Adapting a pediatric weight management program for implementation via telehealth

项目摘要 儿童肥胖症在美国仍然非常普遍，是慢性疾病的主要诱因。 有证据表明，儿童时期的肥胖会持续到成年，使儿童容易患上心脏代谢疾病。 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 那些来自低收入家庭的人并没有从这些努力中同样受益。孩子们需要协调一致 而且经常照顾体重管理，但对儿童来说存在多重社会经济和地理障碍 生活在低收入家庭，并使健康差距长期存在。需要更好的解决方案来改善接入 影响健康结果的护理和持续参与。远程医疗是一种可以改进的方法 获取、参与和减少障碍，尽管简单地使用它不足以促进公平获取； 可能会引入其他障碍并导致不平等。关键问题是：我们如何当面修改 远程保健的儿科体重管理计划公平吗？这项混合方法研究的目标是 研究治疗儿童肥胖症的远程保健方法，以了解影响可获得性和 参与护理并将儿科体重管理计划用于远程医疗。为了这份有指导的职业生涯 开发应用程序，我们建议利用Connect for Health，这是一项由NHLBI和患者资助的研究 中心结果研究所(PCORI)正在实施面对面的儿科体重管理 程序。在实施科学框架指导下，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方案，以 Connect for Health，并对优化的远程医疗计划进行试点测试。我最重要的假设是利益相关者- 知情的远程医疗适应将导致公平获得健康连接儿科体重 管理课程。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结果和获得护理的机会，从而提供护理。我有过 组建了一个在儿童肥胖症、健康公平和实施科学方面具有专业知识的导师团队。 随着我的研究和培训计划，我将发展先进的定量分析，混合方法的技能 设计和实施科学，使我能够实现我的职业目标。

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.