COVID-19 期间，有医疗复杂性的儿童更安全地返校的优先事项。
Priorities for Safer In-Person School for Children With Medical Complexity During COVID-19.
机构信息
Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, Wisconsin.
出版信息
Pediatrics. 2022 Mar 1;149(3). doi: 10.1542/peds.2021-054434.
OBJECTIVES
To establish statewide consensus priorities for safer in-person school for children with medical complexity (CMC) during the coronavirus disease 2019 (COVID-19) pandemic using a rapid, replicable, and transparent priority-setting method.
METHODS
We adapted the Child Health and Nutrition Research Initiative Method, which allows for crowdsourcing ideas from diverse stakeholders and engages technical experts in prioritizing these ideas using predefined scoring criteria. Crowdsourcing surveys solicited ideas from CMC families, school staff, clinicians and administrators through statewide distribution groups/listservs using the prompt: "It is safe for children with complex health issues and those around them (families, teachers, classmates, etc.) to go to school in-person during the COVID-19 pandemic if/when…" Ideas were aggregated and synthesized into a unique list of candidate priorities. Thirty-four experts then scored each candidate priority against 5 criteria (equity, impact on COVID-19, practicality, sustainability, and cost) using a 5-point Likert scale. Scores were weighted and predefined thresholds applied to identify consensus priorities.
RESULTS
From May to June 2021, 460 stakeholders contributed 1166 ideas resulting in 87 candidate priorities. After applying weighted expert scores, 10 consensus CMC-specific priorities exceeded predetermined thresholds. These priorities centered on integrating COVID-19 safety and respiratory action planning into individualized education plans, educating school communities about CMC's unique COVID-19 risks, using medical equipment safely, maintaining curricular flexibility, ensuring masking and vaccination, assigning seats during transportation, and availability of testing and medical staff at school.
CONCLUSIONS
Priorities for CMC, identified by statewide stakeholders, complement and extend existing recommendations. These priorities can guide implementation efforts to support safer in-person education for CMC.
目的
使用快速、可复制和透明的优先级设置方法，为在 2019 年冠状病毒病（COVID-19）大流行期间患有复杂医疗状况（CMC）的儿童建立全州范围内的安全面对面上学共识优先事项。
方法
我们改编了儿童健康与营养研究倡议方法，该方法允许从不同利益相关者那里众包创意，并让技术专家使用预定义的评分标准对这些创意进行优先级排序。众包调查通过全州范围内的分发小组/列表服务向 CMC 家庭、学校工作人员、临床医生和管理人员征求意见，使用的提示是：“在 COVID-19 大流行期间，如果/当......，患有复杂健康问题的儿童及其周围的人（家人、老师、同学等）安全地上学。”创意被汇总并综合成一个独特的候选优先级列表。然后，34 名专家使用 5 点李克特量表对每个候选优先级针对 5 个标准（公平性、对 COVID-19 的影响、实用性、可持续性和成本）进行评分。分数进行加权，并应用预设阈值以确定共识优先事项。
结果
2021 年 5 月至 6 月，460 名利益相关者提出了 1166 条意见，产生了 87 个候选优先事项。应用加权专家评分后，10 项共识 CMC 特定优先事项超过了预定阈值。这些优先事项集中在将 COVID-19 安全和呼吸行动计划纳入个别化教育计划、教育学校社区了解 CMC 的独特 COVID-19 风险、安全使用医疗设备、保持课程灵活性、确保口罩和疫苗接种、在运输过程中分配座位以及在学校提供检测和医务人员。
结论
全州利益相关者确定的 CMC 优先事项补充和扩展了现有建议。这些优先事项可以指导实施工作，以支持 CMC 更安全的面对面教育。
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