Functional Assessment Screening Patient Reported Information: FAST-PRI

描述(申请人提供)：拟议的项目，功能评估筛查片剂-患者报告的信息，是根据PAR-08-270：利用卫生信息技术提高卫生保健质量(R18)而开发的。吸烟、体力活动和与精神健康相关的生活质量差是发病率和死亡率的主要原因，目前的护理系统没有充分解决这些问题。医疗保健提供者在鼓励健康行为和确定影响患者HRQL的因素方面发挥着重要作用。当临床医生与知情、活跃和积极参与的患者合作时，他们在这一角色中发挥的作用是最有效的。我们将评估一种基于我们目前的“功能评估筛查片剂(FAST)”的新工具，该工具旨在通知和激活患者自己的患者报告信息(PRI)。FAST目前使用无线联网平板电脑在患者等待见他们的初级保健提供者时收集PRI，并在患者就诊时将此PRI提供给提供者。FAST-PRI干预中使用的基于健康信息技术(HIT)的新工具称为HIT患者反馈，通过对患者的健康行为(吸烟和缺乏运动)和精神HRQOL提供即时的、个性化的、基于指南的反馈，为患者提供自我管理支持，并鼓励他们在健康方面发挥更积极的作用。这项群组随机对照试验FAST-PRI的完成将为使用HIT患者反馈通知和激活患者并促进健康行为改变的有效性提供重要信息。我们将通过以下三个具体目标来实现这一点：目标1.使用HIT患者对研究指定的PRI(即吸烟、身体不活动和精神HRQOL)的反馈来激活患者。目的2.评估HIT患者反馈对研究指定PRI的影响。目的3.评估HIT患者反馈对研究指定的PRI的有效性的潜在中介因素。我们将在学术团体医疗实践中对HIT患者反馈进行为期12个月的随机对照试验，聚集在医生水平。患者和提供者将在每次临床会面时完成关于健康行为和HRQL讨论的问卷调查。此外，患者参与者将在基线、6个月和12个月完成关于戒烟尝试、体力活动和精神HRQL的问卷调查，以及自我效能和跨学科转介的使用。我们将在基线、12个月和24个月调查医生的自我效能感。最后，我们将从电子病历中提取有关健康行为、HRQOL和转诊的转诊数据。

DESCRIPTION (provided by applicant): The proposed project, Functional Assessment Screening Tablets-Patient Reported Information, has been developed in response to PAR-08-270: Utilizing Health Information Technology to Improve Health Care Quality (R18). Tobacco, physical activity, and poor mental health-related quality of life (HRQoL) are major causes of morbidity and mortality that are not being adequately addressed in the current systems of care. Healthcare providers play an important role in encouraging healthy behaviors and identifying factors that impact patients' HRQoL. Clinicians are most effective in this role when they partner with informed, activated, and engaged patients. We will evaluate a new tool, based our current "Functional Assessment Screening Tablets (FAST)," that is designed to inform and activate patients about their own patient reported information (PRI). The FAST currently uses wirelessly-networked tablet computers to collect PRI while patients wait to see their primary care provider and provides this PRI to providers at the time of the patient's visit. The new health information technology (HIT)-based tool, used in the FAST-PRI intervention and referred to as HIT patient feedback, provides patients with self-management support through immediate, personalized, guideline-based feedback about their health behaviors (tobacco use and physical inactivity) and mental HRQoL and encourages them to take a more active role in their health. Completion of this cluster-randomized controlled trial, FAST-PRI, will provide important information on the effectiveness of using HIT patient feedback to inform and activate patients and promote health behavior change. We will accomplish this through the following three specific aims: Aim 1. Use HIT patient feedback regarding study-designated PRI (i.e., tobacco use, physical inactivity, and mental HRQoL) to activate patients. Aim 2. Assess the impact of HIT patient feedback on study-designated PRI. Aim 3. Evaluate potential mediators of the effectiveness of HIT patient feedback on study-designated PRI. We will conduct a 12-month randomized controlled trial of HIT patient feedback, clustered at the physician level, in an academic group medical practice. Patients and providers will complete questionnaires regarding discussions of health behaviors and HRQoL at each clinical encounter. In addition, patient participants will complete questionnaires regarding smoking quit attempts, physical activity, and their mental HRQoL, as well as self-efficacy and use of interdisciplinary referral at baseline, six and twelve months. We will survey physicians regarding self-efficacy at baseline, 12 and 24 months. Finally, we will abstract referral data from the electronic medical record regarding health behaviors, HRQoL, and referrals.