EFFECT OF EDUCATIONAL INTERVENTION ON ASTHMA MORBIDITY IN INNER CITY CHILDREN

哮喘发病率和死亡率，包括住院率 和急诊室的访问，在美国急剧上升， 特别是在少数民族和贫困人口中。我们的研究将 评估双语哮喘教育计划的有效性 涉及儿童、父母和医疗保健提供者， 在三家帕克兰纪念医院附属医院实施 社区初级保健诊所。哮喘儿童， 曾因下列原因住院或在急诊室就诊： 哮喘在过去五年内将被随机分配到一个 分为两组：一组接受医生治疗， 根据NIH哮喘管理指南接受教育 或参与教育项目的团体， 医生和双语护士教育者， 定期监测患儿的肺功能峰值流量。一 诊所将作为对照，患者将不接受 干预待评估的结果指标包括： 哮喘急性发作的频率，因哮喘而住院的次数 哮喘，哮喘急诊次数，药物治疗 使用由药物评分确定，哮喘严重程度， 通过"哮喘严重程度评分"和自我管理来确定 实践所有患者将在术后随访一年。 干预由哮喘引起的发病率是一个严重的问题， 我们的达拉斯市中心的人口，因为它是在其他城市地区。我们 打算解决社会和经济因素以及健康问题， 护理提供和管理问题，参与 这一人群的发病率。在我们试图确定 通过简单地教育诊所， 根据NIH哮喘管理指南， 更有可能的是，我们将看到显着的改善， 实施强化自我管理方案， 包括患者的客观肺功能监测。

Asthma morbidity and mortality, including rates of hospitalizations and emergency room visits, is rising dramatically in the US, particularly in minority, indigent populations. Our study will assess the effectiveness of a bilingual asthma education program involving children, parents and healthcare providers that will be implemented at three Parkland Memorial Hospital-affiliated Community Oriented Primary Care clinics. Asthmatic children who have been hospitalized or who have had an emergency room visit for asthma within the last five years will be randomly assigned to one of two groups: a group that receives treatment by a physician who has been educated according to the NIH Asthma Management Guidelines or a group that participates in an educational program involving the physician and a bilingual nurse educator and that incorporates regular peak flow monitoring of lung function by the child. One clinic will serve as a control where patients will receive no intervention. The outcome measures to be assessed include: frequency of asthma exacerbations, number of hospitalizations for asthma, number of emergency room visits for asthma, medication usage as determined by a medication score, asthma severity as determined by an "asthma severity score" and self-management practices. All patients will be followed for one year after the intervention. Morbidity caused by asthma is a serious problem in our Dallas inner-city population as it is in other urban areas. We intend to address the social and economic factors and the health care delivery and management issues that participate in the morbidity of this population. While we will attempt to determine if a reduction in morbidity will occur by simply educating the clinic physicians according to the NIH Asthma Management Guidelines, it is more likely that we will see significant improvement only upon implementation of an intensive self-management program that includes objective pulmonary function monitoring by the patient.