HEALTH EDUCATION FOR HIGH RISK URBAN ASTHMATIC CHILDREN

我们建议（1）证明健康教育的功效， 改善低收入城市少数民族哮喘的管理 有学龄前儿童的家庭， 需要住院治疗;（2）测试培训的假设 家长观察、记录和评估孩子的哮喘 症状可以显着提高家庭的有效性 哮喘管理培训。 共有435个家庭， 7岁以下的儿童， 将入组诊断为哮喘的长老会医院 三个治疗组：（1）对照组;（2）哮喘管理组 哮喘管理培训加症状 观察和评价培训。 这三个小组将收到 两个月内举行三次会议：只有父母会收到 训练 对照组进行健康教育 与哮喘无关的项目 哮喘管理培训 基于认知社会学习理论， 并主动掌握，以教授管理技能， 自我效能 观察和评价干预措施适用于 自我调节理论对亲子家庭单位的影响。 我们 假设一个健康教育项目， 症状观察和评估方面的培训将（a）增加 父母观察孩子的症状，（B）改善他们的 （c）提高对儿童症状的评估标准， 父母哮喘管理策略的频率和多样性 （d）增加他们对儿童的控制感 症状 这反过来又会导致（1）减少天数， 哮喘症状;（2）减少使用紧急医疗保健 （3）减少家庭生活的破坏。 数据将 在儿童住院期间收集，在干预后， 在一年和两年。 父母行为的改变 用我们的哮喘自我管理指数和 开发了新的量表来衡量父母的自我调节 流程. 除了获得客观记录外， 住院和急诊室（ER）访问，我们将评估 儿童出现症状的天数， 家庭生活质量，以及观察和 从父母到年龄较大的孩子的评估技能。 结果 应适用于其他慢性病的管理 低收入的少数民族。

We propose to (1) demonstrate the efficacy of health education to improve the management of asthma in low income, urban minority families with pre-school children who have asthma severe enough to require hospitalization; and (2) test the hypothesis that training parents to observe, record and evaluate their child's asthma symptoms can significantly enhance the effectiveness of family asthma management training. A total of 435 families with children less than seven years of age who have been admitted to Presbyterian Hospital with a diagnosis of asthma will be enrolled in three treatment groups: (1) control; (2) asthma management training; and (3) asthma management training plus symptom observation and evaluation training. All three groups will receive three sessions held over two months: only parents will receive training. The control group will receive a health education program unrelated to asthma. The asthma management training is based on cognitive social learning theory and will use modeling and enactive mastery to teach management skills and increase self-efficacy. The observation and evaluation intervention applies self-regulation theory to the family unit of parent and child. We hypothesize that a health education program that incorporates training in symptom observation and evaluation will (a) increase parental observation of child's symptoms, (b) improve their standards for evaluating the child's symptoms, (c) increase the frequency and diversity of asthma management strategies parents use and (d) increase their perception of control of the child's symptoms. These in turn will lead to (1) reduced days with symptoms of asthma; (2) decreased use of emergency health care services; and (3) decreased disruption of family life. Data will be collected while the child is hospitalized, after the intervention, and at one year and two years. Changes in parental behavior will be measured with our Asthma Self-Management Index and with new scales developed to measure parental self-regulation processes. In addition to obtaining objective records of hospitalization and emergency room (ER) visits, we will assess the frequency of days in which the child experiences symptoms, the quality of family life, and the transfer of observation and evaluation skills from parents to older children. The results should be applicable to the management of other chronic diseases in low income minority populations.