HEALTH EDUCATION FOR HIGH RISK URBAN ASTHMATIC CHILDREN

我们建议(1)展示健康教育的成效，以 加强低收入城市少数民族哮喘的管理 有足够严重哮喘的学龄前儿童的家庭 需要住院；以及(2)检验培训的假设 父母观察、记录和评估孩子的哮喘 症状可以显著提高家庭的有效性 哮喘管理培训。共有435个家庭患有 已获准入学的7岁以下儿童 被诊断为哮喘的长老会医院将被纳入 三个治疗组：(1)对照组；(2)哮喘管理 培训；以及(3)哮喘管理培训加症状 观察和评估培训。所有三个小组都将收到 在两个月内举行三次会议：只有家长才能获得 训练。对照组将接受健康教育 与哮喘无关的节目。哮喘管理培训 以认知社会学习理论为基础，将使用建模 和主动掌握，传授管理技能，提高 自我效能。观察和评估干预适用 以亲子为单位的自我调节理论。我们 假设一项健康教育计划 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 评估儿童症状的标准，(C)增加 父母哮喘管理策略的频度和多样性 使用和(D)增加他们对儿童控制的知觉 症状。这些反过来将导致(1)减少天数 哮喘症状；(2)紧急保健服务使用减少 服务；以及(3)减少对家庭生活的干扰。数据将是 在孩子住院期间收集的，经过干预， 一年和两年。父母行为的改变将 使用我们的哮喘自我管理指数和 开发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)就诊，我们将评估 儿童出现症状的天数， 家庭生活质量，以及观察和观察的转移 从父母到年龄较大的孩子的评估技能。结果是 应适用于其他慢性病的管理 在低收入少数群体中。

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.