Improving Vaccine Delivery in Hospitalized Children

项目总结/摘要： 该提案描述了一个为期五年的研究和职业发展培训计划， 她的职业目标是成为一名独立的儿科临床研究人员， 通过加快循证干预措施的转化， 应用于临床实践。该提案的重点是提高疫苗接种率， 住院儿童是NICHD高度优先考虑的人群和问题。高达74%的住院儿童是 缺失≥1种非流感疫苗。目前，住院是一个错过接种疫苗的机会，因为约2%的 住院儿童接种任何非流感疫苗。整合实施科学和用户- Bryan博士的项目目标是设计和测试一种以用户为中心的干预方法， 优化免疫信息系统数据与医院电子健康记录的整合， 改善住院儿童疫苗接种。在目标1中，Bryan博士将进行一项混合方法研究， 对当地和全国的儿科住院医生、护士和药剂师进行抽样，以确定决定因素， 干预措施的背景因素，以确定疫苗接种不足的儿童，并利用 实施研究综合框架。在目标2中，她将与父母、护士、 药剂师、医生和卫生信息技术专家通过讲习班和快速周期 原型设计：为满足用户需求和背景的以用户为中心的干预开发原型 在目标1中确定。她将进行可用性测试和专家评估，以确保设计符合 在干预构建和工作流程整合之前，在目标3，布莱恩博士将部署和驾驶 测试设计的干预措施，以评估临床医生和家长的可行性和可接受性。这次试点测试 将为未来的多中心随机分组有效性实施试验提供信息， 住院儿童的分娩。为了完成这项研究，Bryan博士将在以下方面培养新的能力：1） 实施科学，2）以用户为中心的设计方法，3）基于技术的干预设计。到 为未来的临床试验做准备，以测试开发的干预措施，她还将发展临床试验技能 设计和分析方法的疫苗传播在奖励期间。布莱恩博士已经召集了一个 多学科指导团队，具有疫苗传播研究，实施科学， 以用户为中心的设计和基于技术的干预设计。她的导师致力于确保 这个项目的成功和她的职业发展成为一个独立的研究员。通过实现 在这项提案中，布莱恩博士将解决我们在提高住院患者疫苗接种率方面的关键差距。 孩子最终，该提案将为Bryan博士提供她在实施科学，用户- 中心化设计、基于技术的干预设计、临床试验设计和健康分析方法 致力于改善住院儿童的医疗保健结果的研究事业的通信。

PROJECT SUMMARY/ABSTRACT: This proposal describes a five-year research and career development training plan that will prepare Dr. Bryan to achieve her career goal of becoming an independent pediatric clinical researcher focused on improving healthcare outcomes for hospitalized children by accelerating the translation of evidence-based interventions into clinical practice using innovative technologies. This proposal is focused on improving vaccination rates in hospitalized children, a high priority population and issue for NICHD. Up to 74% of hospitalized children are missing ≥1 non-influenza vaccines. Currently, hospitalization is a missed opportunity to vaccinate as ~2% of hospitalized children receive any non-influenza vaccines. Integrating implementation science and user- centered design methods, Dr. Bryan’s project goal is to design and test a user-centered intervention that optimizes the integration of Immunization Information Systems data into hospital Electronic Health Records to improve vaccine delivery for hospitalized children. In Aim 1, Dr. Bryan will conduct a mixed methods study of a local and national sample of pediatric hospitalists, nurses and pharmacists to identify determinants and contextual factors for an intervention to identify undervaccinated children and offer needed vaccines using the Consolidated Framework for Implementation Research (CFIR). In Aim 2, she will engage with parents, nurses, pharmacists, physicians, and health information technology experts through workshops and rapid cycle prototyping to develop a prototype for a user-centered intervention that meets the user needs and context identified in Aim 1. She will conduct usability testing and expert evaluation to ensure the design meets the requirements prior to the intervention build and workflow integration. In Aim 3, Dr. Bryan will deploy and pilot test the designed intervention to assess feasibility and acceptability for clinicians and parents. This pilot test will inform a future multicenter cluster-randomized effectiveness-implementation trial to improve vaccine delivery in hospitalized children. To complete this research, Dr. Bryan will develop new competencies in: 1) implementation science, 2) user-centered design methods, and 3) technology-based intervention design. To prepare for the future clinical trial to test the developed intervention, she will also develop skills in clinical trials design and analytic methods for vaccine communication during the award period. Dr. Bryan has assembled a multidisciplinary mentorship team with expertise in vaccine communication research, implementation science, user-centered design, and technology-based intervention design. Her mentors are dedicated to ensuring the success of this project and her career development into an independent researcher. By accomplishing the aims in this proposal, Dr. Bryan will address key gaps in our ability to increase vaccination rates in hospitalized children. Ultimately, this proposal will provide Dr. Bryan the skills she needs in implementation science, user- centered design, technology-based intervention design, clinical trials design and analytic methods for health communication for a research career dedicated to improving healthcare outcomes in hospitalized children.