SCHOOL-BASED ASTHMA INTERVENTION PROGRAM

虽然存在有效的儿童哮喘管理指南， 对低收入人群进行有效的哮喘干预 获得医疗保健和哮喘教育不足。目标 是为了确定标准化的哮喘干预措施 学校的项目减少哮喘发病率，如果医疗干预 (drug治疗）结合教育行为干预， 上级单纯的医疗干预。 在七所小学 为主要是西班牙裔，低收入家庭的儿童提供服务，180（5-8 将确定患有哮喘的儿童，并随机分为两组 将比较医疗干预的两组（每组60名儿童） 医疗干预加上教育行为干预， 交叉设计，并与历史对照组（60 儿童）接受目前可用的社区治疗。的 评估和干预将在学校使用移动的 卫生货车。干预措施为期12个月， 将通过哮喘指标评估短期和遗留效应 相关发病率（住院次数、急诊就诊次数、缺席天数） 学校），生活质量，肺功能测定和峰流量变异性，生长和 方案依从性。 结果变量与 社会人口和环境因素也将得到审查。与 这种方法，我们将确定是否以学校为基础的医疗和教育- 行为干预计划是减少哮喘的有效手段 提高低收入家庭儿童的入学率， 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.