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:  [email protected]   

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