P-KIDs CARE: An Intervention to Address Health Systems Delays to Care for Injured Children in Tanzania

点击翻译按钮获取中文摘要

PROJECT SUMMARY/ABSTRACT Every day, 1900 children die from an injury. More than 95% of these pediatric injury deaths occur in low- and middle-income countries (LMICs), with children in sub-Saharan Africa disproportionately affected. In sub- Saharan Africa, pediatric morbidity and mortality could be minimized if children with serious injuries received timely quality care. The objective of the proposed research is to develop and pilot a locally-relevant, multicomponent intervention to streamline the triage process (e.g. patient assessment, stabilization, and disposition) for pediatric injury patients in Tanzania. This health systems intervention will work at the first level of medical contact (e.g., health center and district hospital), in order to facilitate timely disposition and referrals, and subsequently decrease time to definitive care. The proposed study has three aims: 1) With a mixed methods approach, describe the barriers to pediatric injury care at the first medical contact; 2) Iteratively develop the P-KIDs CARE intervention using a nominal group technique and conduct a pre-implementation assessment and refinement; 3) Pilot the P-KIDs CARE intervention and perform an implementation-focused formative evaluation. This career development award is being proposed by Dr. Elizabeth Keating, a Pediatric Emergency Medicine physician-scientist focused on resource-limited settings like Tanzania. During the award period, the candidate will gain the training and mentorship to become an independent clinical investigator focused on developing novel, scalable health systems interventions in resource-limited settings. Along with developing this innovative intervention, the candidate will gain skills in implementation science, health systems intervention development, global clinical trial design, and the responsible conduct of research. The candidate’s career development will be guided by an impressive multi-disciplinary and international team of experienced mentors with extensive expertise in health systems intervention development, global clinical trials, and trauma management. This proposal speaks to NIH’s strategic goals by building capacity for systems-level trauma research in LMICs. By the end of this project, Dr. Keating will have a unique combination of research expertise and will be prepared to submit an R01 proposal that has the potential to improve outcomes for injured children in sub-Saharan Africa.