Howard/Hopkins Center for Reducing Asthma Disparities

描述(由申请人提供)： 尽管我们对哮喘的病理生理学的了解取得了重大进展，治疗哮喘的治疗方法也有了显著的改进，但弱势群体和少数群体仍然背负着不成比例的哮喘负担。造成这一现象的确切原因尚不清楚，但已提出若干因素来解释这一差异，包括易患哮喘或哮喘严重程度的遗传差异、环境暴露(如蟑螂、粉尘)的不同比率、不同社会经济地位患者获得哮喘医疗服务的机会和质量的差异以及哮喘自我管理做法不足，包括对治疗的依从性较差。人们普遍认为，这些因素相互作用，导致在低收入少数群体中观察到哮喘负担过重。霍华德大学和约翰霍普金斯大学在合作研究方面有着悠久而成功的历史，这些研究旨在评估低收入非裔美国儿童和成人哮喘的发病率。这项申请利用这一丰富的历史，建议这些机构和研究人员正式合作，作为霍华德/霍普金斯中心减少哮喘差异的一部分。具体地说，该申请提出了四个研究项目，旨在合作调查与市中心、非裔美国儿童和成年人经历的哮喘负担不成比例相关的因素。这项应用包括评估可能导致非裔美国人社区观察到的过度风险的潜在遗传因素的研究，以及旨在评估补救这种风险的干预策略的提供者-患者沟通研究。此外，霍华德/霍普金斯中心减少哮喘差异的一个重要目标是创造一个真正互惠的文化敏感的培训环境，旨在丰富和提高两个参与机构的研究潜力和哮喘管理能力。

DESCRIPTION (provided by applicant): Despite significant advances in our understanding of the pathophysiology of asthma and marked improvements in the therapies available to treat asthma, disadvantaged and minority communities still carry a disproportionate burden from asthma. The exact reasons for this phenomenon are unknown, however, a number of factors have been proposed to account for this disparity, including genetic differences in vulnerability to asthma or asthma severity, differential rates of environmental exposure (e.g. cockroaches, dust), differences in the accessibility and quality of asthma medical care for patients of differing socioeconomic status, and inadequate asthma self-management practices, including poor adherence with therapy. It is widely believed that these factors interact to cause the observed excess burden of asthma within low-income, minority populations. Howard University and Johns Hopkins University have a long and successful history of collaborative studies designed to evaluate asthma morbidity in low-income, African-American children and adults with asthma. This application draws on this rich history to propose the formal collaboration of these institutions and investigators as a part of the Howard/Hopkins Center for Reducing Asthma Disparities. Specifically, this application presents four research projects designed to collaboratively investigate factors associated with the disproportionate burden of asthma experienced by inner-city, African-American children and adults. This application includes studies that will evaluate both the underlying genetic factors that may contribute to the observed excess risk in African-American communities, as well as studies of provider-patient communication designed to assess intervention strategies for remediating this risk. In addition, an essential goal of the Howard/Hopkins Center for Reducing Asthma Disparities will be to create a culturally sensitive training environment that is truly reciprocal, and designed to both enrich and enhance the research potential and asthma management capabilities of both participating institutions.