Developing Empirical childhood injury prevention program adoption models and diss

描述（由申请人提供）： 研究目标5.该提案是对“预防意外伤害（R21）"供资公告的回应，具体而言，是对研究目标5：关于实施和传播有效干预措施的研究。该项目的主要目标是开发更好的方法，将成功的伤害预防计划传播给那些可以使用它们来降低伤害发病率和死亡率的组织。我们将使用通过对美国儿童医院的调查收集的组织和管理因素来开发预后模型，以采用基于证据的儿童伤害预防计划Safe N' Sound（SNS），并根据我们的调查结果开发受众分析报告和传播策略。重要性该项目的调查结果将扩大有关如何将方案转化为全国保健系统的基本知识，不仅有助于全国儿童医院和相关机构协会的努力，而且可能有助于其他希望传播预防方案和做法的机构。目标.本项目的具体目标是：目标1：开发和验证经验模型，使用组织和管理因素来预测SNS的采用。为实现这一目标，我们将：7制定和启动一项儿童医院网上调查，以说明目前的伤害预防方案以及与这种方案有关的因素; 7与国家儿童权利研究所合作，利用国家儿童权利研究所目前采用的传播办法，向所有成员医院提供完整的安全和健康方案包; 7对会员医院进行跟踪调查，以评估SNS计划的采用情况以及被认为与其采用有关的计划特征。目标二：评估与预测模型相关的错误分类，并由此生成受众分析报告和积极的传播策略。为了实现这一目标，我们将：7使用后续调查数据进行CART分析，以确定与模型错误分类相关的创新特征; 7使用这些特征来增强目标1中预测模型所建议的传播策略。研究设计.该项目是一项观察性研究，或者说是一项自然实验。设定：本研究将在圣刘易斯大学进行行政管理，并与北卡罗来纳州夏洛特的Alberinas医学中心、全国儿童医院和相关机构协会（NACHRI）、国家儿童健康和人类发展研究所（NICHD）以及圣路易斯华盛顿大学乔治沃伦布朗社会工作学院的布朗暴力和伤害预防中心合作进行。参与者在218个NACHRI成员中，187个符合本研究的入选标准，其中包括：美国独立儿童医院或初级教学医院的正式成员，或者是准会员或支持者级别的成员。我们将招募这187名符合条件的NACHRI成员中的每一位参与本研究。我们将代表每家医院邀请首席执行官和伤害预防协调员参加，并将为这种参与提供奖励。结果测量。这项R21研究的目的不是改变特定的结果，而是收集横截面信息，以开发上述模型和产品。一般来说，我们将收集以下信息作为这一过程的结果：一般伤害预防计划的采用情况、Safe N' Sound的采用情况以及与采用或不采用此类计划有关的因素。 公共卫生相关性： 本项目的目的是开发和验证儿童医院伤害预防规划的经验模型，并使用这些模型来制定积极的传播策略。这项研究的结果将使我们能够更好地促进有效的伤害预防计划，并支持其在临床环境中的采用和实施。通过扩大成功项目的覆盖范围，我们可以增加接受此类项目的父母数量，从而减少儿童伤害的负担。

DESCRIPTION (provided by applicant): Project Summary Research Objective 5. The proposal is responsive to the funding announcement, "Preventing Unintentional Injuries (R21)", specifically, research objective 5: Research on implementation and dissemination of effective interventions. The broad goal of this project is to develop better ways of disseminating successful injury prevention programs to those organizations that can use them to decrease injury morbidity and mortality. We will use organizational and administrative factors collected by surveys with US children's hospitals to develop prognostic models for the adoption of an evidence-based childhood injury prevention program, Safe N' Sound (SNS) and develop an audience analysis report and dissemination strategy based on our findings. Importance. Findings from this project will broaden the fundamental knowledge of how programs are translated to nationwide healthcare systems not only to assist the National Association of Children's Hospitals and Related Institutions (NACHRI) in its efforts but potentially other bodies wishing to disseminate prevention programs and practices. Objectives. The specific aims of this project are: Aim 1: Develop and validate empirical models using organizational and administrative factors to predict the adoption of SNS. To accomplish this aim, we will: 7 Develop and launch a web-based survey of children's hospitals to describe current injury prevention programming and factors that are associated with such programming; 7 In partnership with the NACHRI, offer the full Safe N' Sound program package to all member hospitals using the current dissemination approaches employed by NACHRI; and 7 Conduct a follow-up survey of member hospitals to assess SNS program adoption and features of the program that are perceived to be related to its adoption. Aim 2: Evaluate the misclassification associated with the predictive models and from this, generate an audience analysis report and an active dissemination strategy. To accomplish this aim we will: 7 Conduct a CART analysis using follow-up survey data to identify features of the innovation that are related to model misclassification; and, 7 Use these features to enhance the dissemination strategy suggested by the prognostic models in aim 1. Study Design. The proposed project is an observational study, or a natural experiment. Setting: This study will be administratively housed at Saint Louis University and conducted in partnership Carolinas Medical Center in Charlotte North Carolina, the National Association of Children's Hospitals and Related Institutions (NACHRI), the National Institute of Child Health and Human Development (NICHD) and the Brown Center for Violence and Injury Prevention at the George Warren Brown School of Social Work at Washington University in St. Louis. Participants. Of the 218 NACHRI members, 187 meet the inclusion criteria for this study, which includes: US- based, full members from either a freestanding children's hospital or a primary teaching hospital or are associate or supporter level members. We will recruit every one of these 187 eligible NACHRI members for this study. Representing each hospital, we will invite the CEO and the Injury Prevention Coordinator to participate and will provide incentives for this participation. Outcome Measures. This R21 study is not designed to change particular outcomes, but to collect cross- sectional information to develop the models and products described above. Generally speaking, we will capture the following information as outcomes of this process: adoption of injury prevention programs in general, adoption of Safe N' Sound, and factors related to adopting or not adopting such programs. PUBLIC HEALTH RELEVANCE: Project narrative The aims of this project are to develop and validate empirical models of injury prevention programming by children's hospitals and to use these models to develop active dissemination strategies. Findings of this study will allow us to better promote effective injury prevention programs and support their adoption and implementation in clinical settings. By extending the reach of successful programs, we can increase the number of parents who receive such programs, and thus decrease the burden of childhood injuries.