SCHOOL-BASED ASTHMA INTERVENTION PROGRAM

虽然已有经过验证的儿童哮喘管理指南， 低收入贫困人群哮喘的有效干预 获得医疗保健的机会和哮喘教育不足。目标 该提案的目的是确定标准化的哮喘干预措施 学校的项目减少哮喘发病率，如果进行医疗干预 (药物治疗)结合教育-行为干预是 这比单纯的医疗干预要好。在七所小学 为以西班牙裔为主的低收入家庭的儿童提供服务，180(5-8 一岁)哮喘儿童将被识别并随机分成两组 将比较医疗干预措施的小组(每组60名儿童) 到医疗干预加上教育行为干预 交叉设计，并与历史对照组进行比较(60 儿童)接受目前可用的社区治疗。这个 评估和干预将在学校使用移动电话进行 保健车。干预措施的期限为12个月，他们的 短期和遗留影响将通过哮喘的测量来评估。 相关发病率(住院次数、急诊室就诊次数、缺席天数 学校)、生活质量、肺活量和高峰流量变异性、生长和 坚持养生法。结果变量和结果变量之间的关系 此外，还将研究社会人口统计学和环境因素。使用 这种方法我们将确定校本医疗和教育是否- 行为干预计划是减少哮喘的有效手段 低收入儿童的发病率和入学率有所提高， 医疗服务不足的家庭。

While validated guidelines exist for the management of childhood asthma, effective asthma intervention in low-income populations suffers from poor access to the health care and inadequate asthma education. The objectives of this proposal are to determine if a standardized asthma intervention program at school reduces asthma morbidity and if medical intervention (drug therapy) combined with educational-behavioral intervention is superior to medical intervention alone. In seven elementary schools serving children of predominantly Hispanic, low-income families, 180 (5-8 year old) children with asthma will be identified and randomized into two groups (60 children each) in which medical intervention will be compared to medical intervention plus educational-behavioral intervention in a cross-over design, and compared with a historical control group (60 children) receiving currently available community treatment. The evaluations and interventions will take place at school using a mobile health van. The duration of the interventions will be 12 months and their short-term and carry-over effects will be assessed by measures of asthma related morbidity (number of hospitalizations, ER visits, days absent from school), quality of life, spirometry and peak-flow variability, growth and regimen adherence. The relationship between outcome variables and sociodemographics and environmental factors will also be examined. With this approach we will determine if school-based medical and educational- behavioral intervention programs are an effective means of reducing asthma morbidity in and improving school attendance of children of low-income, medically under-served families.