Collaborative Pediatric Critical Care Research Network

 描述（由申请人提供）：协作儿科重症监护研究网络（CPCCRN）是一个高效的研究网络，对于推进儿科重症监护医学的科学和实践至关重要。本次更新申请的总体目标是让韦恩州立大学（WSU）在Kathleen Meert医学博士的领导下继续作为CPCCRN的临床研究中心。Meert博士是WSU过去10年CPCCRN的PI，是一名儿科重症监护医师，拥有丰富的临床和转化研究经验，并在CPCCRN的科学出版物方面有着良好的记录。此外，Meert博士在行为医学和传播科学方面具有研究专长。WSU作为临床站点的优势包括密歇根儿童医院（CHM），这是一家独立的三级护理学术儿童医院，提供全方位的儿科和外科专科服务。CHM的PICU是一个拥有38张床位的多学科单位，每年照顾超过1500名不同种族和民族背景的患者。超过85%的PICU患者在机构内进行了随访。CHM是美国外科医生学会认证的1级儿科创伤中心和美国烧伤协会认证的烧伤中心。WSU的其他优势包括其与联邦资助的多中心研究网络的丰富经验，如新生儿网络，艾滋病毒/艾滋病干预的青少年医学试验网络，神经系统紧急情况治疗试验网络，儿科急诊应用研究网络和儿童肿瘤组。本申请中包含的概念提案建立在Meert博士领导的先前CPCCRN研究的基础上，证明了在PICU中实现高质量父母-临床医生沟通的许多挑战。高质量的沟通对于健康素养低的父母尤其重要，这是造成儿童健康差异的一个关键因素。以患者和家庭为中心的沟通（PFCC）可以提高沟通质量，但部分取决于父母的积极参与（例如，在临床互动中提问。概念提案的目的是开发一种新的沟通干预措施，即问题提示工具包;并确定干预措施在多大程度上可以提高PICU的PFCC，从而改善儿童和家庭的结果。核心假设是使用问题提示工具包将增加父母在临床互动、知识、自我效能和信任中的积极参与，减少父母的焦虑，并最终有助于改善儿童的健康相关生活质量 减轻家庭负担，特别是对健康素养低的家庭。该假设将在追求2个具体目标的多中心研究中进行测试：（1）开发用于危重儿童父母的问题提示工具包;（2）确定 问题提示工具包可以加强PFCC在PICU的使用，并改善儿童和家庭的结果。该建议是重要的，因为它将有助于一个新的沟通干预，可以应用在PICU的做法，以解决父母的沟通需求，改善健康的结果。

 DESCRIPTION (provided by applicant): The Collaborative Pediatric Critical Care Research Network (CPCCRN) is a highly productive research network that is essential to advancing the science and practice of pediatric critical care medicine. The overall aim of this renewal application is for Wayne State University (WSU), under the leadership of Kathleen Meert, MD, to continue as a clinical site in the CPCCRN. Dr. Meert, PI for the CPCCRN at WSU for the past 10 years, is a pediatric intensivist with a wealth of clinical and translational research experienc and an established track record of scientific publications for the CPCCRN. Additionally, Dr. Meert has demonstrated research expertise in behavioral medicine and communication science. Strengths of WSU as a clinical site include the Children s Hospital of Michigan (CHM), a free-standing, tertiary care, academic children s hospital offering the full spectrum of pediatric and surgical subspecialty services. The PICU at CHM is a 38-bed multidisciplinary unit that cares for >1500 patients/year with diverse racial and ethnic backgrounds. Over 85% of PICU patients have follow-up within the institution. CHM is an American College of Surgeons verified Level 1 Pediatric Trauma Center and an American Burn Association verified Burn Center. Additional strengths of WSU include its vast experience with federally-funded multicenter research networks such as the Neonatal Network, Adolescent Medicine Trials Network for HIV/AIDS Intervention, Neurological Emergencies Treatment Trials Network, Pediatric Emergency Care Applied Research Network, and the Children s Oncology Group. The concept proposal included in this application builds on prior CPCCRN research, led by Dr. Meert, demonstrating many challenges to achieving high quality parent-clinician communication in PICUs. High quality communication is especially important for parents with low health literacy, a key contributing factor to child health disparities. Patient- and family-centered communication (PFCC) may improve the quality of communication but depends, in part, on parents active participation (e.g., question asking) during clinical interactions. The objective of the concept proposal is to develop a novel communication intervention, the Question Prompt Toolkit; and determine the extent to which the intervention can enhance PFCC in PICUs, and thus improve child and family outcomes. The central hypothesis is that use of the Question Prompt Toolkit will increase parents active participation in clinical interactions, knowledge, self-efficacy and trust, reduce parent's anxiety, and ultimately contribute to better health-related quality of life for the child and reduced family burden, especially for families with low health literacy. The hypothesis will be tested in multicenter research that pursues 2 specific aims: (1) Develop the Question Prompt Toolkit for use among parents of critically-ill children; and (2) Determine the extent to which the Question Prompt Toolkit can enhance the use of PFCC in PICUs and improve child and family outcomes. The proposal is significant because it will contribute a new communication intervention that can be applied in PICU practice to address parents' communication needs and improve health outcomes.