Early Intervention Outcomes Research using Innovative Patient-Reported Outcome (PRO) Measures

 描述(由申请人提供)：理由和目标：科罗拉多州每年约有5,800名患有发育障碍(如脑瘫、唐氏综合症、复杂慢性病)并延迟获得早期干预(EI-CO)的婴幼儿。Ei-CO的主要目标是帮助儿童在家庭和社区中发挥最佳功能，以增加早期技能获得，并将未来康复和特殊教育服务的使用降至最低，但Ei-CO的影响鲜为人知。本提案通过1)检查EI-CO服务使用的差异(目标1)和2)评估EI-CO服务使用对EI结果的影响(目标2)来满足这一需求。方法：对2008-2013年主要EI-CO计划(n=3,500)的现有Ei-CO数据进行二次分析，并收集登记家庭的初步数据(n=832)。主要因变量是1)EI服务使用(目标1)和2)EI结果(目标2)。EI服务使用量将根据节目计费数据进行衡量，EI服务使用量将根据服务频率和时长进行计算。EI结果将通过在线问卷来衡量，这些问卷涉及功能性任务表现(例如，移动性)和活动参与度(例如，个人护理管理)。计量经济学模型将被用来估计每个结果，条件是儿童和家庭特征，以及功能结果、服务使用和感知的环境障碍。项目影响和与NCMRR的相关性：迫切需要强有力的研究证据来证明EI服务相对于功能结果的充分性，以改善EI服务的交付。然而，有关EI服务使用和结果的知识差距对构建和转化这些知识构成了重大障碍。项目成果将产生关于Ei-CO服务使用差异的重要新知识，以及服务使用差异如何导致功能结果的差异。这些交付成果将提高我们成功竞争NIH R01资金进行规模扩大的多地点EI-CO结果研究的机会。

 DESCRIPTION (provided by applicant): Rationale and Objectives: Approximately 5,800 infants and toddlers with developmental disabilities (e.g., cerebral palsy, Down syndrome, complex chronic conditions) and delays access Early Intervention Colorado (EI-CO) annually. Primary goals of EI-CO is to help children optimally function at home and in the community in order to increase early skill acquisition and minimize future rehabilitation and special education service use, but the effects of EI-CO are poorly understood. This proposal addresses this need by 1) examining disparities in EI-CO service use (Aim 1) and 2) estimating the impact of EI-CO service use on EI outcomes (Aim 2). Methods: Secondary analyses of existing EI-CO data from a major EI-CO program between 2008-2013 (n=3,500) and primary data collection of enrolled families (n=832) are used. Primary dependent variables are 1) EI service use (Aim 1) and 2) EI outcomes (Aim 2). EI service use will be measured from program billing data and dosage of EI service use will be calculated based upon service frequency and duration. EI outcomes will be measured from online questionnaires addressing functional task performance (e.g., mobility) and activity participation (e.g., personal care management). Econometric models will be used to estimate each outcome conditional on child and family characteristics and, for functional outcomes, service use, and perceived environmental barriers. Project Impact and Relevance to NCMRR: There is critical need for robust research evidence about the adequacy of EI services relative to functional outcomes to improve EI service delivery. However, knowledge gaps about EI service use and outcomes have posed significant barriers to building and translating this knowledge. Project results will yield important new knowledge about disparities in EI-CO service use and how disparities in service use contribute to variability in functional outcomes. These deliverables will improve our chances of successfully competing for NIH R01 funds to conduct a scale-up multi-site EI-CO outcomes study.