First name
Nathalie
Middle name
E
Last name
duRivage

Title

A Pilot Randomized Trial of a Video Patient Decision Aid to Facilitate Early Intervention Referrals From Primary Care.

Year of Publication

2017

Date Published

Mar 2017

ISSN Number

1938-2707

Abstract

<p>Many young children identified with developmental concerns in pediatric settings do not receive early intervention (EI). We assessed the impact of a video decision aid and text message reminder on knowledge and attitudes regarding developmental delay and EI as well as referral completion. We conducted a pilot randomized controlled trial in an urban setting and enrolled 64 parent-child dyads referred to EI. Compared with controls, participants who received the intervention demonstrated increased knowledge regarding developmental delay and EI as well as more favorable attitudes in certain topics. Although we did not find a significant difference between arms in EI intake and evaluation, we found a pattern suggestive of increased intake and evaluation among participants with low health literacy in the intervention arm. Additional study is needed to identify strategies that improve the EI referral process for families and to understand the potential targeted role for decision aids and text messages.</p>

DOI

10.1177/0009922816677038

Alternate Title

Clin Pediatr (Phila)

PMID

27834191

Title

Asthma Control Test: Comparing Parent Proxy With Parent and Child Report for Children 6 to 12 Years

Year of Publication

2016

Date Published

2016 Oct 23

Abstract

We compared results of a modified version of the Asthma Control Test using parent proxy report (PP-ACT) with results reported by children and parents using the validated Childhood-Asthma Control Test (C-ACT). 104 parent-child dyads with a child aged 6 to 12 years with asthma were randomized to complete PP-ACT followed by C-ACT or C-ACT followed by PP-ACT. Scores ≤19 indicated uncontrolled asthma. We calculated sensitivity, specificity, positive predictive value, and negative predictive value for the PP-ACT in comparison with the C-ACT, and calculated concordance between the 2 scales. The PP-ACT had sensitivity of 86% and negative predictive value of 88% for detecting uncontrolled asthma. More than 75% of surveys were concordant (κ = 0.54, moderate agreement). Our results suggest that while the PP-ACT missed few children with uncontrolled asthma and may simplify reporting of asthma control in circumstances when child report is not feasible or creates barriers to survey receipt, limitations of proxy reporting should be considered.

PMID

27798397
Fiks, A. G., Gruver, R. S., Virudachalam, S., Gerdes, M., Bishop, C. T., Kalra, G. K., et al. (2014). The Grow2Gether Pilot Study: A Facebook Group Intervention for Mothers to Prevent Obesity from Infancy. Pediatric Academic Societies Meeting. Presented at the. (Original work published 05/2014 C.E.)

Title

Effect of decision support on missed opportunities for human papillomavirus vaccination.

Year of Publication

2014

Number of Pages

734-44

Date Published

2014 Dec

ISSN Number

1873-2607

Abstract

<p><strong>BACKGROUND: </strong>Missed opportunities for human papilloma virus (HPV) vaccination are common, presenting a barrier to achieving widespread vaccine coverage and preventing infection.</p>

<p><strong>PURPOSE: </strong>To compare the impact of clinician- versus family-focused decision support, none, or both on captured opportunities for HPV vaccination.</p>

<p><strong>DESIGN: </strong>Twelve-month cluster randomized controlled trial conducted in 2010-2011.</p>

<p><strong>SETTING/PARTICIPANTS: </strong>Adolescent girls aged 11-17 years due for HPV Dose 1, 2, or 3 receiving care at primary care practices.</p>

<p><strong>INTERVENTION: </strong>Twenty-two primary care practices were cluster randomized to receive a three-part clinician-focused intervention (educational sessions, electronic health record-based alerts, and performance feedback) or none. Within each practice, girls were randomized at the patient level to receive family-focused, automated, educational phone calls or none. Randomization resulted in four groups: clinician-focused, family-focused, combined, or no intervention.</p>

<p><strong>MAIN OUTCOME MEASURES: </strong>Standardized proportions of captured opportunities (due vaccine received at clinician visit) were calculated among girls in each study arm. Analyses were conducted in 2013.</p>

<p><strong>RESULTS: </strong>Among 17,016 adolescent girls and their 32,472 visits (14,247 preventive, 18,225 acute), more HPV opportunities were captured at preventive than acute visits (36% vs 4%, p&lt;0.001). At preventive visits, the clinician intervention increased captured opportunities by 9 percentage points for HPV-1 and 6 percentage points for HPV-3 (p≤0.01), but not HPV-2. At acute visits, the clinician and combined interventions significantly improved captured opportunities for all three doses (p≤0.01). The family intervention was similar to none. Results differed by practice setting; at preventive visits, the clinician intervention was more effective for HPV-1 in suburban than urban settings, whereas at acute visits, the clinician intervention was more effective for all doses at urban practices.</p>

<p><strong>CONCLUSIONS: </strong>Clinician-focused decision support is a more effective strategy than family-focused to prevent missed HPV vaccination opportunities. Given the persistence of missed opportunities even in intervention groups, complementary strategies are needed. This study is registered at clinicaltrials.gov NCT01159093.</p>

DOI

10.1016/j.amepre.2014.08.010

Alternate Title

Am J Prev Med

PMID

25455116

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