Bridging gaps in healthcare services for new families due to COVID-19

弥补新家庭因 COVID-19 造成的医疗保健服务差距

• 批准号: 10244731
• 负责人: Craig F. Garfield
• 金额: $ 90.29万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-13 至 2022-06-08
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10244731
• 关键词: Admission activity; Adult; Adverse effects; Area; Behavioral; Birth; Breast Feeding; COVID-19; COVID-19 pandemic; Caring; Child Rearing; Childhood; Climacteric; Communities; Containment; Contraceptive methods; Crowding; Depression screen; Discipline of obstetrics; Education; Ethnic Origin; Face; Family; Fathers; Feedback; Foundations; Funding; Health; Health Services; Healthcare; Home; Hospitals; Income; Individual; Infant; Infant Health Services; Internet; Intervention; Interview; Knowledge; Lead; Life; Low income; Measures; Medical; Medicine; Mental Health; Mental Health Services; Modeling; Monitor; Newborn Infant; Outcome; Paper; Parents; Patient Outcomes Assessments; Patients; Pediatrics; Postpartum Depression; Postpartum Period; Preventive Health Services; Preventive healthcare; Public Health; Race; Randomized; Randomized Controlled Trials; Reporting; Resources; Risk; Role; Self Administration; Self Efficacy; Services; Social Responsibility; Social support; Surveys; Symptoms; Testing; Touch sensation; Transportation; United States; United States Agency for Healthcare Research and Quality; Vaccination; Visit; Well Child Visits; Woman; anxiety symptoms; arm; base; birth control; child services; collaborative care; depressive symptoms; design; digital health; digital healthcare; distrust; efficacy testing; ethnic minority population; evidence base; experience; global health; health care delivery; health care service; health equity; health equity promotion; health of the mother; health service use; improved; lower income families; pandemic disease; patient oriented; perceived stress; perinatal mental health; physical conditioning; postnatal; postpartum care; primary outcome; racial and ethnic; recruit; residential segregation; response; screening; secondary outcome; service intervention; service utilization; social health determinants; socioeconomic disparity; stress symptom; substance use; success; telehealth; therapy design; transmission process; treatment arm; treatment as usual; urgent care; virtual healthcare

PROJECT SUMMARY The transition to new parenthood is marked by dramatic changes in social roles and responsibilities. To support new parents, obstetric and pediatric healthcare surrounding this transition is designed with a supportive focus to facilitate new parents' navigation of the attendant life changes. The COVID-19 pandemic has altered healthcare delivery in ways that have limited these supportive obstetrics and pediatric services provided at the beginning of new parenthood. Consequently, aspects of preventative healthcare, such as monitoring for symptoms of postpartum depression, discussing optimal birth control options, educating parents on recommended adult and pediatric vaccinations, and providing anticipatory guidance on infant wellness, are less robust. In addition, without professional guidance and support, outcomes of foundational importance to new parents, such as perceived stress, depressive and anxiety symptoms, or parenting and breast-feeding self-efficacy, are worse. Moreover, the COVID-19 pandemic has underscored the impact of the social determinants of health on new family wellness, with racial/ethnic minority and low-income families being differentially impacted by COVID-19 pandemic driven healthcare delivery changes. Recognizing the potential for longitudinal changes in healthcare delivery engendered by the COVID-19 pandemic, a scalable, patient-centered, equity-focused intervention designed to bridge gaps in healthcare services around the transition to new parenthood is needed. This due (N2H), project, “Bridging gaps in healthcare delivery to COVID-19 for parent and infants from birth through the first year of life” aims to evaluate Nursery2Home a patient-informed digital healthcare intervention that s is specifically responsive to the COVID-19 pandemic's impact on new families, with a focus on health equity for racial/ethnic minority and low income families. N2H builds upon previous digital health successes of our team while incorporating the evidence-based collaborative care model for mental health support. N2H is designed to mitigate the adverse effects of healthcare delivery changes in response to the COVID-19 pandemic and to improve health for mothers, fathers, and infants over the first year of life. Developed from feedback given by new parents who delivered during the COVID-19 pandemic, N2H provides 1) parental education about their own physical and mental health, 2) infant wellness resources and tracking of recommended healthcare services, 3) parental mental health screening and support, and 4) systematic case review to optimize the health of new families. We assigned improves In health will test the efficacy of N2H via a randomized controlle trial. In total, 640 diverse families will be randomly to either usual care or N2H intervention arm to evaluate whether, compared to usual care, N2H healt services utilization and patient reported outcomes of foundational importanc to new families. addition, we will evaluate the impact of N2H on racial/ethnic and income-based disparities observed in both services utilization and patient reported outcomes. d h e

项目摘要 向新父母过渡的标志是社会角色和责任的巨大变化。支持 新的父母，产科和儿科医疗保健围绕这一过渡的设计与支持的重点， 帮助新父母了解随之而来的生活变化。COVID-19大流行改变了医疗保健 分娩的方式限制了这些支持性的产科和儿科服务， 新的父母因此，预防性医疗保健的各个方面，例如监测 产后抑郁症，讨论最佳的节育方案，教育父母推荐的成人和 儿科疫苗接种和提供有关婴儿健康的预期指导则不太可靠。此外，本发明还提供了一种方法， 如果没有专业的指导和支持，对于新父母来说具有基础重要性的结果，例如 感受到的压力、抑郁和焦虑症状，或养育子女和母乳喂养的自我效能感更差。 此外，2019冠状病毒病疫情凸显了健康的社会决定因素对新生儿的影响， 家庭健康，种族/少数民族和低收入家庭受到COVID-19的不同影响 疫情驱动的医疗服务变化。 认识到COVID-19可能导致医疗服务发生纵向变化 大流行，一个可扩展的，以患者为中心，以公平为重点的干预措施，旨在弥合医疗保健的差距 需要围绕向新父母过渡提供服务。这 由于 (N2H), 项目，“弥合医疗保健提供方面的差距 为父母和婴儿从出生到生命的第一年提供的新冠肺炎应对措施”旨在评估Nursery 2 Home 患者知情的数字医疗干预， S 专门针对COVID-19 大流行病对新家庭的影响，重点关注少数种族/族裔和低收入家庭的健康公平问题 家庭N2 H建立在我们团队以前的数字健康成功的基础上，同时结合了基于证据的 心理健康支持的协作护理模式。N2 H旨在减轻医疗保健的不良影响 为应对COVID-19大流行，改善母亲、父亲和婴儿的健康， 在生命的第一年。根据COVID-19期间分娩的新父母的反馈制定 N2 H提供1）关于父母自身身心健康的教育，2）婴儿健康 资源和跟踪推荐的医疗保健服务，3）父母心理健康筛查和支持， （4）系统的病例回顾，以优化新家庭的健康。 我们 分配 提高 在 健康 将通过随机对照试验测试N2 H的疗效。总共有640个不同的家庭将被随机 常规治疗或N2 H干预组，以评估与常规治疗相比， 保健服务利用和病人报告的结果对新家庭具有根本重要性。 此外，我们将评估N2 H对种族/民族和收入差异的影响， 服务利用率和患者报告的结果。 D h e