Asthma Communication & Adherence In Inner-City Children

描述(由申请人提供)： 在市中心的非裔美国儿童中，与哮喘相关的发病率和死亡率高得不成比例。非洲裔美国人和贫困儿童的急诊室使用率、住院率更高，生活质量下降，患致命哮喘的风险增加。研究表明，非裔美国儿童接受基于指南的护理的可能性较小，这可能是他们发病率增加的原因。关于哮喘的家庭-医生沟通不足，包括症状严重程度、处方方案、孩子正在使用的其他药物以及疾病管理的心理社会障碍，可能会导致哮喘管理较差。对成年人的研究已经将医患沟通与各种健康结果联系起来，包括症状缓解、功能状态、生理措施和疼痛控制，以及对医疗信息的回忆和理解。此外，对成年人的研究表明，更好的沟通会带来更好的患者依从性。然而，这种关系还没有得到用药依从性的客观衡量标准的证实。此外，很少有研究探讨家庭-医生沟通与儿童健康结果的关系，特别是在市中心患有哮喘的儿童中。一项专注于提高医生哮喘沟通技能的干预研究发现，改善沟通导致医生更多地遵守基于指南的哮喘管理，并对儿童的卫生保健利用产生适度影响。研究人员没有评估改善沟通对哮喘家庭管理的影响。因此，此应用程序的目的是开发儿科哮喘沟通工具(PACT)，并对PACT作为以照顾者为中心的沟通干预的一部分的效用进行试点研究，以改善家庭与医生的沟通和随后的哮喘药物依从性。(摘要结束)

DESCRIPTION (provided by applicant): Asthma-related morbidity and mortality are disproportionately high among inner-city African-American children. African-American and poor children have higher rates of emergency department use, hospitalization, decreased quality of life, and increased risk of fatal asthma. Research has shown that African-American children are less likely to receive guideline-base care, which may account for their increased morbidity. Inadequate family-physician communication about asthma, including symptom severity, the prescribed regimen, other medications the child is using and psychosocial barriers to illness management may contribute to poorer asthma management. Research with adults has linked physician patient communication to a variety of health outcomes, including symptom resolution, functional status, physiologic measures and pain control, and recall and understanding of medical information. Furthermore, research with adults suggests that improved communication results in better patient adherence. However, this relationship has not been corroborated using objective measures of medication adherence. Moreover, little research has been conducted examining the relationship between family-physician communication and children's health outcomes, particularly in inner-city children with asthma. One intervention study that focused on improving physicians' asthma communication skills found that improved communication resulted in physicians increased adherence to guideline-based asthma management and had a moderate impact on the child's health care utilization. The researchers did not assess the impact of improved communication on family management of asthma. Thus, the purpose of this application is to develop a pediatric asthma communication tool (PACT) and conduct a pilot study of the utility of the PACT as part of a caregiver-focused communication intervention to improve family-physician communication and subsequent asthma medication adherence. (End of Abstract)