Coping with Asthma through Life Management (CALM)

通过生活管理 (CALM) 应对哮喘

• 批准号: 10491368
• 负责人: Isaretta Riley
• 金额: $ 16.2万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-20 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10491368
• 关键词: Accident and Emergency department; Address; Adherence; Adult; Asthma; Behavior; Biometry; Biostatistical Methods; Black Populations; Black race; Caregiver Burden; Chronic stress; Clinical; Clinical Psychology; Cognitive; Cohort Studies; Communities; Coping Skills; Cross-Sectional Studies; Death Rate; Doctor of Philosophy; Economics; Effectiveness; Enrollment; Ensure; Feasibility Studies; Focus Groups; Foundations; Funding; General Population; Health; Health behavior; Health system; Hospitalization; Individual; Intervention; Jackson Heart Study; Life; Mentors; Mentorship; Minor; Modeling; Morbidity - disease rate; Narration; National Heart, Lung, and Blood Institute; Occupations; Oral; Outcome; Participant; Patients; Personal Satisfaction; Persons; Problem Solving; Protocols documentation; Provider; Psychosocial Influences; Psychosocial Stress; Qualitative Methods; Quality of life; Randomized; Randomized Controlled Trials; Reporting; Research; Resources; Self Management; Severities; Source; Steroids; Stimulus; Stress; Stress and Coping; Techniques; Testing; Time; Waiting Lists; Withdrawal; acceptability and feasibility; adherence rate; asthma exacerbation; base; black men; black women; career; clinical practice; cohort; coping; design; effective intervention; experience; health disparity; hospitalization rates; improved; innovation; medication compliance; medication nonadherence; mortality; novel; perceived discrimination; pilot test; prevent; programs; psychosocial; public health relevance; skills training; social; stress management; stress state; stressor; theories; therapy design

Project Summary/Abstract: Stress is a key barrier to asthma medication adherence and asthma control. The Lazarus Folkman's Model of Stress states that a person experiences stress when a stimulus, appraised as exceeding their resources, endangers their well-being. In my preliminary focus groups, Black adults with asthma reported that increased psychosocial stress (e.g., perceived discrimination, job stress, caregiver burden), health-related stress (e.g., difficulty self-managing asthma), and economic stress (e.g., economic strain) were barriers to asthma medication adherence and control. However, interventions simultaneously targeting these stressors are not commonly evaluated in Black adults with asthma. To fill this evidence gap, I will identify types of minor stress, chronic stress, and coping strategies associated with increased asthma severity in a NHLBI-funded cohort (i.e., Jackson Heart Study) of Black adults (Aim 1). I will then use these findings to develop and culturally tailor a novel stress management intervention, called CALM (Coping with Asthma through Life Management) (Aim 2), and pilot its implementation in a health system (Aim 3). CALM will be an innovative, culturally-adapted, stress management intervention designed to promote adaptive coping by targeting 3 common sources of stress in Black adults with asthma—psychosocial issues, poor asthma self-management, and economic strain—with the aim of managing the effects of stress and ultimately improving asthma medication adherence and asthma control. My central hypothesis is that CALM, targeting multiple sources of stress specifically faced by Black adults with asthma, will be feasibly implemented in a health system, will be acceptable to program participants, and will provide a potentially effective intervention to increase asthma medication nonadherence and asthma control. The proposed research will be conducted under the mentorship of Dr. L. Ebony Boulware, MD, MPH (primary mentor, health disparities, qualitative methods), Dr. Loretta G. Que, MD (co-primary mentor, asthma research), Dr. Laura Porter, PhD (co-mentor, clinical psychology, health behavior), Dr. Christopher E. Cox, MD, MPH (collaborator, coping skills training), and Dr. Maren Olsen, PhD (collaborator, biostatistics). By accomplishing the research aims, I will yield a finalized CALM intervention that will be ready for a randomized controlled trial and will serve as foundation for an independent research career in asthma health disparities.

项目概要/摘要： 压力是哮喘药物依从性和哮喘控制的关键障碍。Lazarus Folkman模型 压力状态，一个人的经验，当一个刺激，评估为超过他们的资源， 危及他们的健康在我的初步焦点小组中，患有哮喘的黑人成年人报告说， 心理社会压力（例如，感知歧视、工作压力、照顾者负担），与健康有关的压力（例如， 难以自我管理哮喘），和经济压力（例如，经济压力）是哮喘的障碍 药物治疗和控制。然而，同时针对这些压力源的干预措施并不 通常在患有哮喘的黑人成人中进行评估。为了填补这一证据空白，我将确定轻微压力的类型， 慢性压力，以及与NHLBI资助的队列中哮喘严重程度增加相关的应对策略（即， 杰克逊心脏研究）的黑人成年人（目的1）。然后，我将利用这些发现来开发和文化定制一个 新的压力管理干预，称为CALM（通过生活管理应对哮喘）（目标2）， 并在卫生系统中试行（目标3）。CALM将是一个创新的，适应文化的，强调 管理干预，旨在促进适应性应对，针对3个常见的压力源， 患有哮喘的黑人成年人-心理社会问题，哮喘自我管理不良和经济紧张- 目的是管理压力的影响，并最终改善哮喘药物依从性和哮喘 控制我的中心假设是，冷静，针对多种来源的压力，特别是面临的黑色 成年哮喘患者，将在卫生系统中切实可行，将被项目参与者所接受， 并将提供潜在的有效干预，以增加哮喘药物不依从性和哮喘 控制这项研究将在L博士的指导下进行。Ebony Boulware，医学博士，公共卫生硕士 （主要导师，健康差距，定性方法），博士洛雷塔G。Que，医学博士（共同主要导师，哮喘 研究），博士劳拉波特，博士（共同导师，临床心理学，健康行为），博士克里斯托弗E。考克斯， 医学博士，公共卫生硕士（合作者，应对技能培训）和Maren Olsen博士（合作者，生物统计学）。通过 完成研究目标，我将产生一个最终的冷静干预，将准备随机 对照试验，并将作为一个独立的研究职业生涯在哮喘健康差距的基础。