CAM use for Asthma in Low-income Black and White Adults

描述(由申请人提供)： 尽管哮喘药物治疗很出色，但低收入少数群体的哮喘患病率、发病率和死亡率仍在不成比例地增加。吸入性皮质类固醇(ICS)，哮喘治疗的基石，仍然很差。初步数据和文献回顾表明，补充和替代医学(CAM)、民间和精神实践在这一人群中很常见。有趣的是，与白人相比，黑人可能会使用独特的不同的CAM，而低收入群体可能会使用与中上层患者明显不同的CAMS。这项提案的总体目标是通过发现居住在2个城市地区之一的更具代表性的低收入白人和黑人成人中、中度和重度持续性哮喘患者的CAM、民间和精神实践，扩展狭隘地专注于患有严重哮喘的城市黑人成年人的前期工作。在目标1中，对25名白人和25名黑人进行了严格的归纳定性半结构访谈，将发现CAM的使用情况，并为新的CAM工具提供初始数据。在目标2中，ICS的使用将被客观地衡量，以更全面地描述患者的哮喘管理。在设计、实施和评估干预研究之前，这些知识是必要的。

DESCRIPTION (provided by applicant): Asthma prevalence, morbidity and mortality are disproportionately increasing in low-income minorities despite excellent asthma pharmacotherapy. Inhaled corticosteroids (ICS), the cornerstone of asthma therapy, remain poor. Preliminary data and literature reviews suggest that complementary and alternative medicine (CAM), folk and spiritual practices are common in this population. Interestingly, Blacks may use uniquely different CAMs as compared to Whites and low-income groups may use distinctly different CAMS than middle- and upper class patients. The overall aim of this proposal is to extend the preliminary work, which narrowly focused on urban Black adults with severe asthma by discovering the CAM, folk and spiritual practices of a more representative sample of low-income White and Black adults with mid-,moderate- and severe-persistent asthma, residing in 1 of 2 urban areas. In Aim 1, a rigorous inductive qualitative semistructured interview of 25 Whites and 25 Blacks will discover CAM use and provide the initial data for a new CAM tool. In Aim 2, ICS use will be objectively measured to more comprehensively characterize patients' asthma management. This knowledge is necessary before interventional studies can be designed, implemented and evaluated.