Bridging gaps in healthcare services for new familes due to COVID-19

弥补新家庭因 COVID-19 造成的医疗保健服务差距

• 批准号: 10678456
• 负责人: Craig F. Garfield
• 金额: $ 80.89万
• 依托单位: WOMEN AND INFANTS HOSPITAL-RHODE ISLAND
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-13 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10678456
• 关键词: Admission activity; Adult; Adverse effects; Area; Behavioral; Birth; Breast Feeding; COVID-19; COVID-19 pandemic; COVID-19 pandemic effects; Caring; Child Rearing; Childhood; Climacteric; Communities; Containment; Contraceptive methods; Crowding; Depression screen; Discipline of obstetrics; Education; Ethnic Origin; Face; Family; Fathers; Feedback; Foundations; Funding; Health; Health Services; Healthcare; Home; Hospitals; Income; Individual; Infant; Infant Health Services; Internet; Intervention; Interview; Knowledge; Lead; Life; Low income; Measures; Medical; Medicine; Mental Health; Mental Health Services; Modeling; Monitor; Newborn Infant; Outcome; Paper; Parents; Patient Outcomes Assessments; Patients; Pediatrics; Postpartum Depression; Postpartum Period; Preventive Health Services; Preventive healthcare; Public Health; Race; Randomized; Randomized Controlled Trials; Reporting; Resources; Risk; Role; Self Administration; Self Efficacy; Services; Social Responsibility; Social support; Surveys; Symptoms; Testing; Touch sensation; Transportation; United States; United States Agency for Healthcare Research and Quality; Vaccination; Visit; Well Child Visits; Woman; anxiety symptoms; arm; base; birth control; child services; collaborative care; depressive symptoms; design; digital health; digital healthcare; distrust; efficacy testing; ethnic minority; evidence base; experience; global health; health care delivery; health care service; health equity; health equity promotion; health of the mother; health service use; improved; lower income families; pandemic disease; patient oriented; perceived stress; perinatal mental health; physical conditioning; postnatal; postpartum care; primary outcome; racial and ethnic; recruit; residential segregation; response; screening; secondary outcome; service intervention; service utilization; social health determinants; socioeconomic disparity; stress symptom; substance use; success; telehealth; therapy design; transmission process; treatment arm; treatment as usual; urgent care; virtual healthcare

PROJECT SUMMARY The transition to new parenthood is marked by dramatic changes in social roles and responsibilities. To support new parents, obstetric and pediatric healthcare surrounding this transition is designed with a supportive focus to facilitate new parents' navigation of the attendant life changes. The COVID-19 pandemic has altered healthcare delivery in ways that have limited these supportive obstetrics and pediatric services provided at the beginning of new parenthood. Consequently, aspects of preventative healthcare, such as monitoring for symptoms of postpartum depression, discussing optimal birth control options, educating parents on recommended adult and pediatric vaccinations, and providing anticipatory guidance on infant wellness, are less robust. In addition, without professional guidance and support, outcomes of foundational importance to new parents, such as perceived stress, depressive and anxiety symptoms, or parenting and breast-feeding self-efficacy, are worse. Moreover, the COVID-19 pandemic has underscored the impact of the social determinants of health on new family wellness, with racial/ethnic minority and low-income families being differentially impacted by COVID-19 pandemic driven healthcare delivery changes. Recognizing the potential for longitudinal changes in healthcare delivery engendered by the COVID-19 pandemic, a scalable, patient-centered, equity-focused intervention designed to bridge gaps in healthcare services around the transition to new parenthood is needed. This due (N2H), project, “Bridging gaps in healthcare delivery to COVID-19 for parent and infants from birth through the first year of life” aims to evaluate Nursery2Home a patient-informed digital healthcare intervention that s is specifically responsive to the COVID-19 pandemic's impact on new families, with a focus on health equity for racial/ethnic minority and low income families. N2H builds upon previous digital health successes of our team while incorporating the evidence-based collaborative care model for mental health support. N2H is designed to mitigate the adverse effects of healthcare delivery changes in response to the COVID-19 pandemic and to improve health for mothers, fathers, and infants over the first year of life. Developed from feedback given by new parents who delivered during the COVID-19 pandemic, N2H provides 1) parental education about their own physical and mental health, 2) infant wellness resources and tracking of recommended healthcare services, 3) parental mental health screening and support, and 4) systematic case review to optimize the health of new families. We assigned improves In health will test the efficacy of N2H via a randomized controlle trial. In total, 640 diverse families will be randomly to either usual care or N2H intervention arm to evaluate whether, compared to usual care, N2H healt services utilization and patient reported outcomes of foundational importanc to new families. addition, we will evaluate the impact of N2H on racial/ethnic and income-based disparities observed in both services utilization and patient reported outcomes. d h e

项目总结 过渡到新父母的标志是社会角色和责任的戏剧性变化。支持 围绕这一过渡的新父母、产科和儿科医疗保健旨在提供支持性重点 方便新父母导航随之而来的生活变化。新冠肺炎大流行改变了医疗保健 分娩方式限制了#年初提供的这些支持性产科和儿科服务 新为人父母。因此，预防性保健的各个方面，如监测疾病症状 产后抑郁症，讨论最佳节育方案，教育父母推荐的成年人和 儿科疫苗接种，以及为婴儿健康提供预期指导，则不那么有效。此外, 如果没有专业的指导和支持，对新父母来说很重要的基础成果，如 感觉到的压力、抑郁和焦虑症状，或父母养育和母乳喂养的自我效能更差。 此外，新冠肺炎疫情突显了健康的社会决定因素对新的 家庭健康，新冠肺炎对种族/少数民族和低收入家庭的影响存在差异 大流行驱动的医疗保健提供变化。 认识到新冠肺炎可能带来医疗保健服务的纵向变化 大流行，一种可扩展的、以患者为中心、以公平为重点的干预措施，旨在弥合医疗保健方面的差距 需要围绕过渡到新父母的服务。这 到期 (N2H)， 项目，“弥合医疗保健提供方面的差距” 为父母和婴儿从出生到第一年的新冠肺炎 患者告知的数字医疗干预 S 专门响应新冠肺炎 流行病对新家庭的影响，重点是种族/族裔少数群体和低收入群体的健康公平 家人。N2H建立在我们团队之前的数字健康成功的基础上，同时纳入了基于证据的 心理健康支持的协作护理模式。N2H旨在减轻医疗保健的不利影响 为了应对新冠肺炎大流行和改善母亲、父亲和婴儿的健康，分娩发生了变化 在生命的第一年。由新冠肺炎期间分娩的新父母提供的反馈开发而成 流行，N2H提供1)关于他们自己的身心健康的父母教育，2)婴儿的健康 推荐的医疗保健服务的资源和跟踪，3)父母心理健康筛查和支持， (4)系统的病例审查，以优化新家庭的健康。 我们 已分配 改善 在……里面 健康状况 将通过随机对照试验测试N2H的疗效。总共有640个不同的家庭将被随机 常规护理或N2H干预组，以评估与常规护理相比，N2H 卫生服务利用率和患者报告的对新家庭的基础重要性的结果。 此外，我们将评估N2H对观察到的种族/民族和基于收入的差距的影响 服务利用率和患者报告的结果。 D 他