Identifying contributors to racial and ethnic disparities in child occupant safety

确定儿童乘员安全方面种族和民族差异的影响因素

• 批准号: 10685521
• 负责人: Emma Sartin
• 金额: $ 13.03万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10685521
• 关键词: Accident and Emergency department; Accidental Injury; Address; Air Bags; Award; Big Data; Black race; Caregivers; Cessation of life; Characteristics; Child; Childhood; Childhood Injury; Clinical assessments; Code; Cohort Studies; Complex; Continuity of Patient Care; Coupled; Critical Illness; Data; Data Collection; Databases; Development; Diagnostic; Disparity; Economics; Electronics; Epidemiologic Methods; Epidemiology; Ethics; Ethnic Origin; Ethnic Population; Family; Fatality rate; Frequencies; Funding; Future; Goals; Health; Health behavior; Hispanic; Hospitals; Individual; Injury; Intervention; Interview; Joints; Knowledge; Mediation; Mental Health; Mentors; Methodology; Methods; Minority; Minority Groups; Mission; Modeling; Mothers; National Institute of Child Health and Human Development; Outcome; Pathway interactions; Phase; Policies; Population; Population Study; Predictive Factor; Prevalence; Prevention; Public Health; Race; Research; Research Activity; Research Personnel; Safety; Severities; Side; Societies; Source; Strategic Planning; Structure; Surveys; System; Techniques; Technology; Training; Training Activity; Transportation; Traumatic injury; Treatment Factor; Vehicle crash; Visualization; Work; behavior change; career; cost; data management; developmental psychology; disability; disparity elimination; disparity reduction; effective intervention; ethnic disparity; ethnic minority; experience; health disparity; improved; innovation; knowledge integration; novel; pediatric trauma; physical conditioning; prevent; racial disparity; racial minority; racial population; recruit; restraint; skills; social; stress disorder; therapy development

Project Abstract The purpose of this K99/R00 Pathway to Independence award is to enable Dr. Sartin to gain the experience and skills necessary to become an independent investigator focused on identifying, understanding, and eliminating disparities in transportation and pediatric unintentional injuries. Dr. Sartin’s primary objective is to utilize a breadth-to-depth approach that integrates knowledge obtained from population- (breadth) and individual-level (depth) analyses to understand where and why racial and ethnic disparities in child occupant safety arise across the crash injury continuum. In the K99 phase of this project, Dr. Sartin will complete multiple research and training activities to develop knowledge and skills in: (1) advanced epidemiologic/statistical and injury methodologies; (2) management, analysis, and visualization of large databases; (3) advanced R programming; and (4) effective and ethical approaches to researching health disparities. Specifically, Dr. Sartin will complete structured coursework and guided independent study, as well as mentored research with her experienced, interdisciplinary team of mentors and advisors to successfully achieve three aims. In the K99 phase, Dr. Sartin will utilize innovative methods to: analyze a large, unique source of state-level data to determine population-level frequency of child restraint system use across racial/ethnic populations (Aim 1a); identify factors that contribute to lower rates of child restraint system use in minority groups (Aim 1b); and assess how child, driver, and vehicle characteristics impact racial and ethnic disparities observed in child occupants’ crash injury severity (Aim 2). In the R00 phase, Dr. Sartin will recruit recently crash-injured children and a caregiver to participate in a mixed-methods, pilot cohort study—involving surveys, clinical assessments, and semi-structured interviews—to assess short- and long-term mental and physical health outcomes (Aim 3). Findings of the R00 study will serve as preliminary data to support Dr. Sartin’s first R01 proposal. In addition to preparing Dr. Sartin for an independent research career, this work is significant in that it will directly address several critical gaps in child occupant safety. While overall child occupant fatality rates have decreased since 1975, ~3 children die in crashes each day and ~100k more are treated each year in emergency departments for injuries. Further, while overall fatalities have declined, racial and ethnic disparities have widened such that Black children are twice as likely as White children to die in a crash. The high burden and costs of crashes on children ($530M annually) coupled with clear disparities underscore the critical need to enhance child occupant safety, in particular among racial and ethnic minorities. The knowledge gained by this project will ultimately reduce overall rates of pediatric crash injury and death by bolstering protective efforts for the most vulnerable children. This K99/R00 is directly aligned with the NICHD 2020 Strategic Plan’s emphasis to understand the contribution of social, economic, structural, and regional factors that contribute to health disparities, and the Pediatric Trauma and Critical Illness Branch’s mission to prevent, treat, and reduce all forms of traumatic injury across the continuum of care.

项目摘要 这个K99/R 00独立之路奖的目的是使Sartin博士获得经验， 成为独立调查员所需的技能，重点是识别，理解和消除 交通差异和儿科意外伤害。撒丁博士的主要目标是利用 从广度到深度的方法，将从人口（广度）和个人层面获得的知识结合起来 （深入）分析，以了解儿童乘员安全方面的种族和民族差异在哪里以及为什么会出现， 车祸伤害的连续性在该项目的K99阶段，Sartin博士将完成多项研究和培训 开展活动，发展以下方面的知识和技能：（1）先进的流行病学/统计学和伤害方法;（2） 大型数据库的管理，分析和可视化;（3）高级R编程;（4）有效和 研究健康差异的伦理方法。具体来说，Sartin博士将完成结构化的课程 并指导独立研究，以及指导研究与她的经验丰富，跨学科的团队， 导师和顾问，以成功地实现三个目标。在K99阶段，Sartin博士将利用创新的 方法：分析州一级数据的大量独特来源，以确定儿童的人口水平频率 在种族/族裔人群中使用约束系统（目标1a）;确定有助于降低 儿童约束系统在少数群体中的使用（目标1b）;并评估儿童、驾驶员和车辆特征 影响儿童乘员碰撞损伤严重程度中观察到的种族和民族差异（目标2）。在R 00阶段， 博士Sartin将招募最近在车祸中受伤的儿童和一名护理人员参加一个混合方法的试点项目， 队列研究，包括调查、临床评估和半结构化访谈，以评估短期和 长期的心理和身体健康结果（目标3）。R 00研究的结果将作为初步数据 支持撒丁博士的第一个R 01提案除了为Sartin博士的独立研究生涯做准备外， 这项工作的重要性在于它将直接解决儿童乘员安全方面的几个关键差距。虽然总体 自1975年以来，儿童乘员死亡率有所下降，每天约有3名儿童死于车祸， 每年都在急诊室接受治疗。此外，虽然总体死亡人数有所下降，但种族 种族差异扩大，黑人儿童死于种族歧视的可能性是白色儿童的两倍。 个碰撞测试车祸给儿童造成的沉重负担和成本（每年5.3亿美元），以及明显的差异 强调迫切需要加强儿童乘员的安全，特别是在少数种族和族裔中。 本项目所获得的知识将最终降低儿童车祸伤害和死亡的总体发生率， 加强对最弱势儿童的保护工作。该K99/R 00直接与NICHD对齐 2020年战略计划强调理解社会，经济，结构和区域的贡献 儿童创伤和危重病分支的使命是 预防、治疗和减少各种形式的创伤性损伤。