Interconception Care at the University of Mississippi Medical Center: An Innovative and Unique Collaborative Continuous Quality Improvement Project Between the Departments of Pediatrics and Family Medicine
试验速览
- 阶段
- 不适用
- 状态
- Enrolling By Invitation
- 入组人数
- 1,625
- 试验地点
- 1
- 主要终点
- Can pediatric primary care provider screen mother for maternal health behaviors during routine well child visits using brief questionnaires?
研究概览
简要总结
This model will utilize tools from the IMPLICIT (Interventions to Minimize Preterm and Low Birth Weight Infant through Continuous Quality Improvement Techniques) Network (collaboration of academic family medicine providers). The project involves assessing maternal risk behaviors that significantly affect subsequent birth outcomes: specifically smoking cessation, maternal depression, family planning and preconception folic acid supplementation during well child (WCC) visits. There is evidence that screening mothers for depression can be done at WCC. Data from IMPLCIT network has demonstrated increased screening and referral rates as well as decreased rates of prematurity. This is the first collaborative effort between Pediatrics and Family Medicine.
详细描述
Specific Aim(s) 1. Determine feasibility of implementing an ICC model as routine standard of care during well child care visits 2. Assess how often physicians routinely implement this model into their practice 3. Increase rates of screening for smoking, depression, folic acid supplementation and family planning during routine visits.
- Increase rates of referrals for mothers at risk Study Period (inclusive years) This project will take place over a two year period. It will be re-evaluated at monthly intervals to make sure that objectives are being met.
Study Design Study Entry: All mothers presenting with their children to an Ambulatory Pediatric site (North Clinic, Eli Manning and the Pavilion) or Family Medicine (Lakeland and Flowood) for 2 month, 4 month, 6 month, 9 month, 15 month, 18 month and 24 month well child (WCC) visits will be screened for smoking, depression, folic acid supplementation and contraception. Screening will take place at the time of each well child visit. The clinic nurse will present the mother with the screeners for depression and will also ask whether she is smoking, using contraception, and using a folic acid supplementation. Screening scores will be reviewed by the patient's primary care provider. A positive score for PHQ 9 will elicit a referral to Adolescent Medicine and/or Family Medicine for further evaluation. A positive screen for smoking will elicit a referral to the ACT Center at UMMC. Negative responses for contraception use will elicit a referral to Adolescent Medicine and/or Family Medicine for further management. Primary care providers will provide mothers with information and recommendations on folic acid use if they are not using a supplementation.
In Ambulatory Pediatrics mothers in need of services will be referred based on age. Mothers who are 21 years or younger will be referred to Adolescent Medicine. Mothers who are 21 years or older will be referred to Family Medicine. In Family Medicine, mothers will be referred only for depression or smoking cessation.
This project is quality improvement hence screening will be offered to all mothers presenting with their child for well child visits will be screened. Since this project is quality improvement; examining provider behaviors, an exemption from informed consent is requested. Foster parents and non-parental legal guardians will not be screened. Mothers presenting with their child for sick visits will not be screened. Mothers of children older than 2 years of age will not be screened.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 13 Years 至 67 Years（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Pediatric Primary Care Providers and Family Medicine Providers at UMMC
- •Mothers of young infants/toddlers who present with their children for well child visits to UMC primary clinics -
排除标准
- •Specialists at UMMC
- •Fathers, grandparents, legal guardians - this screening only applies to mothers of young infants and toddlers -
结局指标
主要结局
Can pediatric primary care provider screen mother for maternal health behaviors during routine well child visits using brief questionnaires?
时间窗: 2 years
Pediatric primary care providers (and family medicine providers who care for young infants) will screen mothers for maternal behaviors (smoking status, depression, prenatal multivitamin use, family planning) during routine well child visits of infants aged 0-2 years of age. Mothers will be screened for depression using a validated screening tool (Patient Health Questionnaire or PHQ: the 2 item PHQ-2 will be an initial screen; mothers who have a positive PHQ-2 will be offered the 9-item questionnaire ie the PHQ-9); screening for family planning needs, prenatal multivitamin use and smoking status will be in the form of "yes/no" answers.
次要结局
- Can pediatric primary care providers make appropriate recommendations for mothers with at risk behaviors using brief questionnaires?(2 years)