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理解有了显著的进步，治疗哮喘的疗法也有了显著的改进，但弱势群体和少数群体仍然承受着不成比例的哮喘负担。这种现象的确切原因尚不清楚，然而，已经提出了一些因素来解释这种差异，包括哮喘易感性或哮喘严重程度的遗传差异，环境暴露的差异率，（如蟑螂、灰尘）、不同社会经济地位的患者在哮喘医疗护理的可及性和质量方面的差异以及哮喘自我管理实践不足，包括治疗依从性差人们普遍认为，这些因素相互作用，导致低收入少数群体中观察到的哮喘负担过重。霍华德大学和约翰霍普金斯大学在评估低收入非裔美国儿童和成人哮喘发病率的合作研究方面有着悠久而成功的历史。本申请借鉴了这一丰富的历史，提出这些机构和研究人员的正式合作，作为霍华德/霍普金斯减少哮喘差异中心的一部分。具体来说，本申请提出了四个研究项目，旨在合作调查与内城，非洲裔美国儿童和成人经历的哮喘负担不成比例的相关因素。该应用程序包括研究，将评估潜在的遗传因素，可能有助于在非洲裔美国人社区观察到的过度风险，以及研究提供者-患者沟通，旨在评估干预策略，以纠正这种风险。此外，霍华德/霍普金斯减少哮喘差异中心的一个基本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.