Lay-Operator mHealth Network: Real-Time Syndromic Surveillance and Intervention

非专业操作员移动医疗网络：实时症状监测和干预

• 批准号: 9016411
• 负责人: Peter S Spencer
• 金额: $ 19.78万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-02-26 至 2017-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9016411
• 关键词: Academy; Adopted; Adult; Affect; Africa; Africa South of the Sahara; African; American; Area; Behavior; Behavioral; Caregivers; Caring; Catchment Area; Cellular Phone; Cessation of life; Charge; Child; Childhood; Chronic; Chronic Disease; Clinic; Clinical; Cognitive; Communicable Diseases; Communities; Community Health; Community Health Education; Computer software; Computerized Medical Record; Conflict (Psychology); Convulsions; Country; County; Custom; Data; Data Set; Detection; Development; Diagnosis; Diagnostic; Disease; Eating; Educational Intervention; Electronics; Epidemic; Epidemiology; Epilepsy; Ethnic group; Etiology; Evaluation; Frequencies; Funding; Future; Geography; Goals; Government; Growth and Development function; Head; Health; Health Personnel; Health Planning; Health Sciences; Healthcare; Home environment; Human; Individual; Information Networks; Insignia; Interdisciplinary Study; Intervention; Kenya; Learning; Life; Link; Maps; Medical; Medical Geography; Medical Records; Medical Research; Medical Staff; Medical Students; Medicine; Mental Depression; Modeling; Monitor; National Institute of Child Health and Human Development; National Institute of Mental Health; Network-based; Neurologist; Neurology; Neurosciences; Nutritional; Oregon; Pharmacologic Substance; Physicians; Pilot Projects; Population; Public Health; Recording of previous events; Recruitment Activity; Reporting; Research; Research Proposals; Risk; Rural; Rural Population; Science; Scientist; Seizures; Senior Scientist; South Sudan; Speed; Surveys; Syndrome; System; Tablets; Technology; Testing; Time; Training; Treatment Protocols; Uganda; United States National Institutes of Health; Universities; Vocation; Work; aged; atonic seizure; authority; base; career; case-based; computer science; eHealth; effective therapy; improved; innovation; interest; mHealth; medical information system; medical schools; mental development; mid-career faculty; neurobehavioral; nutrition; population based; professor; programs; public health relevance; rapid diagnosis; research study; sensory stimulus; software development; syndromic surveillance; tool; young adult

 DESCRIPTION (provided by applicant): This project explores the development, implementation, and evaluation of a smartphone-/ tablet -based network of village-based, custom-trained, layperson mHealth workers who use simple-to-operate, network-integrated software regularly to report presumptive and medically diagnosed cases of a single illustrative chronic disease: Nodding Syndrome . The long-term goal is to develop a sustainable, inexpensive, monitored, real-time `population-based medical e-geography' and case-based electronic medical record system with which to identify disease hotspots and to mount, as appropriate, rapid diagnosis and treatment , enhanced community education, epidemiological research and long-term health planning. Creation of a cadre of village-based lay mHealth operators who are attracted to a future health-related career (thereby increasing healthcare capacity) is a second long-term goal. Research will be carried out in a rural region of post-conflict northern Uganda where poor nutrition and infectious disease ravage the health of impoverished villagers. Research focus is placed exclusively on Nodding Syndrome (NS), an easily recognizable, chronic, non-communicable childhood disorder of unknown etiology characterized by behavioral changes, including head nodding triggered by eating and other sensory stimuli, retardation of physical and mental development, convulsions and, if untreated, early death.Our pilot study has revealed inordinately long delays (~4 years on average, which we aim to reduce >10-fold) between the time when abnormal behavior (absences, head nodding, and/or convulsions) is first noted by caregivers and medical diagnosis. While treatment is not part of this research proposal, we have shown that appropriate pharmaceutical, nutritional, physical, and educational intervention in a fit-for-purpose facility can dramatically advance the growth and development of affected children, markedly reduce their seizure frequency, and improve cognitive status and learning capacity. We will test whether village-based lay mHealth workers can accurately detect new NS cases, speed their medical diagnosis to activate treatment, and help populate the beginnings of a regional electronic medical record system in Uganda that has been developed, piloted and adopted in neighboring Kenya. Aged 18-25 years, the mHealth workers will reside in the villages they survey and weekly transmit information relating to NS. Electronic tablets will be also be used to collect, enter and download health history into ZidiTM, a DHIS2 integrated central management healthcare information system that has been adopted by the neighboring country of Kenya. Data on NS cases received from mHealth workers and via ZidiTM will be integrated, used to map the disease across the catchment area, and shared with government health authorities. The impact of this program on mHealth workers, medical students, and community health personnel will be evaluated to assess whether a lay-operator mHealth network has utility on a broader scale.

 描述（由申请人提供）：该项目探讨了基于智能手机/平板电脑的网络的开发、实施和评估，该网络由基于村庄的、经过定制培训的、非专业的移动卫生工作者组成，他们定期使用操作简单的网络集成软件来报告单一说明性慢性疾病的推定和医学诊断病例：点头综合征。长期目标是开发一个可持续的、廉价的、受监测的、实时的“基于人口的医疗电子地理”和基于病例的电子病历系统，用以确定疾病热点，并酌情开展快速诊断和治疗、加强社区教育、流行病学研究和长期卫生规划。第二个长期目标是建立一个以村庄为基础的移动保健非专业操作员骨干队伍，他们被未来与健康有关的职业所吸引（从而提高医疗保健能力）。研究将在冲突后的乌干达北方的一个农村地区进行，那里营养不良和传染病破坏了贫困村民的健康。研究重点完全放在点头综合征（NS）上，这是一种病因不明的容易识别的慢性非传染性儿童疾病，其特征是行为变化，包括进食和其他感官刺激引发的点头，身心发育迟缓，抽搐，如果不治疗，过早死亡。（平均约4年，我们的目标是减少>10倍）之间的时间，当异常行为（缺席，点头，和/或抽搐）首次注意到由照顾者和医疗诊断。虽然治疗不是本研究提案的一部分，但我们已经证明，在适合目的的设施中进行适当的药物，营养，身体和教育干预可以显着促进受影响儿童的生长和发育，显着降低他们的癫痫发作频率，并改善认知状态和学习能力。我们将测试以村庄为基础的非专业移动医疗工作者是否能够准确地发现新的NS病例，加快他们的医疗诊断以激活治疗，并帮助乌干达区域电子病历系统的开始，该系统已在邻国肯尼亚开发，试点和采用。移动卫生工作者的年龄在18-25岁之间，将居住在他们调查的那些村庄，每周传递与NS有关的信息。电子平板电脑还将用于收集、输入和下载健康历史到ZidiTM中，ZidiTM是一个DHIS 2集成的中央管理医疗信息系统，已被邻国肯尼亚采用。从移动医疗工作者和通过ZidiTM收到的NS病例数据将被整合，用于绘制整个集水区的疾病地图，并与政府卫生当局共享。该计划对移动医疗工作者，医学生和社区卫生人员的影响将进行评估，以评估外行运营商移动医疗网络是否在更广泛的范围内具有实用性。