A Scalable mHealth Resource to Facilitate Behavioral and Emotional Recovery after Pediatric Traumatic Injury

可扩展的移动医疗资源，促进小儿创伤后行为和情绪恢复

• 批准号: 10673817
• 负责人: Leigh E. Ridings
• 金额: $ 14.8万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-15 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10673817
• 关键词: Acceleration; Accidental Injury; Address; Adult; Affect; Age; Animals; Area; Award; Behavioral; Bite; Caregivers; Caring; Child; Child Traumatic Stress; Childhood; Clinical; Clinical Services; Clinical Trials; Clinical Trials Design; Communication; Consultations; Critical Illness; Data; Data Analyses; Development; Distress; Education; Elements; Emotional; Endowment; Enhancement Technology; Ensure; Environment; Equilibrium; Evaluation; Family; Goals; Grant; Health; Health Status; Health Technology; Hospitalization; Improve Access; Individual; Injury; International; Intervention; Interview; Mental Depression; Mental Health; Mentors; Mentorship; Methodology; Modeling; Monitor; National Institute of Child Health and Human Development; Outcome; Patients; Population; Post-Traumatic Stress Disorders; Preparation; Prevention Research; Protocols documentation; Publications; Quality of Care; Quality of life; Race; Reaction; Recommendation; Recovery; Research; Resources; Risk; Risk Assessment; Risk Reduction; Role; Self Care; Services; Site; Structure; Symptoms; Technology; Testing; Time; Training; Trauma; Trauma Research; Traumatic injury; United States National Institutes of Health; Vehicle crash; Work; Writing; barrier to care; behavioral health; behavioral outcome; career; career development; coping; cost; cost effective; cost efficient; design; effectiveness/implementation trial; evidence base; experience; falls; follow-up; functional disability; implementation evaluation; implementation science; innovation; iterative design; longitudinal analysis; mHealth; pediatric emergency; pediatric trauma; pilot test; post-traumatic stress; programs; public health priorities; resilience; screening; skills; societal costs; statistics; success; trauma care; trauma centers; treatment research; usability

PROJECT SUMMARY/ABSTRACT Pediatric traumatic injury (PTI) is a public health priority, with nearly 300,000 children incurring injuries so severe that they require hospitalization each year. PTI is associated with annual individual and societal costs of $87 billion and elevates risk for posttraumatic stress, depression, and other health risk consequences that affect quality of life, physical recovery, emotional and behavioral outcomes, family roles and routines, and academic functioning. Follow-up care for affected children and caregivers is critical to support behavioral and emotional recovery, but few trauma centers provide these services and established, scalable models of care are lacking. Cost-effective, sustainable interventions are needed to reduce barriers to care and reach families that need it most. Pilot data collected by the candidate suggest that a technology-enhanced model of care is appealing to caregivers and has high potential to address service barriers by providing real-time assistance to help caregivers manage their own distress and their children’s behavioral and emotional recovery. The candidate proposes to develop and systematically evaluate CAARE (Caregivers’ Aid to Accelerate Recovery after pediatric Emergencies), an intervention informed by our ongoing clinical initiatives together with results of qualitative semi-structured interviews with caregivers of young children after PTI. CAARE will consist of education, self-monitoring, and coping resources. Specific aims include: 1) finalize the CAARE model and research protocol with ~15 caregivers after PTI; 2) pilot test CAARE via an open trial (n=60); and 3) assess CAARE implementation feasibility with families (n~20), trauma center directors (n~15), and program managers (n~15). The research environment, facilities, and resources at MUSC are ideally suited for mentored career development in child traumatic stress research. Dovetailing with the research aims, K23 training objectives are to: 1) develop proficiency in clinical trial design, implementation, and evaluation; 2) enhance proficiency in the use of iterative-design technology-based solutions; 3) develop expertise in implementation science; 4) enhance statistical training in clinical trials, longitudinal analyses, and qualitative data analysis; and 5) expand skills in scientific communication, including grant writing, presentations, and publications. Mentorship and consultation from experts in pediatric trauma, health technology solutions, implementation science, and advanced statistics will ensure training goals are met. The candidate’s long-term career goal is to establish a research portfolio that develops, rigorously tests, and scales innovative, cost-efficient, evidence-based health technology resources to improve access and quality of care for trauma-impacted families in real-world settings. These research and training goals directly correspond with priorities detailed in NICHD’s Pediatric Trauma and Critical Illness Branch, and will allow the candidate to become an internationally recognized leader in child and family trauma prevention and treatment research. The training proposed herein is designed to develop expertise in this area, represents a clear progression from prior training, and would not be possible without this K23.

项目概要/摘要 儿童创伤性损伤 (PTI) 是一个公共卫生重点，有近 300,000 名儿童受伤，因此 严重到他们每年都需要住院治疗。 PTI 与年度个人和社会成本相关 870 亿美元，并增加了创伤后压力、抑郁和其他健康风险后果的风险 影响生活质量、身体恢复、情绪和行为结果、家庭角色和日常生活，以及 学术功能。对受影响儿童和护理人员的后续护理对于支持行为和护理至关重要 情绪恢复，但很少有创伤中心提供这些服务和已建立的、可扩展的护理模式 缺乏。需要采取具有成本效益、可持续的干预措施来减少护理障碍并惠及家庭 最需要它的。候选人收集的试点数据表明，技术增强的护理模式是 对护理人员有吸引力，并且具有通过向护理人员提供实时帮助来解决服务障碍的巨大潜力 帮助看护者管理自己的痛苦以及孩子的行为和情绪恢复。这 候选人提议制定并系统评估 CAARE（看护者加速康复援助） 儿科紧急情况后），这是一项根据我们正在进行的临床举措以及以下结果提供的干预措施 PTI 后对幼儿照顾者进行定性半结构化访谈。 CAARE 将包括 教育、自我监控和应对资源。具体目标包括：1）最终确定 CAARE 模型并 PTI 后与约 15 名护理人员的研究协议； 2) 通过公开试验对 CAARE 进行试点测试（n=60）； 3）评估 CAARE 在家庭 (n~20)、创伤中心主任 (n~15) 和项目经理中实施的可行性 (n~15)。 MUSC 的研究环境、设施和资源非常适合指导职业 儿童创伤应激研究的进展。与研究目标相吻合，K23 培训目标是 1) 提高临床试验设计、实施和评估的熟练程度； 2) 提高熟练程度 使用基于迭代设计技术的解决方案； 3）发展实施科学方面的专业知识； 4）增强 临床试验、纵向分析和定性数据分析方面的统计培训； 5）扩展技能 科学传播，包括资助写作、演示和出版物。指导和咨询 来自儿科创伤、卫生技术解决方案、实施科学和高级统计方面的专家 将确保培训目标的实现。候选人的长期职业目标是建立研究组合 开发、严格测试和扩展创新、具有成本效益、循证的健康技术 资源，以改善现实世界中受创伤影响的家庭的护理机会和质量。这些 研究和培训目标直接与 NICHD 的《儿科创伤和危重症》中详细说明的优先事项相对应 疾病分支，将使候选人成为国际公认的儿童和家庭领导者 创伤预防与治疗研究。本文提出的培训旨在培养以下方面的专业知识： 这个领域代表了之前培训的明显进步，如果没有 K23，这是不可能实现的。