North STAR Trial: Specialty Telemedicine Access for Referrals in Rural Alaska
North STAR 试验:阿拉斯加农村地区的转诊专业远程医疗服务
基本信息
- 批准号:10616296
- 负责人:
- 金额:$ 50.43万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-09-17 至 2026-06-30
- 项目状态:未结题
- 来源:
- 关键词:
项目摘要
ABSTRACT
Rural Alaska Native children experience a high prevalence of preventable childhood hearing loss. School-based
programs provide the only access to preventive services for many underserved rural and minority children, yet
loss to follow-up from school hearing screening is common and scarcity of specialists in rural areas compound
barriers to care. The Alaska Tribal Health System addresses geographic barriers to care with a telehealth
network, but the network is not used for school hearing screening and is only available in Tribal regions. This
proposal brings a novel telehealth model directly into schools to reach underserved rural and minority children
across the state of Alaska, including non-Tribal regions. The overall objective is to prospectively implement
and evaluate a new virtual specialty care model in Alaska schools to reduce loss to follow-up from school
hearing screening and improve access to specialty care in rural environments. This work builds on the
team’s recent PCORI-funded cluster-randomized trial that translated Alaska’s existing Tribal telehealth network
in village clinics to a prevention model for school hearing screening referrals. Children randomized to clinic-
based telemedicine specialty referral were 2.3 (95% CI 1.4, 3.8) times more likely to receive an ear/hearing
diagnosis than those receiving the standard referral of a letter home. Success of the clinic-based intervention
varied substantially between communities; stakeholder interviews revealed implementation challenges that could
be addressed by delivering telehealth directly in schools. The current proposal will establish a unique model of
care in Tribal and non-Tribal regions across the state, bringing virtual specialty care directly into schools. Three
accomplished and complementary multi-PIs, who collaborated on PCORI- and NIDCD-funded studies in rural
Alaska, will lead an interdisciplinary team, and an Alaska Stakeholder Team that includes Alaska Commissioners
for Education and Health and Social Services will guide study development. In Aim 1, the team will develop and
pilot an implementation protocol for school-based virtual specialty care for hearing loss through focus groups
and interviews with community stakeholders. In Aim 2, they will conduct a stepped wedge, cluster-randomized
implementation trial of virtual specialty care in three representative regions (n=31 schools; 2,008 children). The
primary outcome is proportion of hearing referrals resulting in specialty follow-up within two months of screening
date. The conservative hypothesis, based on PCORI trial data, is that virtual specialty care will improve follow-
up by 100%. In Aim 3, the team will evaluate sustainability of virtual specialty care in Alaska schools through a
policy analysis to assess alignment between health and education sectors, identify policy and practice barriers
and accelerators, and ascertain payment models for future programmatic financing. This school-based telehealth
model to address preventable childhood hearing loss could be translated to other underserved rural and minority
groups, bringing high-value services into rural schools to alter the paradigm of prevention nationwide.
摘要
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Denise A Dillard其他文献
Open to misuse? A brief investigation into the lacking safeguards of open-source LLMs
容易被滥用?
- DOI:
- 发表时间:
- 期刊:
- 影响因子:0
- 作者:
Kristine L Rhodes;Abigail Echo;Jordan P Lewis;Vanesscia L Cresci;Delight E Satter;Denise A Dillard - 通讯作者:
Denise A Dillard
Denise A Dillard的其他文献
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{{ truncateString('Denise A Dillard', 18)}}的其他基金
North STAR Trial: Specialty Telemedicine Access for Referrals in Rural Alaska
North STAR 试验:阿拉斯加农村地区的转诊专业远程医疗服务
- 批准号:
10340829 - 财政年份:2021
- 资助金额:
$ 50.43万 - 项目类别:
Building Capacity for Dissemination and Implementation Research in a Tribal Healthcare System
部落医疗保健系统传播和实施研究的能力建设
- 批准号:
10223700 - 财政年份:2021
- 资助金额:
$ 50.43万 - 项目类别:
North STAR Trial: Specialty Telemedicine Access for Referrals in Rural Alaska
North STAR 试验:阿拉斯加农村地区的转诊专业远程医疗服务
- 批准号:
10490362 - 财政年份:2021
- 资助金额:
$ 50.43万 - 项目类别:
Marshallese: Alternate Surveillance for COVID-19 in a Unique Population
马绍尔语:对特殊人群中的 COVID-19 进行替代监测
- 批准号:
10540229 - 财政年份:2020
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$ 50.43万 - 项目类别:
Diet and the CPT1A arctic variant: Impact on the Health of Alaska Native Children
饮食和 CPT1A 北极变异:对阿拉斯加原住民儿童健康的影响
- 批准号:
9214253 - 财政年份:2017
- 资助金额:
$ 50.43万 - 项目类别:
Population-based Interventions to Improve Behavioral Health in a Tribal Healthcare System
以人群为基础的干预措施,以改善部落医疗保健系统中的行为健康
- 批准号:
9983087 - 财政年份:2017
- 资助金额:
$ 50.43万 - 项目类别:
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