Adult Asthma: Biology, Society and Environment

描述（由申请人提供）：环境、生物和 心理社会因素都可以单独影响哮喘的疾病负担。 到目前为止，还没有研究考虑到所有三类因素 一起来检查它们对疾病负担的相对贡献， 调查其累积效应是否可以解释健康差异 增加或协同作用。哮喘是一种 理想的慢性疾病，其中描绘的潜在联系， 生物机制、社会因素和物理环境等 具体而言，以显示这些联系如何可能导致健康差距。研究 假设：（1）社会经济地位（SES）的差异， 哮喘的疾病负担; 2）环境、生物和心理社会 因素与哮喘疾病负担有相加性联系，如果不是， 协同作用; 3）疾病负担的SES差异的方差 将通过采用特定环境， 生物学和心理社会学因素。方法：本研究 将利用一个由590名成年哮喘患者组成的小组， 严重性。我们建议进行500次家庭实地访问，以补充这些调查数据 我们将直接收集环境、生物和社会心理方面的信息， 数据我们将量化的具体环境风险因素包括： 致敏、家庭过敏原、ETS暴露和室内空气质量。我们将 也评估感受到的压力和社会支持。此外，我们将链接 受试者通过外部数据集暴露于其他潜在风险。我们还将 管理一项后续调查，以调查以下因素的综合影响： 环境、生物和社会心理暴露对SES的解释 哮喘疾病负担的差异。这项研究结合了A 具有临床医学专业知识的多学科研究人员团队， 社会科学、流行病学、心理学、内分泌学、哮喘治疗和 预防和生物统计学。预期结果和意义： 拟议的调查将有足够的权力，以发现差异， 两组之间的结果比例在10 - 15%的范围内， 0.05二分结果的水平。该项目涉及一项重大研究 需要并可以成为制定公共政策的基础， 环境相关的和其他健康差异在成人哮喘。

DESCRIPTION (provided by applicant): Environmental, biological, and psychosocial factors can all separately influence the disease burden in asthma. As yet, no studies have taken into account all three categories of factors together, to examine their relative contributions to the disease burden and investigate whether their cumulative effects can explain the health disparities of at-risk populations, either additively or synergistically. Asthma is an ideal chronic condition in which to delineate the potential linkages among biological mechanisms, social factors, and physical environments and, more specifically, to show how these linkages may lead to health disparities. Study Hypotheses: 1) There are socioeconomic status (SES) differentials in the disease burden of asthma; 2) Environmental, biological, and psychosocial factors are linked to the asthma disease burden additively, if not synergistically; and 3) The variance in SES differentials of disease burden will be substantially explained by modeling that takes specific environmental, biological, and psychosocial factors into account. Methods: This proposed study will make use of an established panel of 590 adults with asthma of varying severity. We propose to supplement these survey data with 500 home site visits in which we will directly gather environmental, biological, and psychosocial data. Specific environmental risk factors we will quantify include: allergen sensitization, home allergens, ETS exposure, and indoor air quality. We will also assess perceived stress and social support. In addition, we will link subjects to other potential exposures through external data sets. We will also administer a follow-up survey to investigate the combined influence of environmental, biological, and psychosocial exposures in explaining SES disparities in the disease burden of asthma. This study combines a multidisciplinary team of researchers with expertise in clinical medicine, social sciences, epidemiology, psychology, endocrinology, asthma treatment and prevention, and biostatistics. Anticipated Results and Significance: The proposed investigation will have sufficient power to detect differences in the proportions of outcomes between two groups in the range of 10-15 percent at the 0.05 level for dichotomous outcomes. This project addresses a major research need and can be a basis for the development of public policies to address environmentally related and other health disparities in adult asthma.