Development of a provider centered intervention for Non-Traumatic Dental Condition management in the Emergency Department

开发以提供者为中心的急诊科非创伤性牙科疾病管理干预措施

• 批准号: 10597326
• 负责人: Tumader Khouja
• 金额: $ 10.31万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-22 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10597326
• 关键词: Accident and Emergency department; Acute; Adult; Allergic Reaction; Antibiotics; Area; Award; Behavior Therapy; Behavioral; Caring; Clinical Trials; Clostridium difficile; Data; Data Set; Dental; Dental Care; Dentists; Development; Diagnosis; Doctor of Philosophy; Education; Educational Curriculum; Effectiveness; Effectiveness of Interventions; Electronic Health Record; Emergency Department Physician; Emergency department visit; Endodontics; Ensure; Evidence based intervention; Fostering; Goals; Guidelines; Health; Health Services; Health system; Hospitalization; Hospitals; Hour; Individual; Infection; Inflammation; Insurance; Intervention; Interview; Knowledge; Life; Medicaid; Medical; Medical center; Medicare; Mentorship; Methods; Minority; Mission; Modeling; Myocardial Infarction; National Institute of Dental and Craniofacial Research; Nurse Practitioners; Opioid; Oral health; Pain management; Palliative Care; Pathway interactions; Patient Care; Patients; Persons; Pharmacists; Physician Assistants; Physicians; Preventive dental care; Provider; Psychologist; Public Health; Qualitative Methods; Research; Research Methodology; Research Personnel; Rural; Science; Scientist; Serious Adverse Event; Smiling; Source; Surgeon; System; Talents; Testing; Toothache; Training; Uninsured; United States National Institutes of Health; Universities; Variant; Visit; Work; acceptability and feasibility; bacterial resistance; biomedical informatics; career; clinical decision support; cohort; design; effectiveness testing; experience; health care settings; human centered design; improved; indexing; opioid use; pilot test; prescription opioid; programs; skills; success; support tools; symposium; tool; urgent care

PROJECT ABSTRACT This NIDCR Dual Dentist Scientist Pathway to Independence Award (K99/R00) for Tumader Khouja BDS MPH PhD, will establish Dr. Khouja as an independent oral health services researcher developing and implementing evidence-based interventions that integrate dental care into medical settings utilizing both qualitative and quantitative research methods. This long-term goal will be achieved via a 5-year training and research plan that will launch Dr. Khouja’s independent program of research and academic career and support the NIDCR’s mission to increase and maintain a strong cohort of new and talented independent dual degree dentist scientists. The career goals of this program are: (1) training in intervention sciences [and biomedical informatics]; (2) gain expertise in qualitative methods to inform, design, and evaluate theoretically based behavioral interventions, and (3) professional development as an independent researcher. These career goals will be achieved via formal coursework, trainings, national conferences, mentorship, and research experience. The overall objective of this proposal is to understand the barriers and facilitators to non-traumatic dental condition (NTDC) management in the emergency department (ED) through quantitative and qualitative methods. The first aim will determine the national variation in NTDC prescribing in the ED and subsequent ED/urgent care revisits and hospitalizations within 30-days of an index ED visit. Using national electronic health records and integrated claims datasets and a random effects model, we will identify factors associated with prescribing for NTDC and variation at the patient, provider, hospital and state levels. The second aim identifies ED providers’ perceived barriers and facilitators to the management of NTDC in the ED. Using individual in depth interviews, ED providers (physicians, advanced practice providers) will identify the facilitators and barriers to management and prescribing for NTDC in the ED. The third aim will pilot and refine a multifaceted approach for NTDC prescribing in the ED and assess the acceptability and feasibility of the implementation of this strategy in ED settings. We will develop a 2-level interventional strategy [using human centered design methods] that will aid ED providers in NTDC prescribing and refine it based on our findings from the previous aims and field experience. As we test the intervention in an ED, we will use [EHR data from the University of Pittsburgh Medical Center (UPMC) to] evaluate appropriate treatment and clinician experience with ED use for NTDC before and during the intervention. Further trials will test the effectiveness of the intervention in U- and/or R-level proposals. An outstanding interprofessional team comprised of a public health dentist, pharmacist, ED physician, behavioral psychologist, biostatistician [and biomedical infromatician] will provide mentorship to ensure the success of this project. The long-term goal of this program of research is to develop a generalizable and sustainable intervention to improve NTDC management in ED and other medical settings. [This work supports priorities of the U.S. Surgeon General, NIH Director, and NIDCR to integrate oral health and general health through collaborative alliances and creating a diverse pipeline of clinician oral health researchers.]

项目摘要 这个NIDCR双牙医科学家独立奖（K99/R 00）为图马德尔Khouja BDS MPH 博士，将建立Khouja博士作为一个独立的口腔健康服务研究人员， 实施基于证据的干预措施，将牙科护理纳入医疗环境， 定性和定量研究方法。这一长期目标将通过为期5年的培训实现， 一项研究计划，将启动Khouja博士的独立研究和学术生涯计划，并提供支持 NIDCR的使命是增加和保持一个强大的新的和有才华的独立双学位的队列 牙医科学家该计划的职业目标是：（1）干预科学[和生物医学]培训 信息学];（2）获得定性方法的专业知识，以告知，设计和评估理论基础 行为干预;（3）作为独立研究者的专业发展。这些职业目标 将通过正式的课程，培训，国家会议，导师和研究经验来实现。 本提案的总体目标是了解非创伤性牙科治疗的障碍和促进因素。 急诊科（艾德）通过定量和定性的方法进行NTDC管理。 第一个目标是确定在艾德和随后的艾德/紧急护理中NTDC处方的国家差异 首次艾德访视后30天内的再次访视和住院。使用国家电子健康记录， 综合索赔数据集和随机效应模型，我们将确定与处方相关的因素， NTDC和患者、提供者、医院和州一级的变化。第二个目标是确定艾德提供者的 在教育署管理NTDC的感知障碍和促进因素。使用个人深入访谈， 艾德提供者（医生、高级实践提供者）将确定管理的促进因素和障碍 第三个目标是试行和完善NTDC的多方面方法 在艾德处方，并评估在艾德实施该策略的可接受性和可行性 设置.我们将制定一个2级干预策略[使用以人为本的设计方法]， NTDC的艾德提供者根据我们以前的目标和现场经验的发现开处方并改进它。 当我们在艾德中测试干预时，我们将使用来自匹兹堡大学医学中心的[EHR]数据 （UPMC）评价NTDC治疗前和治疗期间使用艾德的适当治疗和临床经验 干预。进一步的试验将测试U级和/或R级提案中干预措施的有效性。一个 杰出的跨专业团队由公共卫生牙医，药剂师，艾德医生，行为 心理学家，生物统计学家[和生物医学信息学家]将提供指导，以确保这一成功 项目这项研究计划的长期目标是制定一个可推广和可持续的 在艾德和其他医疗环境中改善NTDC管理的干预措施。[This工作支持的优先事项 美国外科医生，NIH主任和NIDCR通过以下方式整合口腔健康和一般健康 合作联盟和创建临床口腔健康研究人员的多样化管道。