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

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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.