FORWARD-COVID 19 Supplement

FORWARD-COVID 19 补充资料

• 批准号: 10189267
• 负责人: Ruchi S Gupta
• 金额: $ 25.34万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-15 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10189267
• 关键词: Accident and Emergency department; Adherence; Adult; Advocacy; Affect; Allergens; Allergic Reaction; American; Americas; Anaphylaxis; Anxiety; Asians; Asthma; Behavior; Biological Assay; Businesses; COVID-19; COVID-19 pandemic; Caregivers; Caring; Child; Child Care; Childhood; Clinic; Clinic Visits; Clinical; Data; Decision Making; Diagnosis; Disease Management; Eczema; Education; Emergency Care; Emergency department visit; Emergency medical service; Enrollment; Epinephrine; Family; Food; Food Hypersensitivity; Foundations; Future; Goals; Guidelines; Health; Health Policy; Healthcare; Hispanics; Home environment; Household; Hypersensitivity; Impairment; Individual; Knowledge; Laboratories; Life; Literature; Measures; Medical; Methodology; Methods; Movement; Outcome; Parents; Patient Self-Report; Patients; Pattern; Pharmaceutical Preparations; Phenotype; Population; Practice Management; Prevalence; Prospective Studies; Public Health; Publishing; Quality of life; Reporting; Research; Resources; Sampling; Schools; Severities; Site; Social Distance; Survey Methodology; Surveys; Techniques; Telemedicine; United States; Universities; Visit; base; bullying; burden of illness; cohort; comorbidity; cost; data registry; design; editorial; experience; food environment; health care service utilization; medical schools; pandemic disease; pathogenic virus; patient population; patient registry; peer; prevent; psychosocial; public health intervention; racial difference; racial disparity; racial diversity; response; sample collection; treatment optimization

PROJECT SUMMARY/ABSTRACT Background: Food allergy (FA) is a potentially life-threatening condition that affects an estimated 8% of children in the United States. Although differences between Black and White children in the prevalence and severity of other atopic conditions such as asthma and eczema have been well described, little is known about such differences in FA. The limited existing literature indicates that Black children may have worse clinical outcomes, including rates of FA-related fatal anaphylaxis and FA-related emergency department (ED) visits, than their White peers. Phenotypic and endotypic differences, including rates of sensitization and co- morbidities, between Black and White children are beginning to be examined. Data on racial differences in FA management practices are incomplete; preliminary data suggest that Black families spend significantly less on allergen-free foods and FA medications than do White families. Families caring for children with FA experience significant impairments in psychosocial outcomes, including FA-related quality of life (FAQoL); however, these data come primarily from White, privately insured families, and little is known about psychosocial outcomes in Black families. Two recent reviews concluded that existing studies examining racial disparities in FA are far too methodologically limited to draw definitive conclusions, primarily due to reliance on self-report of FA diagnosis and cross-sectional designs. Specific Aims and Methods: Our goal is to prospectively study a cohort of 800 Black and White children (0- 12 years) with FA in order to: 1) Determine variability in clinical FA outcomes between Black and White patients via quarterly online assessments, annual clinic visits, and medical chart review over a two-year period; 2) Examine phenotypic and endotypic differences between Black and White children with FA using specific laboratory specimen collection techniques and assays; 3) Identify differences between Black and White children in FA management practices by parent report (e.g. allergen avoidance and epinephrine carriage); and 4) Determine differences between Black and White children in psychosocial FA-related outcomes (e.g., FA-related quality of life, bullying, anxiety, and worry) via the above survey methods. Hypotheses and Expected Results: We hypothesize that compared to White children, Black children will: have higher rates of food-allergic reactions and FA-related healthcare utilization; demonstrate unique FA phenotypes and endotypes; have less knowledge of FA management and less adherence to preventative behaviors; have limited access to medications and allergen-free foods; and report better quality of life. Significance and Effects on Other Research: Confirming and further characterizing differences between Black and White children with FA will provide the data required to develop clinical guidelines, optimize treatment, and build health policies that meet the needs of both Black and White children.

项目概要/摘要 背景：食物过敏 (FA) 是一种可能危及生命的疾病，影响估计 8% 的人 在美国的孩子们。尽管黑人和白人儿童在患病率和 哮喘和湿疹等其他特应性疾病的严重程度已得到充分描述，但人们知之甚少 FA 的这种差异。有限的现有文献表明黑人儿童的临床症状可能更差 结果，包括与 FA 相关的致命过敏反应和与 FA 相关的急诊科 (ED) 就诊率， 比他们的白人同龄人表型和内型差异，包括致敏率和协同率 黑人和白人儿童之间的发病率正在开始受到检查。 FA 中种族差异的数据 管理规范不完善；初步数据表明，黑人家庭在以下方面的支出明显减少 与白人家庭相比，他们使用不含过敏原的食品和 FA 药物。照顾具有 FA 经验的儿童的家庭 心理社会结果显着受损，包括 FA 相关的生活质量 (FAQoL)；然而，这些 数据主要来自白人、私人保险家庭，人们对心理社会结果知之甚少。 黑人家庭。最近的两项评论得出的结论是，现有的研究 FA 种族差异的研究太过分了。 方法论上仅限于得出明确的结论，主要是由于 FA 诊断的自我报告的依赖 和横截面设计。 具体目标和方法：我们的目标是前瞻性研究 800 名黑人和白人儿童（0- 12 年）与 FA 合作，以便：1）确定黑人和白人之间临床 FA 结果的变异性 通过两年内的季度在线评估、年度门诊就诊和病历审查对患者进行评估； 2) 使用特定的方法检查患有 FA 的黑人和白人儿童之间的表型和内型差异 实验室标本采集技术和化验； 3）识别黑人和白人之间的差异 家长报告中儿童的 FA 管理实践（例如避免过敏原和携带肾上腺素）； 4) 确定黑人和白人儿童在 FA 相关社会心理结果方面的差异 （例如，与 FA 相关的生活质量、欺凌、焦虑和担忧）通过上述调查方法进行。 假设和预期结果：我们假设与白人儿童相比，黑人儿童将： 食物过敏反应和 FA 相关医疗保健利用率较高；展示独特的FA 表型和内型；对 FA 管理的了解较少，对预防措施的遵守程度较低 行为；获得药物和无过敏原食品的机会有限；并报告更好的生活质量。 对其他研究的意义和影响：确认并进一步表征差异 患有 FA 的黑人和白人儿童将提供制定临床指南所需的数据， 优化治疗并制定满足黑人和白人儿童需求的卫生政策。