OurChild: A Health IT Solution to Reduce Minority Health Disparities

Study Overview
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Brief Summary
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Chinese American immigrant families are a fast-growing immigrant group with unmet early childhood mental health needs. The team proposes to design, build, and implement OurChild, an integrated mHealth/EHR solution to increase access to early childhood mental health knowledge and mental health services and resources for Chinese American children ages 2-6 years old and their parents in the Sunset Park Brooklyn.

Detailed Description
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The goal of this study is to reduce health disparities by designing a digital solution (OurChild) that facilitates connection and bidirectional exchange of information across the cultural, contextual, language, and setting differences that are key barriers to early childhood mental health knowledge and care access for the Chinese American community in Sunset Park, Brooklyn. The first study aim is to iteratively design, build, and test OurChild. To do this, the team will 1) collaborate with family, clinical, and community stakeholders to conduct an early childhood mental health context/needs analysis and participatory design and discovery activities; 2) build a digital library of early childhood mental health resources accessible from OurChild; and 3) pilot and assess the usability and acceptability of a beta version of OurChild in a mixed-methods, cross-sectional cohort of 12 Chinese American parents and their 2- to 6-year-old children (N=24) who receive care at the Sunset Park 7th Avenue Family Health Center; and 5) optimize the design, features, and performance to create OurChild 1.0. The second study aim is to evaluate the reach, effectiveness, adoption, implementation and maintenance of OurChild 1.0 through an implementation cohort study with 120 parent/child dyads (N=240). A mixed-methods approach using metadata collected with the OurChild app, parent-reported data from the app, EHR data, and post-implementation key informant interviews with providers and other stakeholders to determine whether use of OurChild increases referrals of young children for a mental health consultation or evaluation (Primary Aim) will be used. The secondary aims include examining whether use of OurChild increases 1) parent self-efficacy; 2) parent-provider engagement; and 3) linkage with community early childhood resources.

Official Title
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OurChild: A Health IT Solution to Reduce Minority Health Disparities

Conditions
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Mental Health

Intervention / Treatment
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* Other: OurChild mHealth Digital Platform


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Child must be 24 to 72 months old Child must have been receiving pediatric primary care at the 7th Ave FHC for at least 6 months Child must be identified as Chinese and/or preferred language is Chinese in EHR Parents must be at least 18 years old Parents must be the child's parent/legal guardian Parents must be able and willing to provide informed consent Exclusion Criteria: Siblings and parents of previously enrolled children Parents who do not have access to an iOS or Android smartphone

Ages Eligible for Study
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Minimum Age: 2 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: OurChild<br> | Other: OurChild mHealth Digital Platform<br>* The intervention being created and tested in this study is OurChild an integrated mHealth/EHR app, initially designed for the Chinese American community in Sunset Park, Brooklyn. All participants will be assigned to either beta versions undergoing development, or to version 1.0.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Number of Referrals | Change in number of referrals to NYU Langone Child Psychiatry or Developmental Pediatrics | Month 18, Month 45 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Score on Parental Self-Efficacy Scale | The General Self-Efficacy Scale is a 10-item psychometric scale that is designed to assess optimistic self-beliefs to cope with a variety of difficult demands in life. | Month 25, Month 45 | 
| Change in Amount of parent-provider engagement | Engagement defined as at least one interaction or messaging exchange between parent and provider through OurChild messaging portal | Month 18, Month 45 | 
| Change in accessing resources on App | Access to clinical and community early childhood and family services and resources; access defined as click through on resources library tab in OurChild app | Month 25, Month 45 | 
| Score on Betz Physician Confidence Scale | The Betz Scale is a collection of 11 statements describing the provider's perceived barriers to the identification and management of child mental health issues. Responses to each statement consist of Strongly Agree (0), Agree, Uncertain, Disagree, and Strongly Disagree (5). The total range of score is 0-55, with a higher score indicating higher physician confidence in assessing and treating mental health disorders. | Month 48 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Health Information Technology