iRise: Willingness of Low-and Middle-Income Country-based Health Workers to Respond to Public Health Emergencies and Disasters - an mHealth Intervention Study

iRise：中低收入国家卫生工作者应对突发公共卫生事件和灾难的意愿 - 一项移动医疗干预研究

• 批准号: 10880475
• 负责人: Nargis Asad
• 金额: $ 30.4万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-10 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10880475
• 关键词: Accident and Emergency department; Address; Area; Attitude; Case Study; Clinical; Consumption; Control Groups; Data Collection; Disasters; Educational Curriculum; Educational Intervention; Educational workshop; Effectiveness; Emergency Care; Emergency Medicine; Emergency Situation; Event; Exhibits; Group Interviews; Health; Health Personnel; Health Professional; Health Technology; Health system; Hour; Human Resources; Intervention; Intervention Studies; Knowledge; Measures; Medical center; Mobile Health Application; Motivation; Outcome; Pakistan; Perception; Persons; Phase; Politics; Publishing; Questionnaires; Randomized, Controlled Trials; Readiness; Reporting; Research; Resources; Role; Security; Self Efficacy; Structure; Testing; Time; Training; Universities; Work; design; digital; effectiveness measure; effectiveness trial; expectation; global health; group intervention; hazard; health assessment; insight; low and middle-income countries; mHealth; man; novel; online course; pandemic disease; pilot test; population health; pressure; public health emergency; response; tool; webinar; willingness

PROJECT SUMMARY Healthcare workers’ (HCWs’) willingness to report to work in pandemics and other public health emergencies and disasters is a foundational prerequisite for national, regional and global health security amidst an ever- broadening array of natural and manmade emergent threats. Well-documented case reports and research point to significant and concerning gaps in response willingness toward public health emergencies and disasters, including among low- and middle- income country (LMIC)-based HCWs. Further, research to date in LMIC and other settings has highlighted HCWs’ self-efficacy as leading predictor of their willingness to respond (WTR) during such crises. Higher levels of self-efficacy positively influence motivation, willingness to respond and take action, and to persevere when challenges are encountered, including exhibiting teamwork, expressing sensitivity, managing politics and handling pressure. Prior studies by membership of the research team have been accompanied by training interventions that yielded significant increases in self-efficacy, and attendant WTR, among frontline HCWs. However, this training was designed to be in-person and several hours long, which presents a difficult logistical challenge for busy Emergency Department HCWs. Could mobile health (mHealth) technology offer an efficient approach to training and support to enhance self-efficacy and increase WTR among LMIC-based HCWs? To the very best of our knowledge, there has never been a mHealth product or intervention to address self-efficacy and WTR. Accordingly, this gap presents an opportunity to generate a novel mHealth application to enhance frontline LMIC-based healthcare workers' self-efficacy and WTR during public health emergencies and disasters. By extension, such a mHealth intervention could strengthen staffing surge capacity in resource-challenged health systems in LMICs, and thus shore up critical gaps in health security. The study's purpose is first to assess the feasibility of strengthening self-efficacy and response willingness toward public health emergencies, including pandemics, and disasters in emergency department clinical personnel in a LMIC setting (R21); and, if feasible, carry out a trial to confirm the effectiveness of the approach on outcomes (R33) [see below] in Karachi, Pakistan. Our R21-component specific aims (SA) are: SA1: Characterize and measure LMIC-based emergency medicine healthcare workers' (HCWs') baseline self- efficacy toward fulfillment of work-related roles and expectations in pandemics and other public health emergencies and disasters, and their attendant perceptions regarding willingness to respond in such contexts. SA2: Develop and pilot-test a novel mHealth intervention (iRise ["intervention (for) response in significant emergencies"]) among a group of LMIC-based emergency department HCWs to determine its acceptability, reliability, and perceived usefulness in a culturally sensitive and appropriate manner for busy emergency department HCWs in LMIC settings. SA3: Develop local LMIC-based partners' mHealth research capacity and prepare for an effectiveness trial. Under this aim we would focus on strengthening mHealth-based research capacity among health professionals to support conducting trials, digital data collection, and disaster preparedness in Pakistan. If found feasible, the following are our R33 specific aims: SA4: Gauge short-term (1-month), medium-term (6-months), and longer-term (1-year), impacts of this novel iRise mHealth app on LMIC-based HCWs' self-efficacy and willingness to respond during public health emergencies and disasters. SA 5: Further refine the mHealth app to enhance its attitudinal and related impacts on LMIC-based HCWs’ self-efficacy and response willingness in public health emergencies and disasters.

项目摘要 卫生工作者（HCW）在流行病和其他突发公共卫生事件中报告工作的意愿 是国家、区域和全球卫生安全的基本先决条件， 不断扩大的自然和人为的紧急威胁。有据可查的病例报告和研究要点 在应对突发公共卫生事件和灾害的意愿方面存在重大和令人担忧的差距， 包括低收入和中等收入国家的医疗工作者。此外，迄今为止在LMIC的研究 和其他设置突出了HCW的自我效能作为他们愿意回应的主要预测因素 (WTR)在这样的危机中。高水平的自我效能感对动机、回应意愿有积极影响 并采取行动，并在遇到挑战时坚持不懈，包括展示团队合作， 表达敏感性，管理政治和处理压力。按研究成员分列的先前研究 团队一直伴随着培训干预，产生了显着增加自我效能， 在前线医护人员中，然而，这一培训旨在亲自和几个 小时之久，这对忙碌科医护人员来说是一个艰难的后勤挑战。可以 移动的健康技术提供了一种有效的培训和支持方法，以提高自我效能， 增加基于LMIC的HCW之间的WTR？据我们所知，从来没有一个mHealth 产品或干预，以解决自我效能和WTR。因此，这一差距提供了一个机会， 开发一个全新的移动医疗应用程序，以提高基于LMIC的前线医护人员的自我效能， 突发公共卫生事件和灾害期间的WTR。推而广之，这种移动健康干预可以 加强中低收入国家资源紧缺的卫生系统的人员快速部署能力，从而海岸 健康安全方面的差距。 本研究的目的是首先评估自我效能感和反应意愿增强的可行性 应对突发公共卫生事件，包括流行病和急诊科临床灾难 并在可行的情况下进行试验，以确认该方法的有效性 巴基斯坦卡拉奇的成果（R33）[见下文]。我们的R21组件特定目标（SA）是： SA1：表征和测量基于LMIC的急诊医学医护人员（HCW）基线自我评估 在流行病和其他公共卫生领域履行工作相关角色和期望的有效性 这些问题包括紧急情况和灾害，以及随之而来的对在这种情况下作出反应的意愿的看法。 SA2：开发和试点测试一种新的移动健康干预措施（iRise [“干预措施（针对）显著 紧急情况”]），以确定其可接受性， 可靠性，并认为有用的文化敏感和适当的方式为忙碌紧急情况 LMIC设置中的部门HCW。 战略行动3：发展当地中低收入国家合作伙伴的移动健康研究能力，并为有效性试验做准备。 在这一目标下，我们将重点加强卫生专业人员基于移动健康的研究能力 支持在巴基斯坦进行试验、数字数据收集和备灾。 如果可行，以下是我们R33的具体目标： SA 4：衡量本小说的短期（1个月）、中期（6个月）和长期（1年）影响 iRise mHealth应用程序对基于LMIC的HCW的自我效能和在公共卫生期间做出反应的意愿的影响 紧急情况和灾难。 SA 5：进一步完善移动健康应用程序，以增强其对基于LMIC的HCW的态度和相关影响 突发公共卫生事件和灾害中的自我效能感和应对意愿。