Comprehensive Informatics Framework for CER Dissemination

描述(申请人提供)：在这个项目中，我们寻求利用我们在计算机辅助患者教育方面的成功经验，以开发一个全面的信息学框架，以快速适应和传播比较有效性研究(CER)产品，该产品适合不同类别的健康消费者，包括难以接触到的患者。我们将改进我们现有的互动教育平台，以实施和测试个性化持续患者教育(ICope)的新系统。ICope平台将专门设计，以支持CER产品的快速改编、定制和向难以接触到的人群传播。ICope平台将采用通用手段，以互动自定进度教育模块、快速“问答”指南和互动决策辅助工具的形式定制提供CER信息。此外，iCope平台将支持持续患者健康教育的创新理念，使患者能够通过网络、MP3播放器和基于电话的交互式语音应答(IVR)技术轻松访问交互式CER更新。虽然iCope将被设计为支持CER产品的全部范围，但在这个项目中，我们将重点放在名为“治疗2型糖尿病的药片”的比较有效性研究总结指南(CERSG)上。我们将在随机临床试验(RCT)中分别在医院、初级保健和社区环境中评估iCope平台对CERSG知识的影响。为此，总共318名患有糖尿病的老年患者将被纳入并随访6个月。将使用CERSG的印刷版与对照组进行比较。以下基本假设将在随机对照试验中得到验证：在干预后6个月，iCope平台的使用将与老年人对CERSG知识的改善相关。我们还将调查iCope对服药依从性、糖尿病用药满意度和糖化血红蛋白的影响。以下次要假设将被评估：iCope干预将与CERSG接受度的增加、服药依从性自我效能以及对服用糖尿病药物的信念的积极影响相关。将进行成本分析，以评估实施iCope干预措施的直接成本。 公共卫生相关性：本研究的目的是开发和评估个性化持续患者教育(ICope)平台，以适应和传播比较有效性研究(CER)产品在难以接触到的人群中的应用。我们将招募318名老年糖尿病患者参加一项对照临床试验，以评估iCope平台对患者对CER结果的了解、药物自我疗效、依从性、健康信念和对糖尿病药物的满意度的影响。

DESCRIPTION (provided by applicant): In this project we seek to utilize our successful experience in computer-assisted patient education in order to develop a comprehensive informatics framework for rapid adaptation and dissemination of Comparative Effectiveness Research (CER) products tailored to different categories of health consumers including difficult-to-reach patients. We will refine our current interactive education platform to implement and test a novel system for individualized continuous patient education (iCOPE). The iCOPE platform will be specifically designed to support rapid adaptation, customization, and dissemination of the CER products to the difficult-to-reach populations. The iCOPE platform will implement universal means for customized delivery of CER information in the format of interactive self-paced educational modules, quick "question & answer" guides, and interactive decision aids. In addition, the iCOPE platform will support the innovative concept of continuous patient health education by providing patients with easy access to the interactive CER updates via web, MP3 players and phone-based interactive voice response (IVR) technology. Though iCOPE will be designed to support the whole spectrum of CER products, in this project we will focus on the Comparative Effectiveness Research Summary Guide (CERSG) entitled "Pills for Type 2 Diabetes." We will assess the impact of the iCOPE platform on CERSG knowledge in a randomized clinical trial (RCT) separately in hospital, primary care and community environments. For this purpose, overall 318 elderly with diabetes will be enrolled and followed for 6 months. The comparison will be made with control group using printed versions of the CERSG. The following primary hypothesis will be tested in the RCT: Use of the iCOPE platform will be associated with improvement in CERSG knowledge in elderly at 6 month after the intervention. We will also investigate the impact of iCOPE on medication adherence, diabetes medication satisfaction, and HbA1c. The following secondary hypothesis will be evaluated: The iCOPE intervention will be associated with increase in CERSG acceptance, medication adherence self-efficacy, and positive impact on beliefs about taking diabetes medications. Cost analysis will be conducted to assess the direct costs of implementing the iCOPE intervention. PUBLIC HEALTH RELEVANCE: The aim of this study is development and evaluation of individualized continuous patient education (iCOPE) platform for adaptation and dissemination of Comparative Effectiveness Research (CER) products in difficult-to-reach populations. We will enroll 318 elderly with diabetes in a controlled clinical trial to evaluate the impact of iCOPE platform on patient knowledge of CER results, medication self-efficacy, adherence, health beliefs, and satisfaction with diabetes medications.