Mid-Atlantic Pediatric Long COVID Network:Implementing patient-centered and multi-disciplinary practices to improve pediatric long COVID

项目摘要 长期的新冠肺炎会影响孩子身心健康的多个方面。5%至25%的儿童 感染了SARS-CoV-2的人会发展成长期的COVID。持续的健康差距和社会经济 一些因素使某些弱势群体面临更高的SARS感染、发病和死亡风险， CoV-2感染。在儿科，身体、智力或发育障碍（IDDs）的儿童， 从资源有限的区域（例如，没有保险或保险不足的儿童尤其 弱势人群，他们在专门的儿科诊所接受COVID-19儿童治疗的机会有限 后遗症尽管肯尼迪克里格医院的儿童COVID-19后康复诊所取得了成功， 研究所以其综合和以人为本的多学科临床模式获得国际认可 尽管临床团队进行了大量的研究、认识和宣传工作，但在长期的研究和宣传方面仍存在重大差距。 COVID照顾儿童。这些差距包括有限的综合医疗保健治疗，导航资源 学校教育，以及在社区和医疗之家获得及时的长期COVID护理。 这项建议有两个方面，以多方面和独立的方式解决这些差距。第1组将 采用创新的综合保健模式，扩大和加强KKI的服务 儿科COVID-19后康复诊所。这种模式可以帮助支持儿童长期持续的 或波动的症状，承认学校作为文化的重要合作伙伴的关键作用， 在儿童患者的健康状况和康复过程中。Arm 2将涉及开发一部小说 儿科长期COVID远程监控ECHO（社区医疗成果扩展）项目。的 经验丰富的临床团队将为典型发育中的儿童提供关于长期COVID的教育 (TDC)通过一个8-10人的社区教育和指导多学科社区提供者， 课程系列将每年进行调整。 与医疗保健研究和质量机构合作，该提案将实现以下目标 计划目标：（1）扩大和加强现有的诊所，利用创新的综合医疗保健 模式，（2）为更多长期患有COVID的儿童提供服务，（3）扩大提供的服务，（4）加强护理 协调，（5）实施和分享长期COVID管理的最佳实践，（6）支持初级保健 通过儿科长期COVID ECHO项目，为社区提供长期COVID教育和管理，（7） 通过混合方法评估项目的成功，以及（8）通过以下方式传播项目结果： 社区合作伙伴。最后，通过这项提议，一个遍布马里兰州和 将建立一个大西洋中部地区，可以早期有效地治疗儿科长期COVID， 为弱势儿童群体提供医疗服务。

PROJECT SUMMARY Long COVID can affect many aspects of a child’s physical and mental health. Between 5 and 25% of children with SARS-CoV-2 infection go on to develop long COVID. Persistent health disparities and socioeconomic factors have put certain vulnerable populations at higher risk of infection, morbidity, and mortality from SARS- CoV-2 infection. In pediatrics, children with physical, intellectual, or developmental disabilities (IDDs), children from resource-limited areas (e.g., rural), and children that are uninsured or underinsured are particularly vulnerable populations that have limited access to specialized pediatric clinics for children with COVID-19 sequelae. Even with the successes of the Pediatric Post-COVID-19 Rehabilitation Clinic at the Kennedy Krieger Institute to garner international recognition for its integrated and person-centered multidisciplinary clinic model and substantial research, awareness, and advocacy efforts of the clinical team, there remain critical gaps in long COVID care for children. These gaps include limited integrative healthcare treatments, resources for navigating schooling, and access to timely long COVID care in the community and medical home. There are two arms to this proposal to address these gaps in multi-faceted and independent ways. Arm 1 will involve using an innovative integrative health model of care to expand and strengthen the services of the KKI Pediatric Post-COVID-19 Rehabilitation Clinic. This model can help support children with long lasting persistent or fluctuating symptoms, acknowledging the critical roles schools serve as an important partner in the cultural context of health and in the recovery process of pediatric patients. Arm 2 will involve the development of a novel Pediatric Long COVID Telementoring ECHO (Extension for Community Healthcare Outcomes) Project. The highly experienced clinical team will create provider education on long COVID in typically developing children (TDC) and children with IDD to educate and mentor multidisciplinary community providers through an 8-10 course series that will be adapted annually. In partnership with the Agency for Healthcare Research and Quality, this proposal will achieve the following program objectives: (1) expand and strengthen the current clinic to utilize an innovative integrative healthcare model, (2) provide services to more children with long COVID, (3) expand services offered, (4) strengthen care coordination, (5) implement and share best practices for long COVID management, (6) support the primary care community in long COVID education and management through the Pediatric Long COVID ECHO project, (7) evaluate project success through mixed methods evaluations, and (8) disseminate project findings through community partners. In the end, with this proposal a network of community providers across Maryland and the Mid-Atlantic region will be established that can treat pediatric long COVID early and effectively, providing greater access to care in vulnerable pediatric populations.