NATIONAL COOPERATIVE INNER CITY ASTHMA STUDY

全国合作的内城哮喘研究是一个多中心的项目， 在#年进行了随机对照临床干预试验 患有哮喘的儿童。这项研究旨在确定 初级保健、以临床为基础的干预措施(哮喘顾问、医生 教育和控制)。 在纽约市，来自市中心地区的150名4至12岁的儿童 有中到重度哮喘症状或正在服用慢性药物 在过去的一年里，将有资格接受调查。主要 护理诊所将随机分为3个干预组和 这些诊所的儿童将接受为期3年的随访(每年3次)。 在登记参加试验后。哮喘咨询师的干预将 持续3年，并包括减少环境污染的模块 (过敏原、二氧化氮、环境烟草烟雾、霉菌)和 与哮喘相关的心理社会风险，增加依从性和 提高哮喘管理技能。浅谈医生教育干预 将包括每年两次关于哮喘管理的正式会议，为期两次 多年来，对其管理实践的反馈每年3次。一个 将进行观测研究，以评估环境空气的关系 污染到哮喘症状。一项子研究将评估 用指示灯代替炉子减少室内二氧化氮 有自动点火灯的。 对对照组和干预组的症状进行跟踪调查的方法是 每两个月打一次电话。这些小组将在以下方面进行比较 症状天数。此外，还将就以下方面进行比较： 利用率(计划外就诊、住院)、依从性、质量 与哮喘相关的生活、医生知识和哮喘护理质量 行为技能和室内外环境暴露。

The National Cooperative Inner City Asthma Study is a multicenter, controlled, randomized clinical intervention trial carried out in children with asthma. The study is designed to determine the impact of primary care, clinic-based interventions (asthma counselors, physician education, and control) on symptom days. In New York City, 150 children, 4 to 12 years, from inner city areas, who have moderate to severe asthma with symptoms or on chronic medications during the past year, will be eligible for the investigation. Primary care clinics will be randomized into the 3 intervention groups and the children in these clinics will be followed for 3 years (3 visits/year) after enrollment into the trial. The asthma counselor intervention will be ongoing for 3 years and include modules to reduce environmental (allergens, nitrogen dioxide, environmental tobacco smoke, molds) and psychosocial risks associated with asthma, to increase adherence and to improve asthma management skills. The physician education intervention will consist of 2 formal sessions on asthma management per year for 2 years with feedback on their management practices 3 times per year. An observational study will be done to assess the relation of ambient air pollution to asthma symptoms. A substudy will evaluate the effect of reducing indoor nitrogen dioxide by replacing stoves with pilot lights with ones with auto-ignition lights. Follow-up of symptoms in control and intervention groups will be done by telephone every 2 months. The groups will be compared with respect to symptom days. In addition, comparisons will be made with respect to utilization (unscheduled visits, hospitalizations), adherence, quality of life, physician knowledge and quality of asthma care, asthma-related behavior skills and indoor and outdoor environmental exposures.