活动和自我效能。在目标3中，我们将进行混合方法过程评估， 这将提供深入了解范围和实施以及用户体验。目前的提案将 深入了解初级保健创新如何解决教育问题，这直接回应了AHRQ的 对解决SDOH的初级保健创新感兴趣（NOT-HS-19-011）。如果有效，在线格式将 让我们与地方，州和国家合作伙伴合作，迅速传播该计划，以促进高- 为弱势群体提供优质医疗服务。