Personal Health Record for Youth Emancipating from Foster Care

项目摘要 有427 000名儿童受到儿童保护服务机构的监护（即，在美国的寄养。 儿童平均在寄养家庭中生活19个月，26%的儿童在寄养家庭中生活2年或更长时间。 青少年在寄养期间平均经历7次安置变化， 每年有5 000名青年从寄养家庭中解放出来。国家提供独立生活计划之前， 解放，以帮助过渡，其中包括住房和公用事业，援助教育， 关于日常生活活动和监测的课程。然而，对保健自我管理的支持 没有提供，在寄养或从寄养中解放出来的青少年通常无法获得他们的医疗服务。 记录 在拘留期间，医疗记录的查阅由个案工作者管理;寄养青年报告说， 健康信息和个案工作者和照顾者报告说， 孩子们在他们的照顾。缺乏健康信息导致寄养青年报告不知道如何 获得初级保健，慢性病管理不善，可预防疾病增加。提供 来自电子健康记录的健康数据可以改善健康知识，护理协调和患者 这一弱势群体的结果。然而，没有可持续的系统来提供个人健康记录 为这一弱势群体制定了一项方案。 本研究的目的是改善寄养青少年的健康状况，促进其健康行为 正在经历从儿科到成人医疗保健系统的过渡，并正在从寄养中解放出来。作为 作为实现这一目标的关键一步，该项目将创建和分发一份PHR， 18岁时就开始分发。下面描述的目标的执行将使我们能够扩展提供便携式 健康记录到其他社区，在那里儿童福利行政数据库可以与 电子健康记录 我们的项目将创建和分发一份PHR，以培养青年这一弱势群体， 评估可行性的基础。这对未来的研究至关重要，这些研究旨在研究提供PHR是否 一旦青年获得解放，就会改变卫生服务的利用。与寄养青年和社工 参与，我们将创建一个模型PHR。我们将扩大现有的合作与汉密尔顿县就业 和家庭服务，将设计的PHR添加到我们现有的数据共享流程中，我们将与 社区和提供者确保寄养青年在脱离寄养后获得PHR。 该项目将通过提供健康信息，对儿童健康成果产生有意义的影响， 最需要它;我们相信这将最终提高医疗保健利用率，并为 支持额外的赠款，以改善寄养儿童和脱离寄养儿童的健康和福祉。

Project Summary There are 427,000 children in the custody of child protective services (i.e., foster care) in the United States. Children remain in foster care an average 19 months, with 26% of children in foster care for 2 years or longer. Adolescents experience an average of 7 placement changes during their time in foster care, and approximately 5,000 youth emancipate from foster care annually. States provide independent living programs prior to emancipation to help with the transition, which includes housing and utilities, assistance with education, classes about activities of daily living, and monitoring. However, support for health care self-management is not provided, and teens in or emancipating from foster care are generally unable to access their medical records. While in custody, access to medical records is managed by caseworkers; foster youth report limited access to health information and caseworkers and caregivers report not having sufficient health information for the children in their care. This lack of health information results in foster youth reporting no knowledge of how to access primary care, poor management of chronic conditions, and increased preventable disease. Providing health data from the electronic health record could improve health knowledge, care coordination, and patient outcomes in this vulnerable population. However, no sustainable system to provide personal health records (PHRs) to this vulnerable population has been developed. The objective of our research is to improve health outcomes and promote health behaviors in foster youth experiencing a transition from pediatric to adult health care systems and are emancipating from foster care. As a critical step toward accomplishing this goal, this project will create and distribute a PHR for foster youth to be distributed at age 18. The execution of the aims described below will position us to scale providing portable health records to other communities where child welfare administrative databases can be linked with the electronic health record. Our project will create and distribute a PHR to foster youth, a vulnerable population, and lay the necessary foundation to assess feasibility. This is essential for future studies seeking to examine whether providing PHR changes health service utilization once youth have emancipated. With foster youth and caseworker involvement, we will create a model PHR. We will extend existing collaborations with Hamilton County Jobs and Family Services to add designed PHRs to our existing data-sharing processes, and we will work with the community and providers to ensure that foster youth receive a PHR upon emancipation from foster care. This project will have meaningful impact on child health outcomes by delivering health information when youth need it most; we believe this will ultimately lead to improved healthcare utilization and provide infrastructure to support additional grants to improve the health and wellbeing of children in and emancipating from foster care.