Health IT to reduce disparities in risks for sleep-related infant deaths

项目摘要/摘要 这项建议是对PAR19-093的回应，其目标与NIMHD和OBSSR的优先事项一致。 这项研究将考察一种独特的健康信息技术(HIT)工具如何影响患者和提供者 在为社会经济弱势群体提供服务的儿科初级保健诊所实施时的结果 主要是黑人/非裔美国人的人口。 目的1.测试实施新的基于电子病历的婴儿睡眠评估(ISA)的影响，并简要介绍 关于a)儿科临床医生提供预期指导的沟通培训(积极指导和 意外的负面后果)；和b)父母对护理、婴儿安全睡眠知识的满意度， 信仰、报告的做法和观察到的婴儿睡眠环境。 目标2.评估以下机构对实施新的基于EMR的ISA和简要沟通培训的看法 儿科临床医生的优势、劣势及其对预产期交付的影响 指导。 对于目标1，随机对照试验将比较护理标准(SOC)和 伊萨集团。12个半天的诊所课程将随机分配到SOC或ISA。临床医生(N=88)和 他们的新生儿患者的父母(每个研究组188人)将始终留在他们分配的组中 这项研究。ISA小组将在为期2个月的婴儿探视中完成该工具，两组都将拥有 访问录制的音频。当婴儿出生时，将通过家庭调查和观察收集后续数据 3-4个月大。对于目标2，临床医生将在他们的研究结束时完成一个简短的调查 参与。结果将通过同行评议的出版物、演示文稿和摘要进行传播 通过电子媒体分发给儿科、伤害预防、公共卫生、临床信息学、 和健康差距社区。

PROJECT SUMMARY/ABSTRACT This proposal is in response to PAR19-093, and its aims are consistent with NIMHD and OBSSR priorities. This research will examine how a unique health information technology (HIT) tool impacts patient and provider outcomes when implemented in a pediatric primary care clinic serving a socioeconomically disadvantaged population that is primarily Black/African American. Aim 1. To test the impact of implementing a new EMR-based Infant Sleep Assessment (ISA) and brief communication training on a) pediatric clinicians’ delivery of anticipatory guidance (both positive and unintended negative consequences); and b) parents’ satisfaction with care, infant safe sleep knowledge, beliefs, reported practices, and observed infant sleep environments. Aim 2. To assess how implementing the new EMR-based ISA and brief communication training is perceived by pediatric clinicians in terms of its advantages, disadvantages, and impact on their delivery of anticipatory guidance. For Aim 1, a randomized controlled trial will compare outcomes between a Standard of Care (SOC) and an ISA group. Each of 12 half-day clinic sessions will be randomly assigned to SOC or ISA. Clinicians (N=88) and the parents of their newborn patients (N=188 per study group) will remain in their assigned group throughout the study. The ISA group will complete the tool at their 2-month well-baby visit, and both groups will have this visit audio recorded. Follow-up data will be collected by an in-home survey and observation when the infant is 3-4 months old. For Aim 2, a brief survey will be completed by the clinicians at the end of their study participation. Results will be disseminated through peer-reviewed publications, presentations and summary briefs distributed through electronic media to the pediatric, injury prevention, public health, clinical informatics, and health disparities communities.