Peer mentor training to reduce hospitalizations for children with asthma

描述(由申请人提供)：该SBIR快速通道应用程序的总体目标是开发一个基于网络的计划，以培训同伴导师，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。哮喘是2008年1050万天旷课、750万次门诊、64万次急诊和15.7万次住院的原因。Fisher等人最近的工作。(2009)在一项为期两年的随机临床试验中显示，训练有素的同伴导师(来自社区的非专业人员)可以有效地将哮喘儿童的住院率从59.1%减少到36.5%(p&lt；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。面对面培训的速度太慢，费用也太高，不能广泛传播这一减少哮喘儿童住院的有效方法。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计划。在第一阶段，我们的具体目标是开发一个基于网络的工具来培训同伴导师，使导师达到研究中达到的相同资格标准。培训结束后，我们将使用Mentor1to1“(由InquisitHealth开发)来允许同伴导师指导哮喘儿童的父母。Mentor1to1”允许家长和同伴导师之间进行HIPAA兼容的电话交谈，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+Mentor1to1“)应该允许创建一支可扩展的、具有成本效益的同伴导师队伍，以应对减少哮喘相关住院的挑战。在第二阶段，我们的具体目标是用健康计划测试该软件 以及一项随机临床试验中的医疗系统。为实现第一阶段的具体目标，我们将开展以下三项工作：任务1：开展专题小组活动。任务2：迭代开发我们针对同伴导师的基于网络的培训计划原型。任务3.对40名同伴辅导受训者进行同伴培训效果评估。第一阶段可行性测试：(1)70%以上的导师应达到通过笔试(80%正确)和模拟患者考试(80%达到目标)的门槛。(2)70%以上的导师应该对过程测量测试感到满意(在0-4分的Likert评分中，3分或4分，4分表示完全满意)。为了实现第二阶段的具体目标，我们将执行以下四项任务：任务1.收集和利用反馈意见，以改进培训体系。任务2.为同伴导师开发易于获取的材料。任务3.开发系统和自动化以支持同行指导部署。任务4.评估我们接受过网络培训的同伴导师的效能。成功的第二阶段标准：如Fisher等人所说，至少减少30%的住院率。(2009)。

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).