Strategic Planning for the Next Generation of Research on Pediatric Eating Disorders in Primary Care

项目摘要 进食障碍（ED）影响至少5%的青少年，并与精神疾病的高发病率有关。 合并症，自杀和医疗并发症，这需要一个敏感的，多学科的方法， 在乎尽管这些疾病普遍存在，但在症状达到严重程度之前， 需要密集的、侵入性的和昂贵的治疗。初级保健提供者（PCP）通常是 与患有艾德的青少年的家庭联系，但他们经常缺乏培训，无法识别 早期症状/体征或制定适当的管理计划。事实上，目前还没有经过验证的 初级保健中青少年ED的筛查工具，大多数PCP缺乏信心和能力， 评估和诊断这些情况，并获得训练有素的专业提供者咨询和/或 转诊受限于地理区域、费用和缺乏熟悉度。使这些问题更加复杂的是， 描述PCP在治疗团队中的作用的循证指南， 患者、家庭和其他提供者，以及PCP培训和继续培训的最佳内容和形式 教育为了推进基于证据的评估和初级保健中儿科ED的管理， 来自艾德领域内外的科学家、临床医生和社区合作者必须确定 下一代以患者/提供者为中心的研究的差距和优先事项。在此R13应用程序中（共- 由AHRQ和Equip Health，Inc.资助），我们建议召开一个小型的研究开发会议， 创建一个"研究路线图"，支持建立一个证据基础，PCP可以依赖于该基础， 告知教育需求和实际的筛查、诊断和治疗决定。演讲将聚焦 筛查/早期识别，优化PCP在治疗团队中的作用，开展培训， 继续教育课程，并满足特殊人群的需要，所有这些都将由 患者，家属和临床医生的生活经验，以确保未来的研究活动满足他们的需求。 分组讨论将有助于围绕最关键的未解决的科学问题建立共识， 与初级保健中儿科急诊相关的问题。本次会议的成果包括研讨会报告 概述了初级保健中艾德识别和管理的研究议程，以及 学术出版物。在ED对个人和社会都越来越昂贵的时候， 会议将奠定基础，建立一个合作战略，以促进循证护理， 初级保健机构。

PROJECT ABSTRACT Eating disorders (EDs) affect at least 5% of adolescents and are associated with high rates of psychiatric comorbidity, suicidality, and medical complications, which necessitate a sensitive, multidisciplinary approach to care. Despite their prevalence, these disorders are often not recognized until symptoms reach a severity level requiring intensive, invasive, and costly treatment. Primary care providers (PCPs) are typically the first point of contact for families with an adolescent suffering from an ED, yet they are frequently under-trained to recognize early signs/symptoms or develop an appropriate management plan. Indeed, there currently are no validated screening tools for adolescent EDs in primary care, most PCPs lack confidence and competence to adequately assess and diagnose these conditions, and access to trained specialty providers with whom to consult and/or refer is limited by geographic region, cost, and lack of familiarity. Compounding these problems is a lack of evidence-based guidelines describing the role of PCP on the treatment team, best practices for supporting patients, families, and other providers, and optimal content and format for PCP training and continuing education. To advance evidence-based assessment and management of pediatric EDs in primary care, scientists, clinicians, and community collaborators from within and outside the ED field must identify critical gaps and priorities for the next generation of patient/provider-centered research. In this R13 application (co- funded by AHRQ and Equip Health, Inc.), we propose a small Research Development conference to support creation of a “research roadmap” supporting development of an evidence base on which PCPs could rely to inform education needs and practical screening, diagnosis, and treatment decisions. Presentations will focus on screening/early recognition, optimizing the PCP’s role on the treatment team, developing training and continuing education curricula, and catering to needs of special populations, all of which will be informed by the lived experience of patients, families, and clinicians to ensure future research activities meet their needs. Breakout discussions will facilitate consensus-building around the most critical unaddressed scientific questions related to pediatric EDs in primary care. Deliverables from this conference include a workshop report outlining a research agenda on ED recognition and management in primary care, and an accompanying scholarly publication. At a time when EDs are increasingly costly to both the individual and society, this conference will lay the groundwork for establishing a collaborative strategy to advance evidence-based care in primary care settings.