Increasing Infant Preventive Health Service Delivery in an Inner City Population
研究概览
详细说明
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.
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
-
-
Colorado
-
Denver、Colorado、美国、80204
- Denver Health Medical Center
-
-
参与标准
资格标准
适合学习的年龄
- 孩子
- 成人
- 年长者
接受健康志愿者
有资格学习的性别
描述
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.
学习计划
研究是如何设计的?
设计细节
- 主要用途:预防
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
---|---|
无干预:Historical Cohort
This study will first examine risk factors in a defined population of inner city children, using a historical cohort.
|
|
有源比较器: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.
|
|
有源比较器: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.
|
|
有源比较器: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.
|
研究衡量的是什么?
主要结果指标
结果测量 |
---|
Change in Infant immunization status
|
Change in Infant well child care status
|
次要结果测量
结果测量 |
---|
Change in Health care utilization
|
Change in Enrollment in health insurance programs
|
Change in Screening rates for anemia and lead toxicity
|
合作者和调查者
调查人员
- 首席研究员:Simon Hambidge, MD, PhD、UCDHSC
出版物和有用的链接
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.
案例管理的临床试验
-
University of Wisconsin, MadisonJohns Hopkins University; University of Colorado, Denver; Northwestern University; Columbia University 和其他合作者主动,不招人肾脏疾病 | 肾功能衰竭,慢性 | 沟通 | 晚期肾脏疾病 | 姑息治疗 | 生命尽头 | 透析 | 肾透析 | 决策 | 决策辅助 | 决策支持技术 | 肾病专家 | 晚期肾病 | 生命支持治疗美国
-
University of Wisconsin, MadisonNational Institute on Aging (NIA); Oregon Health and Science University; University of Texas Southwestern...完全的
-
University of Wisconsin, MadisonUniversity of Alabama at Birmingham; National Institute on Aging (NIA); University of California... 和其他合作者邀请报名
-
University of California, San FranciscoNational Institute on Aging (NIA); Mount Zion Health Fund招聘中
-
George Washington UniversityTranscultural Psychosocial Organization Nepal完全的