Protocols to ascertain adverse events after telehealth sexual and reproductive health services

项目摘要 这个有导师的Ruth L.Kirschstein国家研究服务奖将为学员，一名博士生提供 加州大学旧金山分校的流行病学，以及成为性健康和生殖健康研究人员所需的培训。 她对这一奖学金的培训目标是获得卫生服务研究、偏见分析和 在专家导师团队的指导下解决缺失数据的方法。这一奖学金将提供 申请人具备开展独立研究所需的技能、内容知识和实践经验 职业生涯侧重于评价性健康和生殖健康方面的服务提供创新。 在COVID期间，远程保健成为提供性健康和生殖健康服务的重要方法- 19大流行。在远程医疗服务中，患者通常被远程筛查，通过以下方式分发任何药物 邮件，并随后监测不良事件的发生。一些研究表明， 远程医疗患者可能比那些接受面对面服务的患者更不可能通过远程医疗进行随访 在药物发放后提供药物，而没有完成随访的患者的结果不是 明白了。这项研究的目标是评估远程医疗协议在识别 不良事件。基于申请者以前的工作和目前的研究状况，这架F-31将涉及 对接受远程健康、性健康和生殖健康的患者进行的队列研究数据的二次分析 卫生服务，以(目标1)估计未返回治疗的患者的不良事件发生率 随访和(目标2)评估远程保健后不良事件诊断的时间和过程 生殖健康服务。这一证据将使远程保健性健康和生殖健康提供者能够 了解未复诊的患者发生不良事件的风险，以及他们的 目前的随访方案是确定不良事件的最佳方案。从这个过程中学到的知识 研究将推进NICHD的使命，确保个人出生时健康和受欢迎，妇女 没有受到生殖过程的伤害。这一建议的主要优点是：(1)依赖于一种 美国远程保健性健康和生殖健康患者的现有预期数据集，申请人 已经有经验；(2)使用严格的方法来评估偏差和处理丢失的数据；以及(3) 测试临床有效的假设，重点关注及时和不断增长的远程保健领域 生殖健康。拟议的研究和培训将为申请者未来的职业生涯做好准备 独立研究人员侧重于性保健和生殖保健方面的服务提供创新。

Project Summary This mentored Ruth L. Kirschstein National Research Service Award will provide the trainee, a PhD student in epidemiology at UCSF, with the training necessary to become a researcher in sexual and reproductive health. Her training goals for this fellowship are to gain expertise in health services research, bias analyses, and methods to address missing data under the guidance of a team of expert mentors. This fellowship will provide the applicant with the skills, content knowledge, and practical experience to launch an independent research career focused on the evaluation of service delivery innovations in sexual and reproductive health. Telehealth became a prominent method of sexual and reproductive health service delivery during the COVID- 19 pandemic. In telehealth services, patients are typically screened remotely, dispensed any medications by mail, and followed subsequently to monitor for the occurrence of adverse events. Some research suggests that telehealth patients may be less likely than those who receive in-person services to follow up with the telehealth provider after medications are dispensed, and the outcomes of patients who do not complete follow-up are not understood. The goal of this research is to evaluate the performance of telehealth protocols at identifying adverse events. Building on the applicant’s prior work and current research position, this F-31 will involve secondary analyses of data from a cohort study of patients who received telehealth sexual and reproductive health services, to (Aim 1) estimate the incidence of adverse events among patients who do not return for follow-up and (Aim 2) assess the timing and process of adverse events diagnoses after telehealth sexual and reproductive health services. This evidence will allow telehealth sexual and reproductive health providers to understand the risk of adverse events among their patients who do not return for follow-up and whether their current follow-up protocols are optimal for the identification of adverse events. Knowledge gained from this research will advance NICHD’s mission to ensure individuals are born healthy and wanted and that women are not harmed by reproductive processes. The major strengths of this proposal are that it: (1) relies on a large existing prospective dataset of US telehealth sexual and reproductive health patients, with which the applicant already has experience; (2) uses rigorous methods for evaluating bias and addressing missing data; and (3) tests clinically impactful hypotheses focusing on the timely and growing field of telehealth for sexual and reproductive health. The proposed research and training will prepare the applicant for her future career as an independent researcher focused on service delivery innovations in sexual and reproductive health care.