P-KIDs CARE: An Intervention to Address Health Systems Delays to Care for Injured Children in Tanzania

项目摘要/摘要 每天都有1900名儿童死于伤害。在这些儿童伤害死亡中，超过95%发生在低位和 中等收入国家(LMIC)，撒哈拉以南非洲的儿童受到的影响不成比例。在子- 在撒哈拉非洲，如果儿童受到严重伤害，可以最大限度地减少儿科发病率和死亡率 及时的优质护理。拟议研究的目标是开发和试点一种与当地相关的、 多组分干预以简化分诊流程(例如，患者评估、稳定和 为坦桑尼亚的儿科伤害患者提供医疗服务)。这一卫生系统干预将在第一级起作用 医疗联系(如保健中心和地区医院)，以便及时处置和转介， 并随后减少最终护理的时间。拟议的研究有三个目标：1)混合 方法：描述第一次医疗接触时儿科伤害护理的障碍；2)反复 使用名义上的团体技术开发P-儿童护理干预，并进行实施前 评估和改进；3)试行儿童护理干预措施，并开展以实施为重点的工作 形成性评价。这一职业发展奖是由儿科医生伊丽莎白·基廷博士提出的 急诊医学医生兼科学家专注于像坦桑尼亚这样的资源有限的环境。在颁奖期间 在此期间，候选人将获得培训和指导，成为一名独立的临床研究员 重点是在资源有限的情况下开发新的、可扩展的卫生系统干预措施。与.一起 开发这种创新的干预措施，候选人将获得实施科学、卫生系统等方面的技能 干预开发、全球临床试验设计和负责任的研究行为。候选人的 职业发展将由一支令人印象深刻的多学科和国际化的经验丰富的团队来指导 在卫生系统干预开发、全球临床试验和创伤方面拥有广泛专业知识的导师 管理层。这项建议通过建立系统级创伤的能力来实现国家卫生研究院的战略目标 LMIC的研究。到这个项目结束时，基廷博士将拥有独特的研究专长组合 并准备提交一份R01提案，该提案有可能改善受伤儿童的结局 在撒哈拉以南非洲。

PROJECT SUMMARY/ABSTRACT Every day, 1900 children die from an injury. More than 95% of these pediatric injury deaths occur in low- and middle-income countries (LMICs), with children in sub-Saharan Africa disproportionately affected. In sub- Saharan Africa, pediatric morbidity and mortality could be minimized if children with serious injuries received timely quality care. The objective of the proposed research is to develop and pilot a locally-relevant, multicomponent intervention to streamline the triage process (e.g. patient assessment, stabilization, and disposition) for pediatric injury patients in Tanzania. This health systems intervention will work at the first level of medical contact (e.g., health center and district hospital), in order to facilitate timely disposition and referrals, and subsequently decrease time to definitive care. The proposed study has three aims: 1) With a mixed methods approach, describe the barriers to pediatric injury care at the first medical contact; 2) Iteratively develop the P-KIDs CARE intervention using a nominal group technique and conduct a pre-implementation assessment and refinement; 3) Pilot the P-KIDs CARE intervention and perform an implementation-focused formative evaluation. This career development award is being proposed by Dr. Elizabeth Keating, a Pediatric Emergency Medicine physician-scientist focused on resource-limited settings like Tanzania. During the award period, the candidate will gain the training and mentorship to become an independent clinical investigator focused on developing novel, scalable health systems interventions in resource-limited settings. Along with developing this innovative intervention, the candidate will gain skills in implementation science, health systems intervention development, global clinical trial design, and the responsible conduct of research. The candidate’s career development will be guided by an impressive multi-disciplinary and international team of experienced mentors with extensive expertise in health systems intervention development, global clinical trials, and trauma management. This proposal speaks to NIH’s strategic goals by building capacity for systems-level trauma research in LMICs. By the end of this project, Dr. Keating will have a unique combination of research expertise and will be prepared to submit an R01 proposal that has the potential to improve outcomes for injured children in sub-Saharan Africa.