Developing a Computerized-Adaptive Test of Parental Health Knowledge

开发父母健康知识的计算机自适应测试

• 批准号: 7848583
• 负责人: KITTY S. CHAN
• 金额: $ 27.52万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-03-01 至 2012-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7848583
• 关键词: Address; Adult; Area; Caregivers; Caring; Child; Child Development; Childhood; Chronic; Chronic Disease; Classification; Clinical; Cognitive; Data; Data Analyses; Dental; Dental Care; Dental Hygiene; Dental caries; Development; Diagnosis; Diet Habits; Disease; District of Columbia; Eating; Education; Future; Goals; Graduate Record Examination; Habits; Health; High Prevalence; Impacted Tooth; Interview; Knowledge; Learning; Left; Low income; Measurement; Measures; Military Personnel; Minority; Oral health; Outcome; Paper; Parents; Patients; Performance; Personnel Recruitments; Play; Population; Population Heterogeneity; Preschool Child; Prevalence; Preventive; Primary Health Care; Process; Provider; Psychometrics; Public Health; Quality of Care; Readability; Reading; Recruitment Activity; Reporting; Respondent; Role; Schools; Self-Administered; Series; Silicon Dioxide; Source; Surveys; System; Technology; Testing; Time; United States Health Resources and Services Administration; United States National Center for Health Statistics; Visit; Work; base; clinically relevant; computerized; early childhood; evidence base; falls; health application; health care quality; health disparity; health literacy; improved; injury prevention; low socioeconomic status; nutrition; pediatrician; prevent; programs; prototype; public health relevance; racial and ethnic; response; simulation; socioeconomics; theories; trait; trend

DESCRIPTION (provided by applicant): Tooth decay is the most common chronic childhood disease and a recent report from the National Center for Health Statistics indicates that the problem is worsening among preschool children. Furthermore, the burden of this condition falls disproportionately upon children from minority and low socioeconomic status groups. Good dietary and oral hygiene practices and use of appropriate dental services and treatments for both the parent and their child are essential to good oral health. To reduce the prevalence of tooth decay and other oral health conditions among preschoolers, it is critical that more parents become knowledgeable about the causes and consequences of major child oral health diseases and actions they can take to prevent them. Anticipatory guidance from pediatric providers remains an important source of information for parents. However, time constraints during clinical encounters and the unique information needs different parents have indicate that new strategies are needed to enhance the efficiency and the patient-centeredness of the anticipatory guidance process. Specifically, if short, precise measures are available to assess parents' knowledge across relevant content areas before an upcoming visit, parent-specific knowledge profiles can be generated to help clinicians tailor their guidance to parents' specific needs. Computerized adaptive testing (CAT), a measurement approach based on item response theory (IRT) in which items selected for presentation is adapted to the subject's ability level, could provide the basis for these short, accurate assessments. This project will develop a prototype for this knowledge assessment CAT system. Given the impact of tooth decay and worsening trend among young children, we will focus on developing an oral health module in this project. Other modules (e.g., in injury prevention and child development) will be developed in future projects. The proposed project will: 1) develop knowledge questions on child oral health; 2) evaluate questions for inclusion based on readability, understandability, clinical relevance and psychometric performance; and 3) develop an experimental CAT prototype and pilot test CAT score validity. Dental, pediatric and measurement experts will develop knowledge questions based on evidenced-based sources. Readability is assessed by evaluating reading level. Cognitive interviews with a socio-demographically diverse group of parents (N=48) will assess understandability. Clinical experts (dental and pediatric) will review items for clinical relevance, clarity and evidence base. Factor and IRT analyses will be used to examine psychometric performance. Preliminary validity of CAT scores will be assessed through simulation studies and known group tests (across parental health literacy and education groups). Data for analyses will be drawn from self-administered surveys of 350 primary caregivers of children recruited from two Washington D.C. pediatric primary care practices serving diverse racial/ethnic and socio-economic populations. PUBLIC HEALTH RELEVANCE: The high prevalence and worsening trend in dental caries and disparities in overall oral health observed for preschoolers highlight the importance of oral health as a major public health problem in children. Evidence of deficits and disparities in parental oral health knowledge indicate that educating parents about the causes, consequences and the preventive actions they can take could be an important first step to addressing this problem. The long-term goal of this project is to develop a series of adaptive parental knowledge assessment tests that can support providers in individualizing anticipatory guidance to the needs of parents and their children, which we hope will improve quality of care and outcomes for children.

描述（由申请人提供）：蛀牙是最常见的慢性儿童疾病，国家卫生统计中心最近的一份报告表明，这个问题在学龄前儿童中正在恶化。此外，这种情况的负担不成比例地福尔斯在少数群体和社会经济地位低下群体的儿童身上。良好的饮食和口腔卫生习惯以及父母和孩子使用适当的牙科服务和治疗对良好的口腔健康至关重要。为了减少学龄前儿童蛀牙和其他口腔健康状况的流行，至关重要的是，更多的父母了解主要儿童口腔健康疾病的原因和后果以及他们可以采取的预防措施。来自儿科提供者的预期指导仍然是父母的重要信息来源。然而，在临床遇到的时间限制和独特的信息需要不同的父母表明，需要新的策略，以提高效率和以病人为中心的预期指导过程。具体而言，如果在即将到来的访问之前可以使用简短、精确的措施来评估父母在相关内容领域的知识，则可以生成父母特定的知识概况，以帮助临床医生根据父母的特定需求定制他们的指导。计算机化自适应测试（CAT）是一种基于项目反应理论（IRT）的测量方法，其中选择用于呈现的项目适合受试者的能力水平，可以为这些简短，准确的评估提供基础。本计画将开发一个知识评估计算机辅助翻译系统的原型。鉴于蛀牙对幼儿的影响及恶化趋势，我们会在计划中集中发展口腔健康单元。其他模块（例如，预防伤害和儿童发展）将在今后的项目中发展。拟议项目将：1）开发儿童口腔健康知识问题; 2）根据可读性、可理解性、临床相关性和心理测量性能评估问题是否包括在内; 3）开发实验性CAT原型和试点测试CAT评分有效性。牙科，儿科和测量专家将根据循证来源开发知识问题。可读性通过评价阅读水平来评估。与社会人口统计学上多样化的父母（N=48）进行认知访谈，评估可理解性。临床专家（牙科和儿科）将审查项目的临床相关性、清晰度和证据基础。因素和IRT分析将用于检查心理测量性能。将通过模拟研究和已知群体测试（跨父母健康知识和教育群体）评估CAT评分的初步有效性。用于分析的数据将来自对350名儿童主要照顾者的自我管理调查，这些儿童主要照顾者是从华盛顿两个儿科初级保健实践中招募的，服务于不同种族/民族和社会经济人群。 公共卫生关系：学龄前儿童龋齿的高患病率和恶化趋势以及整体口腔健康的差异突出了口腔健康作为儿童主要公共卫生问题的重要性。父母口腔健康知识的缺陷和差异的证据表明，教育父母的原因，后果和他们可以采取的预防措施可能是解决这个问题的重要的第一步。该项目的长期目标是开发一系列适应性父母知识评估测试，以支持提供者针对父母及其子女的需求提供个性化的预期指导，我们希望这将提高儿童的护理质量和结果。