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

描述（由申请人提供）：在过去的二十年中，美国受哮喘影响的成年人数量急剧增长，哮喘现在影响1400万成年人。对其中许多人来说，哮喘控制不足，导致严重的发病率和经济负担。我们建议的主要目标是开发和评估一种名为HomeBASE（家庭哮喘支持和教育）的家庭教育和支持干预措施的价值，以降低18-65岁低收入、种族多样化哮喘成年人的哮喘发病率。家庭干预的价值虽然在哮喘儿童中有效，理论上也很有吸引力，但尚未在成人中进行评估。具体而言，该项目将检验以下假设：社区卫生工作者提供哮喘自我管理的教育和支持、家庭环境触发因素评估、哮喘控制资源以及在一年内与医疗提供者进行有效沟通的帮助，将减少哮喘发病率、哮喘相关紧急医疗保健使用和室内哮喘触发因素暴露。将采用参与性研究方法进行随机对照试验。将招募420名参与者并随访两年。主要结果包括无哮喘天数、哮喘相关生活质量和紧急卫生服务使用。将在基线以及一年和两年后亲自收集完整数据。中期数据将通过电话访谈获得。通过访谈、家庭检查和屋尘螨过敏原分析评估哮喘触发因素的暴露。将衡量增量成本效益（每无汞日的美元数）。其他目标包括（1）确保社区参与研究设计、实施、评估和传播;（2）如果HomeBASE证明成功，则传播方案复制的协议和工具。该提案是由当地哮喘联盟金郡哮喘论坛发起和赞助的。它是通过家庭基础指导委员会成员伙伴之间现有的合作关系制定的：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出了建议。

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.