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Adapting a pediatric weight management program for implementation via telehealth

调整儿科体重管理计划以通过远程医疗实施

基本信息

批准号：
10673821
负责人：
Meg Simione
金额：
$ 14.17万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-08-01 至 2027-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10673821
关键词：
Address Adult Age Body mass index Cardiometabolic Disease Caring Characteristics Child Child health care Childhood Chronic Disease Client Clinical Clinical Trials Consolidated Framework for Implementation Research Data Effectiveness Electronic Health Record Employment Equity Ethnic Origin Family Funding General Hospitals Goals Health Health Services Accessibility Healthcare Heart Diseases Household Housing Improve Access Inequity Insurance Internet Interview K-Series Research Career Programs Language Low income Massachusetts Measures Mentors Mentorship Methods Mission National Heart, Lung, and Blood Institute Neighborhood Health Center Obesity Outcome Parents Participant Patient-Focused Outcomes Patients Persons Prevention Race Research Research Institute Research Personnel Research Project Grants Risk Factors Scientist Services Testing Training United States Visit Weight maintenance regimen acceptability and feasibility career career development clinical practice design digital health effectiveness evaluation ethnic diversity experience geographic barrier health care delivery health care quality health disparity health equity health literacy high risk implementation evaluation implementation framework implementation research implementation science implementation strategy improved innovation multidisciplinary obesity in children pilot test prevent primary care visit programs public health insurance racial diversity satisfaction skills social socioeconomics telehealth

项目摘要

Project Summary Childhood obesity remains highly prevalent in the United States and is a major contributor to chronic disease. Evidence suggests that obesity in childhood persists into adulthood, predisposing children to cardio-metabolic diseases. Despite national efforts to expand prevention and treatment, racially/ethnically diverse children and those from low-income households have not benefitted equally from such efforts. Children require coordinated and frequent care for weight management, but multiple socioeconomic and geographic barriers, exist for children living in low-income households and perpetuate health disparities. Better solutions are needed to improve access to care and ongoing participation that impact health outcomes. Telehealth is an approach that can improve access, participation, and mitigate barriers, though simply using it is not sufficient to promote equitable access; other barriers may be introduced and result in inequities. The key question is: how can we modify in-person pediatric weight management programs for telehealth to be equitable? The goal of this mixed methods study is to examine telehealth approaches for childhood obesity to understand multi-level factors that impact access and participation in care and adapt a pediatric weight management program for telehealth. For this mentored career development application, we propose leveraging Connect for Health, a study funded by NHLBI and Patient Centered Outcomes Research Institute (PCORI) that is implementing an in-person pediatric weight management program. Guided by implementation science frameworks, we will analyze electronic health record (EHR) data of current telehealth approaches, conduct qualitative interviews, develop targeted telehealth adaptations to Connect for Health, and pilot test the optimized telehealth program. My overarching hypothesis is stakeholder- informed telehealth adaptations will result in equitable access to the Connect for Health pediatric weight management program. As a clinician-scientist, the long-term goal of my research is to optimize pediatric health care delivery by improving health outcomes and access to care through implementation science. I have assembled a mentorship team with expertise in childhood obesity, health equity, and implementation science. Along with my research and training plan, I will develop skills in advanced quantitative analyses, mixed methods design, and implementation science that will enable me to achieve my career goals.

项目摘要儿童肥胖症在美国仍然非常普遍，是慢性病的主要原因。有证据表明，儿童期肥胖持续到成年，使儿童易患心脏代谢性疾病。疾病尽管国家努力扩大预防和治疗，但种族/族裔多样化的儿童和来自低收入家庭的人没有平等地从这些努力中受益。儿童需要协调和频繁的体重管理，但儿童存在多重社会经济和地理障碍，生活在低收入家庭，并使健康差距永久化。需要更好的解决方案来改善获取护理和持续参与，影响健康结果。远程医疗是一种可以改善获取、参与和减少障碍，尽管仅仅使用它不足以促进公平获取; 可能会引入其他障碍，造成不公平。关键问题是：我们如何亲自修改远程医疗的儿科体重管理计划是否公平？这项混合方法研究的目的是检查儿童肥胖症的远程保健方法，以了解影响获取的多层次因素，参与护理，并调整儿科体重管理计划，以进行远程保健。为了这个有指导的职业生涯开发应用程序，我们建议利用连接健康，由NHLBI和患者资助的研究中心成果研究所（PCRI）正在实施一项面对面的儿科体重管理程序.在实施科学框架的指导下，我们将分析电子健康记录（EHR）数据，目前的远程保健方法，进行定性访谈，制定有针对性的远程保健适应措施，连接健康，并试点测试优化的远程保健计划。我的首要假设是利益相关者- 知情的远程医疗适应将导致公平获得连接健康儿科体重管理程序。作为一名临床科学家，我研究的长期目标是优化儿科健康通过实施科学，改善健康成果和获得护理的机会，提供护理。我有组建了一个具有儿童肥胖、健康公平和实施科学方面专业知识的导师团队。沿着我的研究和培训计划，我将发展先进的定量分析，混合方法，设计和实施科学，这将使我能够实现我的职业目标。