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多中心、实用主义、个体水平随机对照试验的设计与实施,旨在评估 Baby2Home,一种支持新手父母的移动健康干预措施。

The design and implementation of a multi-center, pragmatic, individual-level randomized controlled trial to evaluate Baby2Home, an mHealth intervention to support new parents.

机构信息

Warren Alpert Medical School, Brown University, Providence, RI, USA.

Department of Pediatrics, Northwestern University Feinberg School of Medicine and Lurie Children's Hospital, Chicago, IL, USA.

出版信息

Contemp Clin Trials. 2024 Jul;142:107571. doi: 10.1016/j.cct.2024.107571. Epub 2024 May 11.

Abstract

BACKGROUND

Becoming a parent is a transformative experience requiring multiple transitions, including the need to navigate several components of health care, manage any mental health issues, and develop and sustain an approach to infant feeding. Baby2Home (B2H) is a digital intervention built on the collaborative care model (CCM) designed to support families during these transitions to parenthood.

OBJECTIVES

We aim to investigate the effects of B2H on preventive healthcare utilization for the family unit and patient-reported outcomes (PROs) trajectories with a focus on mental health. We also aim to evaluate heterogeneity in treatment effects across social determinants of health including self-reported race and ethnicity and household income. We hypothesize that B2H will lead to optimized healthcare utilization, improved PROs trajectories, and reduced racial, ethnic, and income-based disparities in these outcomes as compared to usual care.

METHODS

B2H is a multi-center, pragmatic, individual-level randomized controlled trial. We will enroll 640 families who will be randomized to: [1] B2H + usual care, or [2] usual care alone. Preventive healthcare utilization is self-reported and confirmed from medical records and includes attendance at the postpartum visit, contraception use, depression screening, vaccine uptake, well-baby visit attendance, and breastfeeding at 6 months. PROs trajectories will be analyzed after collection at 1 month, 2 months, 4 months, 6 months and 12 months. PROs include assessments of stress, depression, anxiety, self-efficacy and relationship health.

IMPLICATIONS

If B2H proves effective, it would provide a scalable digital intervention to improve care for families throughout the transition to new parenthood.

摘要

背景

成为父母是一个具有变革性的经历,需要经历多个转变,包括需要掌握医疗保健的多个方面,管理任何心理健康问题,并制定和维持一种婴儿喂养方式。Baby2Home(B2H)是一种基于协作护理模式(CCM)构建的数字干预措施,旨在为家庭提供支持,帮助他们顺利过渡到为人父母的阶段。

目的

我们旨在研究 B2H 对家庭单位预防保健利用的影响以及患者报告结果(PROs)轨迹,重点关注心理健康。我们还旨在评估治疗效果在健康社会决定因素方面的异质性,包括自我报告的种族和民族以及家庭收入。我们假设与常规护理相比,B2H 将导致优化的医疗保健利用、改善 PROs 轨迹,并减少这些结果中的种族、民族和收入差异。

方法

B2H 是一项多中心、实用、个体水平的随机对照试验。我们将招募 640 个家庭,他们将随机分为:[1] B2H+常规护理,或[2]常规护理。预防保健利用情况由自我报告并通过医疗记录确认,包括参加产后访视、使用避孕药具、抑郁筛查、疫苗接种、定期进行婴儿健康检查以及母乳喂养至 6 个月。在收集了 1 个月、2 个月、4 个月、6 个月和 12 个月的 PROs 后,将对其轨迹进行分析。PROs 包括压力、抑郁、焦虑、自我效能感和关系健康的评估。

意义

如果 B2H 被证明有效,它将提供一种可扩展的数字干预措施,以改善家庭在新父母阶段的护理。

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