Shared Decision Making in ADHD

多动症的共同决策

• 批准号: 7737744
• 负责人: Alexander Gabriel Fiks
• 金额: $ 12.61万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7737744
• 关键词: Accident and Emergency department; Adherence; African American; Attention deficit hyperactivity disorder; Award; Child; Child health care; Childhood; Complement; Computer Systems; Conduct Clinical Trials; Conflict (Psychology); Country; Data; Decision Aid; Decision Making; Device or Instrument Development; Doctor of Medicine; Educational workshop; Effectiveness; Ethnic Origin; Evidence based treatment; Family; Goals; Grant; Health; Impairment; Institute of Medicine (U.S.); Intervention; K-Series Research Career Programs; Knowledge; Language; Length; Link; Longitudinal Studies; Measurement; Measures; Mentorship; Outcome; Parents; Patients; Population; Prevalence; Primary Health Care; Principal Investigator; Process; Race; Reporting; Research; Research Personnel; Role; Sampling; Schools; Selection for Treatments; Severities; Socioeconomic Status; Structure; Subgroup; Symptoms; System; Training; Treatment outcome; Uncertainty; Validity and Reliability; Visit; Work; base; career; cohort; cultural values; effective intervention; functional disability; health information technology; improved; instrument; pediatrician; practice-based research network; preference; prototype; public health relevance; shared decision making; skills; symposium; treatment as usual

DESCRIPTION (provided by applicant): Alexander Fiks, M.D., MSCE is an urban primary care pediatrician who studies health information technology (HIT) to improve child health outcomes. Dr. Fiks' research has found that although clinician-focused HIT interventions are effective, their impact could be increased by facilitating information exchange between clinicians and families in order to clarify treatment preferences and goals, a process called shared decision making (SDM). Although Dr. Fiks' long-term career goal is to become an independent investigator expert in the large-scale implementation of SDM using HIT for multiple pediatric conditions, this career development award will focus on Attention-Deficit/Hyperactivity Disorder (ADHD). ADHD is an ideal prototype condition for SDM: families choose between multiple evidence-based treatments; personal/cultural values influence their selection; treatment disparities exist; and little work has so far been done to untangle these effects to support decision making. During this award, Dr. Fiks will: (1) assess the prevalence, determinants, and impact of SDM in primary care for a nationally representative sample of children with ADHD, (2) develop an instrument to measure families' preferences and goals for ADHD treatment, and (3) assess the feasibility and acceptability, and explore the outcomes of an ADHD, HIT-based SDM pilot intervention in primary care. The hypothesis of this application is that use of an instrument to capture families' ADHD treatment preferences and goals within an HIT-based system will facilitate SDM and improve adherence to and outcomes from treatment. This research, utilizing a pediatric practice-based research network, will complement formal coursework, workshop/conference participation, and skilled mentorship to train Dr. Fiks to achieve his career goals. Dr. Fiks' specific educational aims are to (1) develop expert skills to evaluate the effectiveness of HIT-enabled SDM including the study of longitudinal/clustered data and the conduct of clinical trials, (2) develop advanced skills in health measurement and instrument development, and (3) advance his knowledge of approaches to encourage SDM including the use of decision aids and HIT. This 5 year award will provide Dr. Fiks with the training and pilot data needed to launch an R01-level trial of SDM for ADHD. PUBLIC HEALTH RELEVANCE: Prioritized by the Institute of Medicine, shared decision making (SDM) promises to match families to acceptable treatments and improve child health outcomes. By capturing, transferring, and processing health information, computer systems can support SDM on a large-scale. This grant explores the role of these systems to facilitate SDM for ADHD, a condition impairing more than 4 million children in this country.

描述（由申请人提供）：亚历山大菲克斯，医学博士，MSCE是一个城市初级保健儿科医生谁研究健康信息技术（HIT），以改善儿童健康的结果。Fiks博士的研究发现，尽管以临床医生为中心的HIT干预措施是有效的，但通过促进临床医生和家庭之间的信息交流，以澄清治疗偏好， 这一过程被称为共享决策（SDM）。虽然菲克斯博士的长期职业目标是成为一名独立的调查专家，在大规模实施SDM使用HIT多种儿科疾病，这个职业发展奖将集中在注意力缺陷/多动障碍（ADHD）。ADHD是SDM的理想原型条件：家庭在多种循证治疗之间进行选择;个人/文化价值观影响他们的选择;治疗差异存在;迄今为止，几乎没有工作来解开这些影响以支持决策。在此奖项期间，Fiks博士将：（1）评估SDM在初级保健中的患病率，决定因素和对ADHD儿童的全国代表性样本的影响，（2）开发一种工具来衡量家庭对ADHD治疗的偏好和目标，以及（3）评估可行性和可接受性，并探索ADHD，基于HIT的SDM试点干预在初级保健中的结果。本申请的假设是，在基于HIT的系统中使用工具来捕获家庭的ADHD治疗偏好和目标将促进SDM并改善治疗的依从性和结果。这项研究，利用儿科实践为基础的研究网络，将补充正式的课程，研讨会/会议的参与，和熟练的导师培训博士。Fiks博士的具体教育目标是（1）发展专家技能，以评估HIT启用SDM的有效性，包括纵向/聚类数据的研究和临床试验的进行，（2）发展健康测量和仪器开发的高级技能，以及（3）推进他对方法的了解，以鼓励SDM，包括使用决策辅助工具和HIT。这个为期5年的奖项将为Fiks博士提供启动R 01级SDM治疗ADHD试验所需的培训和试点数据。 公共卫生相关性：由医学研究所优先考虑，共同决策（SDM）承诺将家庭与可接受的治疗相匹配，并改善儿童健康结果。通过捕获、传输和处理健康信息，计算机系统可以大规模地支持SDM。这项赠款探讨了这些系统的作用，以促进SDM为多动症，一个条件损害了超过400万儿童在这个国家。