WHAT FAMILY PROCESSES AFFECT CHILDHOOD ASTHMA OUTCOME?

这项由NHLBI （1-R01-HL53391）资助的纵向研究的中心目的是阐明特定家庭过程对3组7-12岁哮喘儿童的依从性行为和治疗结果可能起到保护或有害作用的程度和机制：80名儿童参加儿童哮喘管理项目（CAMP）丹佛站点，80名儿童在一个大型的、最先进的健康维护组织接受哮喘相关护理，60名儿童通过使用学校记录来确定在各种不同的卫生保健系统中接受治疗的哮喘儿童。三个主要的具体目标是：(1)检查家庭过程变量与哮喘治疗依从性的横截面相关性和纵向影响程度，以及三个地点（临床试验样本、管理护理样本和社区治疗样本）之间这种关系的一致性；(2)检验家庭过程变量与哮喘治疗结果的横断面相关和纵向影响程度，以及这种关系在三个地点之间的一致性；(3)确定治疗依从性是否介导特定家庭过程与哮喘治疗结果之间的关系，以及这种关系在三个位点之间的一致性。

The central aim of this longitudinal study, funded by the NHLBI (1-R01-HL53391) is to clarify the extent to which and the mechanisms whereby specific family processes may be protective or deleterious to adherence behaviors and treatment outcome in 3 groups of asthmatic children, aged 7-12 years: 80 children participating in the Denver site of the Childhood Asthma Management Program (CAMP), 80 children receiving asthma-related care in a large, state-of-the-art, health maintenance organization, and 60 children recruited by using school records to identify children with asthma receiving their care in a variety of different health care systems. The three primary specific aims are: (1) to examine the extent to which family process variables are cross-sectionally associated with and longitudinally influence adherence to asthma treatment, as well as the consistency of this relationship across the three sites - a clinical trial sample, a managed care sample, and a community treatment sample; (2) to examine the extent to which family process variables are cross-sectionally associated with and longitudinally influence asthma treatment outcome, as well as the consistency of this relationship across the three sites; (3) to determine whether adherence with treatment mediates the relationship between specific family processes and asthma treatment outcome, as well as the consistency of this relationship across the three sites.