Parent Initiated Prevention Program

描述：(由申请人提供)这项随机对照试验测试了一种计算机驱动的、以患者为中心的专家系统，以改善对年轻儿科患者的循证预防。我们建议研究实时父母主动预防计划(PIPP)在改变初级提供者提供预防护理以及父母预防行为方面的有效性。PIPP由两部分组成：家长教育部分和提供者反馈部分。PIPP与其他提供者干预措施(包括其他计算机化的干预措施)的不同之处在于，它在父母本人的要求下并在他们的控制下，直接向父母提供特定年龄的、基于证据的建议，然后通过互联网访问，无论是在家里还是在提供者办公室的等候室访问。此外，它还有能力向提供者通报父母有兴趣了解更多信息的主题。使用析因设计来评估其两个组成部分的边际效益，PIPP将部署在一个拥有商业上可用的电子医疗记录系统的执业网络的四个诊所。我们假设，这种方法将改善父母与提供者之间的沟通，而不是预防保健，而且通过赋予家庭权力，它本身可能足以改善预防做法。为了这项研究的目的，我们选择关注青春期前的儿童，因为我们认为以青少年为重点的干预将直接针对青少年(而不是他们的父母)，因此，不能轻易地将其包括在拟议的设计中。我们的三个具体目标和相应的假设是： (1)增加0-7岁儿童父母遵循的循证预防建议的数量。H1：与对照组相比，PIPP的父母将更有可能为他们的孩子报告符合循证预防的行为。 (2)增加父母与子女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父母报告与其提供者讨论预防主题的可能性更大。 H3：与对照组相比，PIPP家长在选定的消费者健康评估(CAHPS)项目上会报告更高的分数。

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.