Parent Initiated Prevention Program

产品说明：（申请人提供）这项随机对照试验测试了一个计算机驱动的、以患者为中心的专家系统，以改善为年轻儿科患者提供循证预防。我们建议研究的有效性，实时家长发起的预防计划（PIPP）在改变初级提供者提供的预防保健以及家长的预防行为。PIPP有两个组成部分：家长教育和提供者反馈。PIPP与其他提供者干预措施（包括其他计算机化干预措施）的不同之处在于，它在父母自己的要求下，在他们的控制下，在通过互联网访问健康儿童之前，直接向父母提供针对年龄的，基于证据的建议，无论是在家里还是在他们的提供者办公室的候诊室。此外，它有能力向提供者通报父母有兴趣了解更多的主题。使用析因设计来评估其两个组成部分的边际效益，PIPP将部署在具有商业电子病历系统的实践网络的四个诊所中。我们假设，这种方法将改善父母提供预防性保健的沟通，并赋予家庭，它本身可能足以改善预防措施。我们选择将重点放在青春期前儿童的目的，这项研究，因为我们认为，以预防为重点的干预将直接针对青少年（而不是他们的父母），因此，不能轻易地被纳入拟议的设计。我们的三个具体目标和相应的假设是： (1)增加0-7岁儿童的父母遵循循证预防建议的数量。H1：与对照组相比，PIPP父母更有可能报告其子女符合循证预防的行为。 (2)增加父母与其子女的初级保健提供者讨论的循证预防主题的数量。H2：与对照组相比，PIPP父母更有可能报告与其提供者讨论预防主题。 (3)为了改善父母对所提供护理质量的看法。H3：与对照组相比，PIPP父母在选定的消费者健康计划评估（CAHPS）项目上的得分更高。

DESCRIPTION: (Provided by the Applicant) This randomized controlled trial tests a computer-driven, patient-centered, expert system to improve the provision of evidence-based prevention for young pediatric patients. We propose to study the effectiveness of a real-time Parent-Initiated Prevention Program (PIPP) in changing primary providers' delivery of preventive care as well as parental preventive behaviors. PIPP has two components: a parent educational one and a provider feedback one. PIPP differs from other provider interventions (including other computerized interventions) in that it delivers age specific, evidence-based recommendations directly to parents at their own behest and under their control prior to well-child visits via the Internet, accessed either at home or while in the waiting room of their providers' offices. In addition, it has the capacity to inform providers of the topics that parents are interested in learning more about. Using a factorial design to assess the marginal benefit of both of its components, PIPP will be deployed in four clinics of a practice network that has a commercially available electronic medical record system. We hypothesize that this approach will improve parent-provider communication over preventive health care, and by empowering families, it may be sufficient in itself to improve preventive practices. We have chosen to focus on pre-adolescent children for the purposes of this study because we believe an adolescent-focused intervention would target adolescents directly (rather than their parents) and, therefore, could not easily be included in the proposed design. Our three specific aims and accompanying hypotheses are: (1) To increase the number of evidence-based prevention recommendations that are followed by parents of children aged 0-7 years.H1: Compared to controls, PIPP parents will be more likely to report behaviors consistent with evidence-based prevention for their children. (2) To increase the number of evidence-based prevention topics that are discussed by parents with their children's primary care providers.H2: Compared to controls, PIPP parents will be more likely to report discussing prevention topics with their providers. (3) To improve parental perceptions of the quality of care provided.H3: Compared to controls, PIPP parents will report higher scores on selected Consumer Assessment of Health Plans (CAHPS) items.