Addressing Barriers to Physical Activity in Inner-City Schoolchildren with Asthma

解决内城区哮喘学童体育活动的障碍

• 批准号: 7950436
• 负责人: Marina Reznik
• 金额: $ 13.31万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-16 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7950436
• 关键词: Absenteeism; Accident and Emergency department; Acute; Address; Adoption; Advisory Committees; African American; Age; Area; Asthma; Attitude; Behavior Therapy; Behavioral; Body mass index; Breathing; Caring; Child; Childhood Asthma; Chronic Disease; Clinical Investigator; Clinical Research; Clinical Trials; Collaborations; Communities; Comorbidity; Competence; Cross-Sectional Studies; Data; Disease; Education; Effectiveness; Effectiveness of Interventions; Environment; Exercise; Exercise Physiology; Experimental Designs; Feedback; Foundations; Funding; Future; Goals; Hand; Health; Health Services; Health education; Hispanics; Hospitalization; Human Resources; Intervention; Intervention Trial; Interview; Knowledge; Link; Literature; Low income; Measures; Medicine; Methodology; Minority; Morbidity - disease rate; New York; New York City; Nursing Schools; Obesity; Outcome; Outcome Measure; Overweight; Parents; Participant; Patient Self-Report; Pediatric Hospitals; Pediatrics; Phase; Physical Education; Physical activity; Pilot Projects; Prevalence; Primary Health Care; Protocols documentation; Provider; Qualitative Methods; Qualitative Research; Quality of life; Randomized Controlled Trials; Recruitment Activity; Reporting; Research; Research Methodology; Resources; Sample Size; School Nursing; School-Age Population; Schools; Self Efficacy; Severities; Site; Social support; Structure; Students; Symptoms; Target Populations; Testing; Time; Training; Underrepresented Minority; United States; Visit; Vulnerable Populations; Weight; Youth; base; behavior change; college; community based participatory research; design; elementary school; fitness; improved; inner city; medically underserved; motivated behavior; obesity prevention; professor; public health relevance; sex; skills; teacher; theories; therapy development

DESCRIPTION (provided by applicant): The candidate, Marina Reznik, MD, MS is an Assistant Professor of Pediatrics at the Albert Einstein College of Medicine (Einstein), Children's Hospital at Montefiore (CHAM). Her long-term goal is to become a productive, independently funded clinical investigator with expertise in developing community-based interventions to improve the health care services and outcomes for medically underserved minority children with chronic diseases such as asthma and obesity. To achieve her goal, Dr. Reznik seeks to augment her prior basic training in clinical research methods and gain skills through combination of advanced didactic courses in behavioral methodology, qualitative research, advanced experimental designs and Community-Based Participatory Research (CBPR) and conducting proposed research. Her research is aimed at developing an intervention that will address barriers and facilitators to physical activity in inner-city minority elementary school students with asthma, more than half of whom are also overweight. Her research agenda is to generate rigorous evidence to improve physical activity in this vulnerable population through an intervention targeted to the needs of the community and developed in partnership with the community. Dr. Reznik proposes a two- phase project to develop and then evaluate a pilot intervention. In phase I, she will identify barriers and facilitators to physical activity using qualitative methods and inform intervention development (Specific Aims 1 and 2). Semi-structured interviews will be conducted with students, parents, school personnel and representatives from the community to identify barriers and facilitators to physical activity in children with asthma. Guided by the results of the qualitative analysis and CBPR principles, a Collaborative Board with representatives from the New York City Departments of Education and Health, South Bronx Asthma Partnership, schools, and parents will be established to provide feedback on intervention development. In phase II, the intervention will be tested via a pilot randomized controlled trial (RCT) for scientific and practical feasibility while assessing the proximal goal of improved physical activity levels, measured objectively with an accelerometer (Specific Aim 3). This pilot study will take place at four resource-poor elementary schools in the Bronx, New York. This study will inform a future large-scale cluster RCT to test the effectiveness of the developed intervention on improving physical activity and fitness levels, motivating behavior change, achieving healthier weight trajectories, and reducing asthma-related morbidity in inner-city minority students with asthma. In the rich research environment of Einstein and CHAM, Dr. Reznik will be guided by a team of three local experts in community-based clinical trials of obesity prevention (Dr. Wylie-Rosett); qualitative research, behavioral intervention trials and CBPR (Dr. Bauman); and clinical trials of school-based exercise intervention (Dr. Ozuah). Advisory committee includes strong foundation in clinical trials of asthma interventions (Drs. Crain and Cabana), design and analysis of clinical trials (Dr. Kim) and exercise physiology (Dr. Rowlands). PUBLIC HEALTH RELEVANCE: Physical activity has been shown to improve pediatric asthma outcomes. However, physical activity levels are low in the United States' children and may even be lower in children with asthma due to disease-related barriers to participation in physical activity. This proposal will address the existent gaps in the literature by identifying barriers and facilitators to participation in physical activity in inner-city minority elementary schoolchildren with asthma, more that half of whom are also overweight; developing and refining a school- based intervention in partnership with the community to improve physical activity; and conducting a pilot randomized controlled trial of the intervention to determine feasibility and obtain preliminary data for a future large-scale trial.

