Adult Asthma: Biology, Society and Environment

描述(由申请人提供)：环境、生物和 心理社会因素均可分别影响哮喘患者的疾病负担。 到目前为止，还没有研究考虑到所有这三类因素 共同检查它们对疾病负担的相对贡献，并 调查它们的累积效应是否可以解释健康差异 高危人群的风险，无论是相加还是协同作用。哮喘是一种 描述潜在联系的理想慢性状态 生物机制、社会因素和物理环境等 具体地说，是为了表明这些联系可能如何导致健康差距。学习 假设：1)在社会经济地位(SES)方面， 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是相加的，如果不是的话 协同作用；以及3)疾病负担的SES差异 将通过采用特定环境的建模来解释 生物、心理和社会因素都被考虑在内。方法：这项拟议的研究 将利用一个由590名患有不同类型哮喘的成年人组成的现有小组 严肃性。我们建议通过访问500个家庭站点来补充这些调查数据 我们将直接收集环境、生物和心理社会方面的信息 数据。我们将量化的具体环境风险因素包括：过敏原 致敏、家庭过敏原、ETS暴露和室内空气质量。我们会 也要评估感受到的压力和社会支持。此外，我们还将链接 受试者通过外部数据集接触到其他潜在的风险。我们还将 管理后续调查，以调查以下各项的综合影响 环境、生物和心理社会暴露在解释SES中的作用 在哮喘的疾病负担方面存在差异。这项研究结合了一个 拥有临床医学专业知识的多学科研究团队， 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。预期成果和意义： 拟议的调查将有足够的权力发现 两组之间的结果比例在10%-15%的范围内 二分结果的0.05水平。这个项目涉及一项重要的研究 需要并可以成为制定公共政策的基础，以解决 成人哮喘中与环境和其他健康相关的差异。

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.