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

项目概要/摘要 本提案是对PAR 19 -093的回应，其目标与NIMHD和OBSSR的优先事项一致。 这项研究将探讨如何一个独特的健康信息技术（HIT）工具影响病人和供应商 在为社会经济弱势群体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。 目标1.为了测试实施新的基于EMR的婴儿睡眠评估（伊萨）的影响， 沟通培训：a）儿科临床医生提供预期指导（积极和 意外的负面后果）;和B）父母对护理的满意度，婴儿安全睡眠知识， 信念，报告的做法，并观察婴儿睡眠环境。 目标2.评估如何实施新的基于EMR的伊萨和简短的沟通培训是由 儿科临床医生在其优点，缺点，并对他们的预期交付的影响， 指导 对于目标1，一项随机对照试验将比较标准治疗（SOC）和 伊萨组。将12个半天门诊中的每一个随机分配至SOC或伊萨。临床医生（N=88）和 新生儿患者的父母（每个研究组N=188）将在整个研究期间留在其分配的组中 书房伊萨小组将在2个月的婴儿健康访视时完成该工具， 访问录音。随访数据将在婴儿出生后通过家庭调查和观察收集。 3-4个月大了对于目标2，临床医生将在研究结束时完成简短调查 参与的将通过同行审查的出版物、介绍和摘要传播成果 通过电子媒体向儿科、伤害预防、公共卫生、临床信息学， 和健康差异的社区。

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.