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: 10448847
• 负责人: Emma Sartin
• 金额: $ 13.07万
• 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/10448847
• 关键词: Accident and Emergency department; Accidental Injury; Address; Air Bags; Award; Big Data; Black race; Caregivers; Centers for Disease Control and Prevention (U.S.); 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; Doctor of Philosophy; Economics; Epidemiologic Methods; Epidemiology; Ethics; Ethnic Origin; Ethnic group; Family; Fatality rate; Frequencies; Funding; Future; Goals; Health; Health Disparities Research; 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; Time; 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; novel; pediatric trauma; physical conditioning; prevent; racial and ethnic; racial and ethnic disparities; racial minority; 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 K99/R00 独立之路奖的目的是让 Sartin 博士获得经验和 成为一名独立调查员所需的技能，专注于识别、理解和消除 交通和儿童意外伤害方面的差异。 Sartin 博士的主要目标是利用 从广度到深度的方法，整合从人口（广度）和个人层面获得的知识 （深度）分析，以了解儿童乘员安全方面的种族和民族差异在何处以及为何出现 碰撞伤害连续体。在该项目的K99阶段，Sartin博士将完成多项研究和培训 发展以下方面知识和技能的活动：(1) 先进的流行病学/统计和伤害方法； (2) 大型数据库的管理、分析和可视化； (3)高级R编程； (4) 有效且 研究健康差异的道德方法。具体来说，萨丁博士将完成结构化课程作业 并指导独立研究，以及与她经验丰富的跨学科团队一起指导研究 导师和顾问成功实现三个目标。在K99阶段，Sartin博士将利用创新 方法： 分析大量、独特的州级数据源以确定儿童的人口水平频率 跨种族/族裔人群使用约束系统（目标 1a）；确定导致较低发生率的因素 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 影响观察到的儿童乘员碰撞伤害严重程度的种族和民族差异（目标 2）。在R00阶段， 萨丁博士将招募最近坠机受伤的儿童和一名护理人员参加混合方法试点 队列研究——涉及调查、临床评估和半结构化访谈——以评估短期和 长期身心健康成果（目标 3）。 R00研究结果将作为初步数据 支持 Sartin 博士的第一个 R01 提案。除了为萨丁博士的独立研究生涯做好准备外， 这项工作意义重大，因为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 3 名儿童死于车祸，另有约 10 万名儿童死亡 每年都会因受伤而在急诊室接受治疗。此外，虽然总体死亡人数有所下降，但种族 种族差异已经扩大，黑人儿童在种族歧视中死亡的可能性是白人儿童的两倍 碰撞。儿童交通事故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，特别是少数种族和族裔儿童的安全。 通过该项目获得的知识最终将降低儿科碰撞伤害和死亡率的总体比率 加强对最弱势儿童的保护工作。此 K99/R00 直接与 NICHD 对齐 2020 年战略计划强调了解社会、经济、结构和区域的贡献 造成健康差异的因素，以及儿科创伤和危重疾病科的使命 在整个护理过程中预防、治疗和减少所有形式的创伤性伤害。