描述（由申请人提供）：候选人，Marina Reznik，医学博士，硕士，阿尔伯特·爱因斯坦医学院（爱因斯坦），蒙特菲奥里儿童医院（CHAM）儿科助理教授。她的长期目标是成为一名富有成效的、独立资助的临床研究者，具有开发社区干预措施的专业知识，以改善患有哮喘和肥胖等慢性疾病的医疗服务不足的少数民族儿童的医疗保健服务和结果。为了实现她的目标，Reznik博士寻求加强她之前在临床研究方法方面的基础训练，并通过结合行为方法论，定性研究，先进实验设计和社区参与式研究（CBPR）的高级教学课程获得技能，并进行拟议的研究。她的研究旨在开发一种干预措施，以解决市中心少数民族小学生患有哮喘的体育活动障碍和促进因素，其中一半以上的学生也超重。她的研究议程是通过针对社区需求并与社区合作开发的干预措施，为改善弱势群体的体育活动提供严格的证据。雷兹尼克博士提出了一个两阶段的项目来开发和评估一项试点干预措施。在第一阶段，她将使用定性方法识别身体活动的障碍和促进因素，并告知干预措施的发展（具体目标1和2）。将与学生、家长、学校工作人员和社区代表进行半结构化访谈，以确定哮喘儿童体育活动的障碍和促进因素。在定性分析结果和CBPR原则的指导下，将成立一个由纽约市教育和卫生部、南布朗克斯哮喘伙伴关系、学校和家长代表组成的合作委员会，就干预措施的发展提供反馈。在第二阶段，干预措施将通过一项试点随机对照试验（RCT）进行科学和实践可行性测试，同时评估提高身体活动水平的近期目标，用加速度计客观测量（具体目标3）。这项试点研究将在纽约州布朗克斯四所资源贫乏的小学进行。这项研究将为未来的大规模集群随机对照试验提供信息，以测试开发的干预措施在改善城市少数民族哮喘学生的身体活动和健康水平、激励行为改变、实现更健康的体重轨迹和减少哮喘相关发病率方面的有效性。在爱因斯坦和CHAM丰富的研究环境中，Reznik博士将由三名当地专家组成的团队指导，进行以社区为基础的肥胖预防临床试验（Wylie-Rosett博士）；质性研究、行为干预试验和CBPR (Dr. Bauman)；以及基于学校的运动干预的临床试验（Ozuah博士）。咨询委员会包括哮喘干预临床试验的坚实基础(dr。Crain和Cabana)，临床试验的设计和分析（Kim博士）和运动生理学（Rowlands博士）。