Peer mentor training to reduce hospitalizations for children with asthma

描述（由申请人提供）：这个SBIR快速通道申请的总体目标是开发一个基于网络的项目，培训同伴导师，指导哮喘儿童的父母减少急诊室就诊和住院的方法。有710万儿童患有哮喘。2008年，哮喘导致1050万天缺课、750万门诊就诊、64万急诊和15.7万住院。Fisher等人（2009）最近的工作表明，在一项为期2年的随机临床试验中，经过培训的同伴导师（来自社区的外行人）可以有效地将哮喘儿童的住院率从59.1%降低到36.5% （p<0.01）。临床试验中使用的培训方案包括3个月的面对面培训。现场培训过于缓慢和昂贵，无法广泛传播这种有效的方法来减少哮喘儿童的住院治疗。为了克服这一传播障碍，我们正在开发一个基于网络的培训项目。在第一阶段，我们的具体目标是开发一个基于网络的工具，用于培训同行导师，使导师达到与研究中达到的相同的资格标准。在培训之后，我们将使用“Mentor1to1”（由InquisitHealth开发），让同侪导师指导哮喘儿童的父母。“Mentor1to1”允许家长和同侪导师之间的电话对话符合hipaa标准，易于管理、跟踪并集成到临床工作流程中。拟议的平台（网络培训加上Mentor1to1）应该允许创建一个可扩展的、具有成本效益的同伴导师队伍，以应对减少哮喘相关住院治疗的挑战。在第二阶段，我们的具体目标是用一个健康计划来测试这个软件

DESCRIPTION (provided by applicant): The overall goal of this SBIR Fast-Track application is to develop a web-based program to train peer mentors to guide parents of children with asthma on methods to reduce ED visits and hospitalizations. There are 7.1 million children with asthma. Asthma is the cause of 10.5 million missed days of school, 7.5 million outpatient visits, 640,000 ED visits, and 157,000 hospitalization visits in 2008. Recent work by Fisher et al. (2009) has shown in a 2-year randomized clinical trial that trained peers mentors (lay individuals from the community) can be effective in reducing hospitalizations for asthmatic children from 59.1 percent to 36.5 percent (p<0.01). The training protocol used in the clinical trial involved 3 months of in-person training. In-person training is too slow and expensive to allow for general dissemination of this effective method for reducing hospitalizations in children with asthma. To overcome this barrier to dissemination, we are developing a web-based training program. In Phase I, our Specific Aim is to develop a web-based tool for training peer mentors such that the mentors meet the same qualification standards achieved in the study. Following training, we will use Mentor1to1" (developed by InquisitHealth) to allow the peer mentors to coach parents of children with asthma. Mentor1to1" allows for HIPAA-compliant phone conversations between a parent and a peer mentor that are easily managed, tracked, and integrated into clinical workflow. The proposed platform (web-training plus Mentor1to1") should allow for the creation of a scalable, cost-effective peer mentor workforce to meet the challenge of reducing asthma-related hospitalizations. In Phase II, our Specific Aim is to test this software with a health plan and a health system in a randomized clinical trial. To achieve our Phase I Specific Aim, we will carry out the following three Tasks: Task 1: Conduct Focus Groups. Task 2: Iterative Development of our Web-based Training Program Prototype for Peer Mentors. Task 3. Evaluate Peer Training Efficacy with 40 Peer Mentor-Trainees. Phase I Test of Feasibility: (1) 70 percent+ of mentors should meet the threshold set for both passing the written (80 percent correct) and simulated patient exams (80 percent of objectives met). (2) 70 percent+ of mentors should be satisfied with the Process Measure Tests (score at 3 or 4 on a 0-4 Likert scale, with 4 being completely satisfied). To achieve our Phase II Specific Aim, we will carry out the following four Tasks: Task 1. Gather and Utilize Feedback to Improve Training System. Task 2. Develop Easy-Access Material for Peer Mentors. Task 3. Develop Systems and Automation to Support Peer Mentoring Deployment. Task 4. Evaluate Efficacy of our Web-Trained Peer Mentors. Phase II Criteria for Success: Reduce hospitalizations by at least 30 percent, as in Fisher et al. (2009).