Clinical Decision Support for Collaborative Diet Goal Setting in Primary Care

在这个项目中，我们将优化和试点测试一种新的临床决策支持协作饮食目标设定 在为未投保和投保不足的病人服务的诊所进行初级保健。因为他们之间的紧密联系 在饮食、肥胖和慢性病之间，饮食行为改变干预是 慢性病的预防和管理。尽管患者的医疗服务提供者会与他们谈论饮食， 体重有更多的成功达到饮食和体重的目标，这些对话是罕见的。这次错失的 机会是由于PCP缺乏培训和时间，以及混合的态度，能力， 对饮食咨询的信心。与此同时，即使是慢性病的饮食方法 越来越多地利用移动的应用程序和患者生成的数据进行复杂的个性化， 干预措施在很大程度上依赖于患者收集和解释个人数据， 实施饮食行为改变目标的管理。这使得这些干预措施更少 为受慢性病影响最严重的人群提供方便和用户友好的服务。拟议 研究，我们将完善饮食目标临床决策支持的健康信息技术（HIT）的工具， 为PCP提供数据驱动的指导，以个性化，循证，协作饮食目标设定， 病人可以离开他们的初级保健遇到的行为意图和目标自我效能 开始饮食自我管理。我们的目标是使这种合作目标的设定切实可行， 通过以用户为中心的设计来优化技术及其插入 临床工作流程我们还将与20名具有联邦资格的初级保健提供者一起对饮食目标CDS进行试点测试。 健康中心（CIMHC）诊所计划进行大规模的验证性试验。我们的长期目标是将Diet 将CDS纳入为来自健康社区的患者提供服务的CDHCs的临床工作流程 差异，并简化患者报告的饮食数据的收集，合成和解释， 交流饮食目标选项，以支持初级保健接触中的协作目标设定。

In this project we will optimize and pilot test a novel clinical decision support for collaborative diet goal setting in primary care encounters at clinics serving un- and under-insured patients. Because of the strong link between diet, obesity, and chronic disease, dietary behavior change interventions are a vital component of chronic disease prevention and management. Although patients whose providers talk with them about diet and weight have more success reaching diet and weight goals, these conversations are rare. This missed opportunity is attributed to PCPs’ lack of training and time, as well as mixed attitudes, competence, and confidence about diet counseling. At the same time, even as dietary approaches for chronic disease increasingly leverage mobile applications and patient-generated data for sophisticated personalization, these interventions rely heavily on patients to collect and interpret personal data and solely address self- management for implementation of dietary behavior change goals. This makes these interventions less accessible and user-friendly for the populations who are most affected by chronic disease. In the proposed research we will refine Diet Goal Clinical Decision Support a health information technology (HIT) tool that provides PCPs with data-driven guidance for personalized, evidence-based, collaborative diet goal setting so that patients can leave their primary care encounter with the behavioral intention and goal self-efficacy necessary to initiate dietary self-management. We aim to make this collaborative goal setting feasible in primary care encounters through user-centered design to optimize both the technology and its insertion into the clinical workflow. We will also pilot test Diet Goal CDS with 20 primary care providers in federally qualified health center (FQHC) clinics to plan for a large-scale confirmatory trial. Our long-term goal is to embed Diet Goal CDS into the clinical workflow at FQHCs that serve patients from communities experiencing health disparities and simplify the collection, synthesis, and interpretation of patient-reported dietary data as easy-to- communicate diet goal options to support collaborative goal setting in primary care encounters.