HomeBASE (Home-Based Asthma Support and Education for Adults)

描述(由申请人提供)：在过去的二十年里，美国患有哮喘的成年人的数量急剧增加，目前有1400万成年人患有哮喘。对他们中的许多人来说，对哮喘的控制不够充分，导致了大量的发病率和经济负担。我们建议的主要目标是开发和评估名为HomeBase(基于家庭的哮喘支持和教育)的家庭教育和支持干预措施的价值，以减少18-65岁的低收入、种族多元化的哮喘成年人的哮喘发病率。家庭干预的价值，虽然对哮喘儿童有效，理论上很有吸引力，但在成年人中还没有得到评估。具体地说，该项目将检验这样一种假设，即社区卫生工作者在一年的时间里提供关于哮喘自我管理的教育和支持、对家庭环境诱因的评估、用于哮喘控制的资源以及在与医疗提供者有效沟通方面的协助，将减少哮喘发病率、与哮喘相关的紧急卫生保健使用和暴露在室内哮喘诱因中。将使用参与性研究方法进行随机对照试验。420名参与者将被登记并跟踪两年。主要结果包括哮喘无症状天数、哮喘相关生活质量和紧急卫生服务使用情况。所有数据将在基线时亲自收集，并在一年和两年后收集。临时数据将通过电话访问获得。对哮喘诱因的暴露将通过访谈、家庭检查和屋尘尘埃过敏原分析来评估。将衡量增量成本效益(每无症状一天的费用)。其他目标包括(1)确保社区参与研究设计、实施、评估和传播，以及(2)如果HomeBase被证明是成功的，传播程序复制的协议和工具。这项提议是由当地哮喘联盟金县哮喘论坛发起并赞助的。它是通过家庭基地指导委员会成员合作伙伴之间现有的合作关系发展起来的，这些合作伙伴包括哮喘患者、私营部门诊所和医院、社区诊所、当地公立医院、当地卫生部门、社区组织和华盛顿大学。由哮喘患者组成的社区咨询小组就提案的制定提供了建议。

DESCRIPTION (provided by applicant): The number of adults affected by asthma in the United States has grown dramatically in the past two decades and asthma now affects 14 million adults. Control of asthma is inadequate for many of them, leading to substantial morbidity and economic burden. The primary goal of our proposal is to develop and assess the value of a home-based education and support intervention called HomeBASE (Home-Based Asthma Support and Education) for reducing asthma morbidity among low-income, ethnically diverse adults with asthma ages 18-65. The value of an in-home intervention, while effective among children with asthma and theoretically appealing, has not been assessed among adults. Specifically, the project will test the hypothesis that community health workers providing education and support for self-management of asthma, assessment of the home for environmental triggers, resources for asthma control, and assistance in effective communication with medical providers over the course of one year will reduce asthma morbidity, asthma- related urgent health care use and exposure to indoor asthma triggers. A randomized controlled trial using participatory research methods will be used. Four hundred twenty participants will be enrolled and followed for two years. Primary outcomes include asthma symptom-free days, asthma-related quality of life and urgent health service use. Full data will be collected in person at baseline, and one and two years later. Interim data will be obtained through telephone interviews. Exposure to asthma triggers will be assessed through interviews, home inspection and analysis of house dust for mite allergen. The incremental cost- effectiveness (dollars per symptom-free day) will be measured. Other aims include (1) ensuring community participation in study design, implementation, evaluation and dissemination and (2) and disseminating protocols and tools for program replication should HomeBASE prove successful. The proposal was initiated by and is sponsored by the King County Asthma Forum, the local asthma coalition. It has been developed through existing collaborative relationships among partners who are members of the HomeBASE Steering Committee: people with asthma, private sector clinics and hospitals, community clinics, the local public hospital, the local health department, community-based organizations and the University of Washington. The Community Advisory Group, consisting of people with asthma, has advised on proposal development.