Online Safety Assessment & Individualized Portal Reinforcing Pediatrician Advice

描述(由申请人提供)：这是一个极具创新性的项目，旨在完善针对0-8岁儿童的在线儿童乘客安全检查前评估，其结果是在针对家庭的个性化门户网站上呈现定制的安全信息，为临床医生量身定做的信息，以提示在儿童探视过程中感知到的安全实践障碍的讨论，以及在门户网站中产生的提醒信息，该门户网站为优化家庭安全措施提供重复提醒和社交网络支持。其目标是利用行为改变的最新知识来改进儿童乘客和其他安全做法，这可能会对新生儿期后儿童发病率和死亡率的头号原因产生巨大影响。该提案建立在先前工作的基础上，包括1)一个名为CHADIS(儿童健康与发展互动系统)的系统，该系统提供一系列全面的基于网络的探视前家长问卷，以及链接的决策支持和资源，供目前在全国范围内使用的临床医生使用；以及2)由约翰·霍普金斯大学伤害研究和政策中心进行的先前关于父母安全教育的研究开发的材料。在第一阶段，我们将通过认知访谈的迭代过程，完善以理论为导向的家长对儿童乘客安全实践的评估，以创建针对儿童年龄、社会人口统计、父母信念和感知障碍的定制安全信息。我们还将建立一个基本的家长门户网站机制，将它们提供给个别家长。在第二阶段，我们将完成在体检前传递这些量身定做的信息的系统，提示临床医生在就诊期间解决感知到的障碍，并通过门户网站提醒和跟踪支持，以促进就诊后安全行为的改变，包括创建社交网络。该门户还将包含根据家长调查问卷输入的关于儿童的重新编排的叙述，以形成一本可打印的记忆书，将吸引回访该网站及其安全信息。第二阶段将包括一项随机对照试验(RCT)，1200名儿童使用新的评估加上增强的基于网络的系统，新的评估，但标准美国儿科学会讲义，或通常的护理控制做法。总部基地安全QI认证和门户网站的赞助将在第三阶段进行。 公共卫生相关性：该项目将为0-8岁儿童创建一个理论驱动并经过测试的在线儿童乘客安全访问前评估，其结果是在可申请专利的个性化“婴儿书”类型的家庭门户网站上展示定制的安全信息，并为临床医生定制信息，以促使讨论在探视儿童期间感知到的安全做法障碍，并在门户网站中生成提醒信息，为优化家庭安全措施提供重复提醒和社交网络支持。其目标是利用行为改变的最新知识来改善儿童乘客和其他安全做法，并结合创新技术，利用常规儿童护理，以影响新生儿期后儿童发病率和死亡率的头号原因。

DESCRIPTION (provided by applicant): This is an extremely innovative project to refine a theory driven online previsit assessment of child passenger safety for 0-8 year old children that results in tailored safety messages presented on an individualized portal for the family, messages for clinicians tailored to prompt discussion of perceived barriers to safety practices during well child visits and resulting reminder messages in a portal that provides repeat reminders and social network support for optimizing family safety measures. The goal is to use state of the art knowledge of behavior change to improve child passenger and other safety practices with potentially enormous impact on the number one cause of morbidity and mortality of children beyond the newborn period. The proposal builds on prior work, including 1) a system called CHADIS (Child Health and Development Interactive System) that delivers a comprehensive array of web-based pre-visit parent questionnaires with linked decision support and resources for clinicians now in use in practices nationally; and 2) materials developed from prior research on parent safety education conducted by the Center for Injury Research and Policy at Johns Hopkins University. In Phase 1 we will refine a theory driven parent assessment of child passenger safety practices through an iterative process of cognitive interviews in order to create tailored safety messages specific to child age, sociodemographics, and parental beliefs and perceived barriers. We will also create a basic parent web portal mechanism to deliver them to individual parents. In Phase II we will complete the system for delivering these tailored messages prior to check ups, prompts for clinicians to address perceived barriers during visits, and reminders and follow through supports via the portal to facilitate safety behavior change after the visit including creating a social network. The portal will also contain a reframed narrative of the child derived from parent questionnaire input to form a printable Memory Book which will attract return visits to the site and its safety messages. Phase II will include a randomized control trial (RCT) of 1200 children using either the new assessment plus the Enhanced web-based system, the new assessment but Standard American Academy of Pediatrics handouts, or usual care Control practices. ABP safety QI certification and sponsorships for the portal will be sought in Phase III. PUBLIC HEALTH RELEVANCE: This project will create a theory driven and tested online pre-visit assessment of child passenger safety for 0-8 year old children that results in tailored safety messages presented on a patentable individualized "baby book" type portal for the family, and also messages for clinicians tailored to prompt discussion of perceived barriers to safety practices during well child visits and resulting reminder messages in a portal that provides repeat reminders and social network support for optimizing family safety measures. The goal is to use state of the art knowledge of behavior change to improve child passenger and other safety practices in conjunction with innovative technology to leverage routine child care for purposes of impacting on the number one cause of morbidity and mortality of children beyond the newborn period.