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

基本信息

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
项目类别：
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

项目摘要

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.]

项目摘要这项NIDCR双牙医科学家途径获得独立奖（K99/r00）博士，将建立Khouja博士为独立的口腔健康服务研究人员，正在发展和实施基于证据的干预措施，将牙科护理整合到医疗环境中定性和定量研究方法。这个长期目标将通过5年的培训实现，并且研究计划将启动Khouja博士的独立研究，学术职业和支持计划 NIDCR的使命是增加和维持一系列新的和才华横溢的独立双重学位牙医科学家。该计划的职业目标是：（1）干预科学培训[和生物医学信息]；（2）获得定性方法的专业知识，以告知，设计和评估理论上的评估行为干预，以及（3）作为独立研究人员的专业发展。这些职业目标将通过正式的课程，培训，民族会议，精神训练和研究经验来实现。该提案的总体目的是了解非创伤牙齿的障碍和促进者通过定量和定性方法，急诊科（ED）的条件（NTDC）管理。第一个目的将决定ED和随后的ED/紧急护理中NTDC规定的国家差异索引访问30天内的重新审视和住院。使用国家电子健康记录和综合索赔数据集和一个随机效应模型，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。第二个目标确定了ED提供商的 ED中NTDC管理的障碍和促进者。使用个人深入访谈， ED提供商（医师，高级执业提供者）将确定管理人员的促进者和障碍并在ED中为NTDC开处方。第三个目标将试行并完善NTDC的多方面方法在ED中开处方并评估ED中实施此策略的可接受性和可行性设置。我们将制定一种2级介入策略（使用人类以人为中心的设计方法），以帮助 NTDC处方的ED提供商根据我们以前的目标和现场经验的发现，并根据我们的发现进行了完善。当我们测试ED的干预措施时，我们将使用[匹兹堡大学医学中心的EHR数据（UPMC）评估在NTDC之前和期间使用ED使用的适当治疗和临床经验干预。进一步的试验将测试干预措施对U-和/或R级建议的有效性。一个杰出的专业小组完成了公共卫生牙医，药剂师，身体，行为的完成心理学家，生物统计学家[和生物医学界人士]将提供精神训练，以确保这一成功项目。该研究计划的长期目标是开发可概括且可持续的干预以改善ED和其他医疗环境中的NTDC管理。 [这项工作支持美国外科医生，NIH主任和NIDCR通过协作联盟并创建了临床口腔健康研究人员的不同管道。]