Practice-based research networks (PBRN) are research laboratories where primary care providers in concert with the University departments can generate evidence that will determine best clinical practice and treatment effectiveness.
The aim of this application is to create a pediatric PBRN that will recruit and retain practices with interested practitioners to participate in clinical research focused on important problems in daily practice. The hub of the PBRN is the Children's Hospital of Pittsburgh of UPMC Health System (CHP UPMCHS). Participating practices are Children's Community Pediatrics, a subsidiary of CHP UPMCHS comprised of 68 pediatricians (serving 100,000), Pittsburgh Pediatric Associates, a closely affiliated practice (serving 12,000) and the Primary Care Center of CHP(serving 13,500 children). The size and diversity of this PBRN are ideal for the conduct of efficient studies leading to results that will be generalizable. This collaboration of community physicians and CHP UPMCHS will generate research and foster best pediatric practice within and beyond the network. The proposed pilot project will apply the core components of the Wagner chronic disease model to health promotion and disease prevention in primary care. The initial study will be aimed at increasing adherence to recommendations for the prevention of unintentional injuries, which are the most common cause of death and disability in young children. The study will be a prospective, controlled, clinical trial. The intervention will revolve around 5 safety issues: use of car restraints, presence of functional smoke detectors, appropriate tap water temperature, safe storage of hazardous materials and safe storage of guns. The study will focus on providing decision support and clinical information systems to the physicians, redesigning the health care delivery system, facilitating self-management for families and providing effective links with community resources. The purpose of the pilot is to determine the feasibility and acceptability of this model for changing behaviors of families and physicians. We will determine the differential impact, if any, on several minority populations (racial, rural, urban) and will estimate sample size and costs for a PBRN-wide study as the next step.
