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 ( 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:

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