Achieving Pediatric Health Equity by Responding to Identified Sociomedical risks with Effective Unified Purpose –Co-design and Evaluation of the RISEUP System

项目总结 儿童健康结果中的公平差距至少部分是由于没有充分解决以下社会决定因素造成的 健康，定义为“人们出生、生活、学习、工作、玩耍、崇拜和衰老的条件”。有耐心的 以及与有毒住房、准入障碍和社会经济剥夺等决定因素有关的家庭需求 破坏健康，并将注意力从完成随访、服药和其他服务上转移 促进最佳健康和幸福结果的恶习。没有充分考虑到社会决定因素，例如 很明显，健康差距的持久性很强。因此，能够有效监控 然后整合风险和主动应对医疗和社会需求将更有可能实现 更好、更公平的结果。因此，该项目的目标是共同设计和评估 以有效的统一目的识别社会医疗风险的系统(RiseUp)，以最好地满足这两种医疗 以及儿童及其社区的社会需求。中心假设是，一个集成的系统协同 与医疗保健、人类服务、基于付款人的利益相关者和儿科患者的父母一起设计，将 通过提高对情况的认识和告知，促进不同条件下更好、更公平的结果 针对共同根本原因的跨部门行动。这一假设将通过三个具体的 目标：1)确定三种慢性儿科疾病(哮喘、 I型糖尿病和镰状细胞疾病)；2)共同设计响应系统- TEM将共享理论付诸实施并解决医疗-社会风险；以及3)评估医疗-社会风险的效果- 使用RiseUp的患者和人群健康结果的社会监测和响应系统 在照顾哮喘、糖尿病和生活在高发病率、高贫困社区的镰状细胞儿童方面。 拟议研究的贡献是共同设计和评估RiseUp，这一监测和响应 与医疗保健、人类服务和支付者利益相关者以及儿科父母合作的系统- RIC患者。这项研究意义重大，因为医学和社会数据结合在一起将提供AHRQ- 优先考虑儿童和社区的360度视角，使我们更接近贫困的根源因素 健康。这一建议在监测差距的根本原因以及共同设计和评估方面具有创新性 综合、协调的应对系统。这样的数据集成，由以人为中心的共同设计加速 和以人口为基础的质量改进，为后续的规模和传播带来了巨大的希望。预期 成果包括医疗保健和人类服务系统协作的潜在变革性模板- 有效地监测和应对差距。事实上，RiseUp将通过促进预防对儿童产生积极影响- 解决社会决定因素和公平改善儿童结果的积极方法，是一个弱点-- BLE和AHRQ-优先考虑的人群。

PROJECT SUMMARY Equity gaps in child health outcomes result, at least in part, from insufficiently addressed social determinants of health, defined as “the conditions in which people are born, live, learn, work, play, worship, and age.” Patient and family needs related to determinants like toxic housing, access barriers, and socioeconomic deprivation undermine health and shift attention away from completion of follow-up visits, medication fills, and other ser- vices that promote optimal health and well-being outcomes. Insufficiently addressed social determinants ex- plain much of the persistence in health disparities. As a result, healthcare systems that effectively monitor for risks and then integrate proactive responses to both medical and social needs will be more likely to achieve better, equitable outcomes. Thus, the objective of this project is to co-design and evaluate the “Responding to Identified Sociomedical risks with Effective Unified Purpose” System (RISEUP) to best meet both the medical and social needs of children and their communities. The central hypothesis is that an integrated system co- designed with healthcare-, human service-, payer-based stakeholders, and parents of pediatric patients, will promote better, more equitable outcomes across conditions by enhancing situation awareness and informing cross-sector actions directed at common root causes. This hypothesis will be tested through three specific aims: 1) Identify common root causes of health equity gaps across three chronic pediatric conditions (asthma, type 1 diabetes, and sickle cell disease) using an integrated monitoring system; 2) Co-design a response sys- tem to operationalize shared theory and address medical-social risks; and 3) Evaluate the effects of a medical- social monitoring and response system on patient- and population-level health outcomes, employing RISEUP in the care of children with asthma, diabetes, and sickle cell living in high-morbidity, high-poverty communities. The contribution of the proposed research is to co-design and evaluate RISEUP, this monitoring and response system in partnership with healthcare-, human service-, and payer-based stakeholders, and parents of pediat- ric patients. This research is significant because both medical and social data together would provide AHRQ- prioritized 360-degree views of children and communities, getting us closer to those factors at the root of poor health. This proposal is innovative in its monitoring of disparities’ root causes and the co-design and evaluation of integrated, coordinated response systems. Such data integration, accelerated by human-centered co-design and population-based quality improvement, holds great promise for subsequent scale and spread. Expected outcomes include a potentially transformative template for healthcare and human service systems to collabora- tively monitor and respond to disparities. Indeed, RISEUP will positively affect children by facilitating a preven- tive approach to addressing the social determinants and equitably improving outcomes for children, a vulnera- ble and AHRQ-prioritized population.