Project ASPIRE: Improving Pediatric Asthma Management for Urban Families

ASPIRE 项目：改善城市家庭的小儿哮喘管理

• 批准号: 7069253
• 负责人: MARIANNE CELANO
• 金额: $ 12.41万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-01 至 2008-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7069253
• 关键词: adolescence (12-20); asthma; behavioral /social science research tag; caregivers; child rearing; clinical research; early /brief intervention /therapy; education evaluation /planning; family structure /dynamics; family therapy; health education; human subject; low socioeconomic status; middle childhood (6-11); outcomes research; patient care management; patient oriented research; stress; therapy compliance; training; urban area

DESCRIPTION (provided by applicant): Family stress has been identified as a mechanism by which low socioeconomic status may be linked to adverse asthma outcomes. Family and caregiver stress have a negative impact on children's asthma management behaviors and asthma outcomes, yet few asthma education interventions include a psychological component to assess and modify the impact of stress on asthma self-management. Given cultural variation in the experience of stress and the stigma associated with mental health problems, educational interventions with psychological components are best designed in collaboration with members of the target community, who can insure that program content and format will be responsive to their specific needs and culturally-influenced health beliefs. In collaboration with the American Lung Association - Southeast and our Community Advisory Board, we will design and pilot-test a home-based family intervention that integrates individually tailored asthma education with strategies to reduce the impact of caregiver and family stress on asthma management. The aims of this treatment development proposal are to: (1) conduct focus groups with children with persistent asthma and their parents to refine the content of the family intervention, and (2) conduct a pilot study of the family intervention, evaluating its initial efficacy, feasibility, and acceptability for 25 families receiving the family intervention as compared to 25 families receiving enhanced treatment as usual (trigger control resources and a written asthma action plan). Primary treatment outcomes include measures of asthma self-management (self-reported management, observed MDI/spacer technique, urinary cotinine to assess exposure to environmental tobacco smoke) and morbidity (number of symptom days, school days missed for asthma, and urgent health care utilization for asthma). Secondary outcomes include parent-child relationship quality, family cohesion, and caregiver stress. A secondary aim of the study is to assess the cost effectiveness of the intervention from the perspective of a health services payer. If successful, the home-based family intervention can improve the asthma management of caregivers under stress and their children. We hope that this research will result in a replicable and sustainable model that can be adopted by community-based organizations to reduce the high asthma morbidity reported for low-income children with asthma living in urban, stressful environments.

描述（由申请人提供）：家庭压力已被确定为一种机制，通过这种机制，社会经济地位可能与不良哮喘结局有关。家庭和照料者的压力对儿童的哮喘管理行为和哮喘成果产生负面影响，但是很少有哮喘教育干预措施包括评估和改变压力对哮喘自我管理的影响的心理组成部分。鉴于压力经验和与心理健康问题相关的污名的文化差异，最适合与目标社区成员合作设计的与心理成分的教育干预措施，他们可以确保计划内容和格式将对其特定需求和文化影响的健康信念做出反应。在与美国肺协会和我们的社区顾问委员会合作的情况下，我们将设计和试验基于家庭的家庭干预措施，该家庭干预将单独量身定制的哮喘教育与减少护理人员和家庭压力对哮喘管理的影响的策略相结合。该治疗发展计划的目的是：（1）与持续性哮喘的儿童及其父母进行焦点小组，以完善家庭干预的内容，以及（2）进行家庭干预的试点研究，与25个家庭干预的25家家庭的最初疗效，可行性和可接受性相比，与25个家庭相比，将其作为触发措施作为用来触发的25个家庭，以触发为基础（触发效果）（触发触发资源）（触发）（触发）（触发触发资源）。主要的治疗结果包括哮喘自我管理的措施（自我报告的管理，观察到的MDI/间隔技术，尿可替宁，以评估对环境烟草烟雾的暴露）和发病率（症状天数，哮喘的上学天数量，哮喘的上学天数以及哮喘的紧急医疗保健利用）。次要结果包括亲子关系质量，家庭凝聚力和护理人员压力。该研究的次要目的是从卫生服务付款人的角度评估干预的成本效益。如果成功的话，家庭干预可以改善压力下的护理人员哮喘管理。我们希望这项研究将导致一个可复制和可持续的模型，社区组织可以采用这种模型，以减少针对生活在城市，压力大的环境中的低收入哮喘儿童报告的高哮喘发病率。