Increasing Infant Preventive Health Service Delivery in an Inner City Population
調査の概要
詳細な説明
The overall aim of the proposed project is to increase receipt of a broad array of childhood preventive health services in a population of disadvantaged inner city children. Specific hypotheses concerning risk factors for infant under-immunization and lack of receipt of well child care will be tested. This study will first examine these risk factors in a defined population of inner city children, using a historical cohort. Finally, through the use of a randomized controlled trial in a prospective birth cohort, it will test an intervention, based partly on the evidence gathered from the initial study phases, to increase immunization rates and well child care delivery in those children most at risk for "falling through the cracks." These studies will be conducted in the Denver Health community health network, the largest integrated community health care system in the United States.
Information gathered via rigorous exploration of risk factors for inadequate preventive service receipt in inner city children is especially important at present, because despite rising immunization rates around the country, it is clear that "pockets of need" remain in many urban locations. Children in these pockets of need, in addition to being under-immunized, also are at higher risk for lack of other preventive services, and suffer from higher rates of iron deficiency anemia and lead poisoning. The knowledge gained from both the descriptive and interventional parts of the study will provide crucial information for physicians who care for these children, health care systems that serve them, and policy makers responsible for promoting effective tools and funding their implementation. The information gained herein will also provide important methodological insight for generalists who wish to conduct interventional studies in large urban populations, by further refining existing methods used in design and implementation of large cohort studies in disadvantaged children.
Although this project will be conducted among a population of disadvantaged inner city children, many of the findings from these studies will likely be applicable in health care systems that serve other socioeconomic groups. All primary care physicians who care for children face the challenge of trying to boost childhood immunization rates over 90%, and to increase the delivery of a full spectrum of preventive health services to children. The investigators hope that the evidence from this project will inform and shape both the clinical practice of individual health care providers and health care systems charged with providing preventive health care to children in a wide variety of settings.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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Colorado
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Denver、Colorado、アメリカ、80204
- Denver Health Medical Center
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参加基準
適格基準
就学可能な年齢
- 子
- 大人
- 高齢者
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Any child born at Denver Health Medical Center between 2/1/04 and 1/31/05 who receives primary care at one of 3 community health centers.
Exclusion Criteria:
- No medical care in the Denver Health community health system after 42 days of age.
- Birthweight less than 1500 grams.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:防止
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
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介入なし:Historical Cohort
This study will first examine risk factors in a defined population of inner city children, using a historical cohort.
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アクティブコンパレータ:Reminder Recall Outreach
To determine how well Reminder Recall Outreach will increase immunization rates and well child care delivery in those children most at risk for "falling through the cracks."
These studies will be conducted in the Denver Health community health network, the largest integrated community health care system in the United States.
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アクティブコンパレータ:Case Management
To determine how well Case Management will increase immunization rates and well child care delivery in those children most at risk for "falling through the cracks."
These studies will be conducted in the Denver Health community health network, the largest integrated community health care system in the United States.
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アクティブコンパレータ:Patient Navigation
To determine how well Patient Navigation will increase immunization rates and well child care delivery in those children most at risk for "falling through the cracks."
These studies will be conducted in the Denver Health community health network, the largest integrated community health care system in the United States.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
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Change in Infant immunization status
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Change in Infant well child care status
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二次結果の測定
結果測定 |
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Change in Health care utilization
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Change in Enrollment in health insurance programs
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Change in Screening rates for anemia and lead toxicity
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協力者と研究者
捜査官
- 主任研究者:Simon Hambidge, MD, PhD、UCDHSC
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
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