PREVENTING CHILDHOOD INJURIES IN PRIMARY PEDIATRIC CARE
Release Date: March 27, 2000
NOTICE: HD-00-006
SOURCES SOUGHT: NICHD-SS-00-002
National Institute of Child Health and Human Development
(http://www.nichd.nih.gov/about/org/od/oam/)
The NICHD is planning to award a contract to determine the feasibility of
conducting a randomized efficacy trial of the integration of injury
prevention intervention (on the provider and system levels) into routine
pediatric health care provided by community delivery sites. The purpose of
this notice is to solicit potential contractual sources for the feasibility
study that meet the research, organizational, and experience requirements to
perform the work.
Background
Unintentional injuries are a leading cause of preventable death among United
States children. Medical visits related to preventable, nonfatal injuries
occur for approximately 25 percent of children (by age three years),
including 14.7 percent annually (in ages one to four years). These injuries
cause a high rate of child morbidity, including surgery, bed restriction
and/or loss of activity for one or more days. Community interventions for
household safety to prevent these injuries have made progress in raising the
awareness of parents, but these attempts show limited or no effect on
reducing hazards or injuries. Brief injury prevention counseling by
pediatric clinicians at routine medical care visits is effective in improving
the safety practices in U.S. households with young children and some evidence
shows decreased injuries. Such counseling by pediatricians appears to be
cost-beneficial. The American Academy of Pediatrics (AAP), American Academy
of Family Physicians, and the United States Preventive Services Task Force
recommend including age-appropriate injury prevention counseling in routine
medical care of infants, children, and adolescents. However, a small
proportion of U.S. children receive injury prevention counseling from their
health care provider. The need exists for innovative interventions to reduce
personal and systems barriers that detract from the ability of providers to
deliver preventive care.
The purpose of this study is to determine the feasibility of introducing
office-based interventions compatible with current AAP guidelines, and
coordinated aids to increase and improve injury prevention guidance in
primary care. The interventions will be on the systems level [targeting
providers, caretakers of children (ages newborn to 24 months), and office
systems]. The specific aims of this research are: (1) develop a research-
primary care partnership between the Contractor and the delivery site(s) for
development, implementation, and pilot tests of office-based injury
prevention interventions and measurement of intervention impact, (2) develop
and execute system-level demonstration interventions, based on AAP guidelines
targeting parents of patients, providers, and the office system, designed to
promote the delivery of injury prevention guidance, (3) determine the
acceptability to providers, extended staff, and parents of patients of the
demonstration interventions, and (4) determine the immediate impact of the
demonstration interventions. A research-primary care partnership with the
pediatric delivery site(s) will be facilitated and maintained for the
duration of the study. Clinical and administrative staff and parents of
patients (ages newborn to 24 months) will be recruited for participation
(pediatric care providers, N = 8-12, parents of patients, N=300). Key
informant administrators and clinicians will be interviewed for the formative
work on intervention development. For the pilot intervention assessments,
parents and physicians will be exposed to one or more demonstration
interventions on the system level. They will be interviewed prior to
exposure and three weeks after exposure. The feasibility outcomes are
acceptability and immediate impact. Process evaluations to be conducted
include: (1) elements of the partnership between the site(s) and the research
staff for the duration of the study, and (2) intervention functioning during
the
pilot testing.
Expectations of Potential Contractor
In order to obtain data that will provide a foundation for the efficacy
study, the Contractor must demonstrate the ability to access a defined
community delivery site for the feasibility research that reflects the
service delivery and organization requirements for the potential efficacy
trial. Collaborations between the health services research (e.g.,
university, academic health services research centers) and health care
delivery (e.g., Independent Practice Association managed-care type groups,
staff or group Health Maintenance Organization, Managed Care Organization,
consortium of private pediatric care providers) are encouraged. The
Contractor and the delivery site(s) must have an active collaboration on
current health services and/or biobehavioral research. The site(s) should
demonstrate a strong commitment to preventive pediatric care and promoting
standardized delivery of injury prevention services through system and
resource supports. The Contractor must demonstrate the ability to implement
and pilot test, in the defined delivery site(s), demonstration interventions
on the system level that target parents of patients, pediatric clinical
staff, and the office system. In order to assure the successful conduct of
the feasibility study, the Contractor will be asked to develop a research-
primary care partnership for preventive services delivery and implementation
of the study interventions.
THIS IS NOT AN ANNOUNCEMENT OF RFP AVAILABILITY. The purpose of this
synopsis is to develop a list of potential sources with the above
qualifications to perform the work described.
Capability statements should be submitted (via mail, FAX, or E-mail) to the
following address by April 28, 2000.
Ms. Lynn Salo
Contract Specialist
Contracts Management Branch, OAM
National Institute of Child Health and Human Development
6100 Executive Boulevard, Suite 7A07, MSC 7510
Bethesda, MD 20892-7510
Telephone: 301-496-4611
FAX: 301-402-3676
E-mail: nichdcmb@mail.nih.gov