Delivering Geospatial Intelligence to Health Care Providers

Study Overview
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Brief Summary
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Physician counseling for physical activity, dental services, and academic support services such as tutoring could be improved through physician knowledge of local community resources and physician counseling directing patients to such services that are near the patient's residential address. This study will test the hypothesis that an electronic medical record enhanced with geographic information systems can improved physician counseling for physical activity, dental services, and academic support services by identifying services that are near the patient's residential address and informing MD's of such info at the point of care.

Official Title
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Delivering Geospatial Intelligence to Health Care Providers

Conditions
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Overweight

Intervention / Treatment
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* Other: CHICA GIS (enhanced electronic medical record)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Referrals to three community resources will be studied: dentists (children older than 1 year), after school tutoring services (children older than 7 years), and physical education programs (children older than 5 years). Exclusion Criteria: Inability of parent to complete data collection instruments spoken (via telephone survey) or written in English or Spanish. Inability to participate in community based physical activity programs due to health related condition

Ages Eligible for Study
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Minimum Age: 1 Year
Maximum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: routine counseling (control group)<br>Children will receive typical counseling for obesity prevention, dental caries prevention, or school problems per routine standards for pediatrician anticipatory guidance | |
| Experimental: CHICA GIS<br>In randomly assigned experimental clinics, physicians will counsel patients to increase physical activity, seek dental care, or seek academic support services such as tutoring; this counseling will be assisted by an experimental intervention which consist of an electronic medical record that prompts specific counseling in conjunction with a geographic information system. The enhanced electronic medical record will map community resources to support physician counseling and lifestyle modification | Other: CHICA GIS (enhanced electronic medical record)<br>* An electronic medical record enhanced with geographic information systems will assist physicians in directing patients to community resources for increasing physical activity, preventing dental caries or addressing school problems<br>* Other names: CHICA GIS;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Improved physician counseling | For the intervention clinics, data gathered by CHICA-GIS on the physician worksheet and just-in-time handouts will also allow us to determine the percentage of children who received behavioral counseling about dentistry, school performance, or physical activity by the physician, as well as the percentage of children who were referred to a community resource. | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| User experience and satisfaction | Surveys will be administered at baseline and end of the trial (18 months) to the entire staff of each practice, in order to document how each practice is organized and provide detailed information about community referral processes. Staff will also be asked about their satisfaction with the CHICA system, CHICA-GIS (Intervention Clinics only), and the community referral module (Intervention Clinics only). | 24 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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obesity, overweight, dental caries, school problems, school failure, child BMI > 85th percentile, Needing dental preventive services, Needing academic support for school problems