Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Division of General Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Pediatr Pulmonol. 2024 Nov;59(11):2800-2808. doi: 10.1002/ppul.27129. Epub 2024 Jun 13.
The lung and sleep health of adults is heavily influenced by early factors, both genetic and environmental; therefore, optimizing respiratory health begins in childhood. Multiple barriers impede improvements in lung and sleep health for children. First, the traditional siloing between general pediatric care in the community, pediatric pulmonary and sleep subspecialty care, and the research community limits the translation of knowledge into practice. Additionally, identifying and addressing health disparities remains a challenge. The 2021 NHLBI-sponsored workshop "Defining and Promoting Pediatric Pulmonary Health (DAPH)" was a first step in defining critical gaps in our current healthcare system in identifying and optimizing lung and sleep health in children. The workshop identified key opportunities including measuring pulmonary function in young children, sleep-focused outcomes, developing biomarkers, and longitudinal research cohorts. To expand on the work of DAPH and continue initiatives to improve childhood lung and sleep health, the Pediatrics & Pulmonary Network: Improving Health Together conference was held in 2023.
A modified Delphi process was applied to form consensus surrounding gaps, barriers, and action items, with the goal of identifying the most urgent opportnities for improving childhood lung and sleep health.
Cross-cutting foundational principles were identified as: (1) Authentic Stakeholder Collaboration & Engagement, (2) Reach & Implementation in Real World Settings, (3) Understanding Current Landscape & Resources and (4) Purposeful Diversity, Equity, & Inclusion Initiatives.
To improve lung and sleep health in children, these principles should be the foundation for research design, development, and implementation.
成人的肺部和睡眠健康受遗传和环境等早期因素的影响较大；因此，呼吸健康的优化始于儿童时期。多种障碍阻碍了儿童的肺部和睡眠健康的改善。首先，社区普通儿科护理、儿科肺科和睡眠亚专业护理以及研究界之间的传统隔阂限制了知识向实践的转化。此外，确定和解决健康差距仍然是一个挑战。2021 年 NHLBI 主办的“定义和促进儿科肺部健康（DAPH）”研讨会是定义我们当前医疗保健系统中识别和优化儿童肺部和睡眠健康的关键差距的第一步。该研讨会确定了一些关键机会，包括在幼儿中测量肺功能、以睡眠为重点的结果、开发生物标志物和纵向研究队列。为了扩大 DAPH 的工作范围并继续开展改善儿童肺部和睡眠健康的倡议，2023 年举行了儿科与肺科网络：共同改善健康会议。
采用改良 Delphi 流程来形成围绕差距、障碍和行动计划的共识，目标是确定改善儿童肺部和睡眠健康的最紧迫机会。
确定了跨领域的基本原则，包括：（1）真实的利益相关者合作与参与，（2）在真实世界环境中的推广和实施，（3）了解当前的现状和资源，以及（4）有目的的多样性、公平性和包容性倡议。
为了改善儿童的肺部和睡眠健康，这些原则应该成为研究设计、开发和实施的基础。
