Helping gEnerations Identify Risks (Heirs) to Health

帮助几代人识别健康风险（继承人）

• 批准号: 9795308
• 负责人: Jennifer E DeVoe
• 金额: $ 39.65万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-01 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9795308
• 关键词: Helping; gEnerations; Identify; Risks; Heirs

Project Summary Preventive and acute healthcare are essential to ensure child health, yet, many children do not receive adequate care. Research shows the factors associated with receipt of healthcare for children are having health insurance coverage and/or a usual source of care and parental factors such as health conditions and health insurance coverage. Additionally, social determinants of health (SDH) (e.g., neighborhood social deprivation, poverty rate, food availability) are likely another burden on families' healthcare utilization, therefore, it is important to take them into account to improve children's receipt of recommended healthcare. The parental and/or SDH factors most strongly associated with children's receipt of recommended care are largely unknown. Further, the pathways between and among these different factors are not clearly defined. Additionally, it is essential to understand parents' perspectives on what prevents receipt of recommended healthcare for their children and what they believe primary care can do to intervene. Without this information, effective interventions to improve children's receipt of recommended healthcare cannot be devised. Therefore, this study aims to examine the relationships between parental factors (i.e., receipt of healthcare, burden of disease), SDH, and children's receipt of recommended healthcare. We will use comprehensive, outpatient primary care electronic health record (EHR) data from OCHIN's (not an acronym) network of community health centers on >2 million patients (n=354,915 children) from 18 states. In addition, we will interview about 30-40 parents to understand the factors facilitating or hindering children's receipt of recommended care. The specific aims are: Aim 1. Identify the parental healthcare and health factors most strongly associated with children's access to and utilization of recommended healthcare. Aim 2. Explore the influence of SDH on family healthcare access and utilization. Aim 3. Discover additional barriers and facilitators of accessing children's recommended healthcare and assess parental beliefs about how primary care could help them overcome these barriers. We will employ a sequential mixed-methods approach to iteratively learn from the qualitative interviews and conduct additional quantitative analyses based on important qualitative insights. Aims 1 and 2 identify EHR-based parental healthcare and health factors and SDH most strongly associated with children's receipt of recommended care, while Aim 3 explores “real-life” parent perceptions of what helps or hinders receipt of recommended care and identifies the barriers that parents believe primary care can intervene on. The proposed work will be the first to understand the complex relationship of parental healthcare and health factors and SDH and children's receipt of recommended healthcare and to identify the barriers that parents believe primary care can intervene on. This formative work will propel potential interventions to improve children's recommended care receipt. We will capitalize on unique data resources that provide information about healthcare and health of vulnerable families.

项目概要 预防性和紧急医疗保健对于确保儿童健康至关重要，然而，许多儿童没有接受 足够的照顾。研究表明，与儿童接受医疗保健相关的因素是健康 保险范围和/或通常的护理来源和父母因素，例如健康状况和健康状况 保险范围。此外，健康的社会决定因素 (SDH)（例如，邻里社会剥夺、 贫困率、粮食供应量）可能是家庭医疗保健利用的另一个负担，因此， 重要的是要考虑到这些因素，以改善儿童接受建议的医疗保健的情况。父母的 和/或与儿童接受推荐护理最密切相关的 SDH 因素主要是 未知。此外，这些不同因素之间的途径尚未明确定义。 此外，了解家长对于阻碍收到推荐的原因的看法也很重要。 他们的孩子的医疗保健以及他们认为初级保健可以采取哪些干预措施。如果没有这些信息， 无法设计出有效的干预措施来改善儿童接受建议的医疗保健的情况。所以， 本研究旨在探讨父母因素之间的关系（即接受医疗保健、家庭负担） 病）、SDH 以及儿童接受推荐的医疗保健。我们将使用综合门诊 来自 OCHIN（不是缩写）社区健康网络的初级保健电子健康记录 (EHR) 数据 以来自 18 个州的超过 200 万患者（n = 354,915 名儿童）为中心。另外，我们还会采访30-40名左右 家长了解促进或阻碍儿童接受建议护理的因素。具体的 目标是： 目标 1. 确定与儿童的健康最密切相关的父母保健和健康因素 获得和利用推荐的医疗保健。目标2.探讨SDH对家庭的影响 医疗保健的获取和利用。目标 3：发现获取儿童信息的其他障碍和促进因素 建议医疗保健并评估父母对初级保健如何帮助他们克服困难的信念 这些障碍。我们将采用顺序混合方法来迭代地从定性学习中学习 访谈并根据重要的定性见解进行额外的定量分析。目标 1 和 2 确定基于 EHR 的家长保健和健康因素以及与儿童的健康密切相关的 SDH 接受建议的护理，而目标 3 则探讨“现实生活中”家长对什么有帮助或有阻碍的看法 接受建议的护理，并确定父母认为初级护理可以干预的障碍。 拟议的工作将是第一个了解父母保健与健康的复杂关系的工作 因素和 SDH 以及儿童接受建议的医疗保健的情况，并确定父母所面临的障碍 相信初级保健可以进行干预。这项形成性工作将推动潜在的干预措施，以改善 儿童推荐的护理收据。我们将利用提供信息的独特数据资源 关于弱势家庭的医疗保健和健康。