ASTHMA SELF-MANAGEMENT FOR ADOLESCENTS

描述(申请人摘要) 这项研究的目标是开发策略来帮助九年级和十年级 患有持续性哮喘的学生学习控制哮喘并在没有哮喘的情况下生活 对身体或社会活动的限制。青少年，特别是那些 来自少数群体的人，患病率、发病率和 因哮喘而死亡的儿童比5-12岁的儿童多，但有 解决这些问题的工作很少。哥伦比亚大学理工学院 医生和外科医生(CU)、纽约市教育委员会(BOE)和 纽约市医学与健康研究协会(MHRA) 提出一项合作来检验这样一种假设，即密集的校本 针对9年级和10年级学生的哮喘教育计划 哮喘，加上对其社区的强化哮喘教育 医生，可以改善学生的健康状况，提高生活质量， 自我调节健康行为的能力。这项研究建立在我们的 之前在纽约市的学校工作，并得到了 教育委员会的领导层。具体目标：与京东方合作 工作人员我们将测试以下方案的有效性：(1)筛查 识别9年级和10年级的哮喘学生，并评估他们的情况 哮喘得到控制；(2)对患有哮喘的学生进行强化哮喘教育 基于学校开放呼吸道和哮喘自我的持续性哮喘 由调查人员制定的管理程序；(3)继续医学 对通过社区医生治疗学生的社区医生的教育 MD/家庭伙伴关系计划由调查人员制定，并辅之以 基于NHLBI哮喘指南的密集学术详细计划 护理；(4)为每个人制定哮喘的书面管理计划 学生与家人和医生在一起；以及(5)转介缺乏能力的学生 向接受过以下培训的医生提供持续的初级医疗护理 哮喘管理。假设：我们假设患有哮喘的学生 参加这项干预的学生将有，相对于对照组的学生 组，在三个主要结果指标上有明显的改善： (1.1)减少哮喘症状出现的频率；(1.2)提高生活质量；以及 (1.3)增强哮喘的自我调节能力。我们还将检查 四个次要结果衡量标准：(2.1)限制活动的天数；(2.2) 紧急或紧急使用保健服务；(2.3)就学； (2.4)学校表现；(2.5)患有书面哮喘的学生比例 医生提供的管理计划；及(2.6) 学生吸入了由其本人开出的抗炎药 医生。

DESCRIPTION (Applicant's Abstract) The goal of this research is to develop strategies to help 9th and 10th grade students with persistent asthma learn to control their asthma and live without restrictions in physical or social activity. Adolescents, particularly those from minority groups, have a higher risk for prevalence, morbidity, and mortality due to asthma than children aged 5-12 years, yet there has been little work to address these problems. Columbia University College of Physicians & Surgeons (CU), the New York City Board of Education (BOE), and the Medical and Health Research Association of New York City, Inc. (MHRA) propose a collaboration to test the hypothesis that an intensive school-based asthma education program for 9th and 10th grade students who have persistent asthma, coupled with intensive asthma education for their community physicians, can improve the students' health status, quality of life, and ability to self-regulate their health behavior. This study builds on our previous work in New York City schools, and has the enthusiastic support of the leadership of the Board of Education. Specific aims: Working with BOE staff we will test the effectiveness of the following program: (1) screening to identify 9th and 10th grade students with asthma and assess how well their asthma is controlled; (2) intensive asthma education for students with persistent asthma based on the Open Airways for Schools and Asthma Self- Regulation programs developed by the investigators; (3) continuing medical education for the community physicians who treat the students through the MD/Family Partnership program developed by the investigators, supplemented by an intensive academic detailing program based on NHLBI guidelines for asthma care; (4) development of a written asthma management plan for asthma for each student with the family and physician; and (5) referral of students who lack continuing, primary medical care to physicians who have received training in asthma management. Hypothesis: We hypothesize that students with asthma enrolled in this intervention will have, relative to students in the control group, significantly greater improvement on three primary outcome measures: (1.1) reduced asthma symptom frequency; (1.2) improved quality of life; and (1.3) greater capacity for self-regulation of asthma. We will also examine four secondary outcome measures: (2.1) days with activity restriction; (2.2) urgent or emergency use of health care services; (2.3) school attendance; (2.4) school performance; (2.5) the proportion of students with written asthma management plans provided by their physician;and (2.6) the proportion of students who have inhaled antiinflammatory medicine prescribed by their physician.