Technology-Enhanced Asthma Care in Children at Clinic and Home (TEACCCH) Study

项目摘要/摘要 候选人：Kristin Kan，医学硕士硕士，儿科医生和临床研究员，专注于设计 以及实施循证的卫生系统干预措施，以支持哮喘儿童。菅直人博士的 长期目标是成为一名独立的医生-研究员和实施科学方面的领先专家 以及卫生系统干预措施，以改善哮喘儿童的结果和护理质量。 研究背景：在550万患有儿童哮喘的美国儿童中，超过一半的儿童哮喘得不到控制 症状部分归因于哮喘自我管理不善，导致急性非计划治疗率高和 活动限制。支持以指南为基础的预防性哮喘护理，特别是坚持药物治疗， 是减少哮喘高危人群中失控症状的关键一步。有证据表明 建议移动医疗(MHealth)技术可以成为有效干预措施的一部分，以改善 坚持和症状控制。然而，我们之前的mHealth哮喘试验和其他研究的数据 建议在现实世界的医疗保健中使用mHealth的限制部分归因于缺乏优化 保健系统整合mHealth工具和实施战略。 具体目标：(1)与照顾者一起优化mHealth儿童哮喘干预和实施计划 和卫生系统利益攸关方通过以用户为中心的设计研讨会和访谈。(2)开展 适应性、移动健康哮喘干预和多方利益攸关方实施计划的可行性研究 提高哮喘症状控制和用药依从性。 研究计划：为了实现这些目标，菅直人博士将聘请哮喘儿童的照顾者，临床 工作人员和卫生系统管理员，以完善现有mHealth哮喘干预的设计，确定 将卫生保健服务的干预措施整合到卫生保健提供中，并设计实施 策略。然后，Kan博士将对照顾者-儿童二人组进行可行性试验，这些人将被随机分配到 适应性mHealth哮喘干预。这些发现将有助于为未来的全面混合实施做好准备。 有效性试验。 职业发展规划：Kan博士的培训目标包括：(1)获得以用户为中心的设计经验 (UCD)方法，(2)在卫生保健环境中发展临床试验设计和评估方面的专业知识，(3)增加 具备实施科学研究方法的能力，以及(4)学习统计分析技术 纵向数据。菅直人博士的职业发展目标将得到跨学科指导的良好支持 团队，计划了一系列的授课学习，并实施了她的研究计划。 环境：菅直人博士有一个由NIH资助的核心导师和顾问团队，他们致力于 指导她走向独立，并得到了西北大学和鲁里儿童基金会的支持 医院，拥有卓越的研究基础设施，并致力于支持初级调查人员。

PROJECT SUMMARY/ABSTRACT Candidate: Kristin Kan, MD MPH MSc is a pediatric physician and clinical investigator focused on designing and implementing evidence-based, health-system interventions to support children with asthma. Dr. Kan’s long-term goal is to be an independent physician-investigator and leading expert in implementation science and health system interventions that improve the outcomes and quality of care for children with asthma. Research Context: Of the 5.5 million US children with pediatric asthma, over half have uncontrolled symptoms due in part to poor asthma self-management, leading to high rates of acute unscheduled care and activity limitations. Supporting guideline-based preventive asthma care, especially adherence to medications, is a critical step in reducing uncontrolled symptoms among high-risk asthma populations. There is evidence suggesting that mobile health (mHealth) technologies can be part of an effective intervention to improve adherence and symptom control. However, data from our previous mHealth asthma trial and other studies suggest that limitations in mHealth use in real-world health care are partly attributable to the lack of optimizing health system integration of the mHealth tool and the implementation strategy. Specific Aims: (1) Optimize a mHealth pediatric asthma intervention and implementation plan with caregivers and health system stakeholders through user-centered design workshops and interviews. (2) Conduct a feasibility study of an adaptive, mHealth asthma intervention and multi-stakeholder implementation plan to improve asthma symptom control and medication adherence. Research Plan: To accomplish these aims, Dr. Kan will engage caregivers of children with asthma, clinical staff, and health system administrators to refine the design of an existing mHealth asthma intervention, identify health care services to integrate the intervention in health care delivery, and design an implementation strategy. Dr. Kan will then conduct a feasibility trial with caregiver-child dyads, whom will be randomized to an adaptive mHealth asthma intervention. Findings will help prepare for a future, full-scale hybrid implementation- effectiveness trial. Career Development Plan: Dr. Kan’s training goals include: (1) acquire experience in user-centered design (UCD) methods, (2) develop expertise in clinical trial design & evaluation in health care settings, (3) increase competencies in implementation science research methods, and (4) learn statistical techniques for analyzing longitudinal data. Dr. Kan’s career development goals will be well-supported by an interdisciplinary mentorship team, a planned series of didactic learning, and implementation of her research plan. Environment: Dr. Kan has a NIH-funded core mentorship and advisory team, who are dedicated to mentoring her to independence, and is also supported by Northwestern University and Lurie Children’s Hospital, both with outstanding research infrastructures and commitments to supporting junior investigators.