Advancing Equity in Early Childhood Developmental Screening Through Item Response Theory and User-Centered Design

通过项目反应理论和以用户为中心的设计促进幼儿发展筛查的公平性

• 批准号: 10808542
• 负责人: Kendra Liljenquist
• 金额: $ 14.67万
• 依托单位: SEATTLE CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2025-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10808542
• 关键词: Advancing; Equity; Early; Childhood; Developmental

Project Summary Over one-third of all U.S. children are at-risk for negative long-term health, behavioral and emotional outcomes, due to circumstances of poverty. Beginning in early childhood, children living in low-income circumstances are twice as likely to experience developmental delay in one or more developmental domains including: 1) motor, 2) cognitive, 3) communication, and 4) social-emotional. For Black and Latino children this risk is compounded due to structural racism. Specifically, racial and ethnic minority children and children living in low-income circumstances experience severe inequities in access to appropriate developmental screening and support. These inequities result in missed opportunities to intervene at critical developmental periods, contributing to economic and racial disparities in school readiness and long-term cognitive and behavioral disabilities. A report by the American Academy of Pediatrics identified two key barriers to enhancing screening and referral practices: 1) lack of provider time to carry out more frequent screenings, and 2) difficulty accessing services once families are referred. To address these barriers, I will design specifications of a computer adaptive developmental assessment that includes contextually and culturally appropriate items, to be used by parents, clinicians, and community health workers to improve developmental assessment in primary care settings. Informed by principles of patient-centered measurement and user-centered design I will carry out the following specific aims of this project: Aim 1: Identify optimal items in English and Spanish to include in a new developmental assessment – computer adaptive test; Aim 2: Develop a prototype for a new developmental assessment – computer adaptive test informing a primary care based developmental support intervention. This project will result in 1) culturally and contextually appropriate developmental assessment items in English and Spanish ready for standardization to nationally representative samples, and 2) design specifications to inform building a high- fidelity developmental assessment - computer adaptive test for clinical integration. This research plan is part of a K01 proposal designed to provide me with scholarly training, mentorship, and support to gain skills and experience needed to be an independent investigator, conducting community-engaged research to design effective developmental assessment and response practices, to address economic and racial disparities in child development outcomes. To achieve this objective, I will pursue training in: (1) advanced Item Response Theory, (2) user centered design, (3) clinical effectiveness research.

项目摘要 超过三分之一的美国儿童面临长期健康、行为和情绪不良的风险 结果，由于贫困的情况。从儿童早期开始，生活在低收入家庭的儿童 在一个或多个发展领域中，环境经历发展迟缓的可能性是前者的两倍 包括：1)运动，2)认知，3)交流，4)社交-情感。对于黑人和拉丁裔儿童来说 结构性种族主义加剧了风险。具体地说，种族和少数民族儿童和儿童 生活在低收入环境中的人在获得适当的 发育筛查和支持。这些不平等导致错失了在关键时刻进行干预的机会 发展阶段，造成就学和长期就学方面的经济和种族差异 认知和行为障碍。美国儿科学会的一份报告确定了两个关键 加强筛查和转介做法的障碍：1)缺乏时间进行更频繁的筛查和转诊 筛查，以及2)一旦家庭被转介，就难以获得服务。为了解决这些障碍，我将 计算机自适应发展评估的设计规范，包括上下文 以及文化上合适的项目，供父母、临床医生和社区卫生工作者使用 改进初级保健环境中的发展评估。以病人为中心的原则 测量和以用户为中心的设计我将实现本项目的以下具体目标：目标1： 确定英语和西班牙语的最佳项目，以纳入新的发展评估- 计算机适应性测验.目标2：开发一种新的发展性评估的原型--计算机 提供基于初级保健的发育支持干预的适应性测试。这个项目将会产生 1)用英文和西班牙文编写的符合文化和语境的发展评估项目 标准化到全国有代表性的样品，以及2)设计规范，以告知建设一个高- 保真度发展评估--临床整合的计算机自适应测验。这项研究计划是 K01建议书旨在为我提供学术培训、指导和支持，以获得技能和 需要作为一名独立调查员的经验，进行社区参与的研究以设计 有效的发展评估和应对做法，以解决#年的经济和种族差距 儿童发展成果。为了实现这一目标，我将在以下方面进行培训：(1)高级项目反应 理论，(2)以用户为中心的设计，(3)临床疗效研究。