Caregiver Quality of Life in Pediatric Asthma: Family and Cultural Predictors

描述(由申请人提供)：儿童哮喘的健康差距仍然是一个重大的公共卫生问题。患有哮喘的少数族裔儿童，特别是拉丁裔和非裔美国儿童，发病率(如急诊科使用率)和死亡率增加的风险更大。由于儿童哮喘是在家庭背景下进行管理的，解释这种差异的机制可能包括父母的生活质量(QOL；父母对孩子疾病的适应)、家庭对哮喘的看法以及照顾者的哮喘状况。特别是，照顾者的生活质量可能是解释ED利用的种族和民族差异的关键因素。此外，关于哮喘的文化信仰很可能是照顾者生活质量的重要方面，而目前对照顾者生活质量的测量并未涵盖这些方面。对照顾者生活质量的评估为医疗保健提供者和临床医生提供了关于儿童哮喘和治疗方案可能给家庭日常生活带来的负担以及有效控制哮喘的障碍的关键知识。这项研究是对有哮喘儿童的拉丁裔(多米尼加人和波多黎各人)、非裔美国人和非拉丁裔白人(NLW)家庭的照顾者生活质量的调查。首先，将分析从罗德岛/波多黎各哮喘中心为NHLBI资助的研究--“儿童哮喘差异：认知和管理”(U01-HI072438，G.Fritz，G.Canino，PI)--收集的数据。RIPRAC是NHLBI资助的仅有的四个研究哮喘健康差异的中心之一。通过这些分析，将在罗德岛和波多黎各的拉丁裔和NLW照顾者中检查广泛使用的儿童哮喘照顾者生活质量问卷(PACQLQ；Juniper等人，1996年)的有效性。其次，将收集150个有哮喘儿童的拉丁裔、非裔美国人和非裔美国人家庭的数据。将评估哮喘信念、照顾者哮喘、照顾者生活质量和ED使用之间的种族和民族差异。这项研究的结果将被用于确定以家庭为基础的干预措施的可修改目标，以改善照顾者的生活质量，并降低患有哮喘的非裔美国人和拉丁裔儿童的发病率。好了！ 公共卫生相关性：儿童哮喘方面的健康差距是一个日益严重的公共卫生问题，特别是与非拉美裔白人相比，拉美裔和非裔美国儿童对急救服务的使用率增加。由于儿童哮喘是在家庭中管理的，与急救服务利用相关的途径可能包括基于文化的哮喘信念对照顾者生活质量的影响。最终，这项研究的结果将确定以家庭为基础的干预措施的可修改目标，以改善父母对儿童哮喘的适应，并降低拉美裔和非裔美国儿童的发病率。好了！

DESCRIPTION (provided by applicant): Health disparities in pediatric asthma continue to be a significant public health concern. Racial and ethnic minority children with asthma, particularly Latino and African American children, are at greater risk for increased morbidity (e.g., emergency department (ED) utilization) and mortality. As pediatric asthma is managed within the family context, mechanisms to explain such differences might include parent quality of life (QOL; parent adaption to the child's illness), family beliefs about asthma, and caregiver asthma status. In particular, caregiver QOL may be a key factor in pathways explaining racial and ethnic differences in ED utilization. Further, it is likely that culturally based beliefs about asthma are important aspects of caregiver QOL that are not captured by current measurements of caregiver QOL. Assessments of caregiver QOL provide critical knowledge to health care providers and clinicians regarding the burden that the child's asthma and treatment regimen can present on the family's daily life and barriers to effective asthma control. This study is an investigation of caregiver QOL in Latino (Dominican and Puerto Rican), African American, and Non-Latino White (NLW) families with a child with asthma. First, data collected from the Rhode Island/Puerto Rico Asthma Center for the NHLBI funded study, "Pediatric Asthma Disparities: Perceptions and Management" (U01- HI072438, G. Fritz, G. Canino, PIs), will be analyzed. RIPRAC is one of only four NHLBI funded centers examining asthma health disparities. Through these analyses, the validity of the widely used, Pediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ; Juniper et al., 1996) will be examined among Latino and NLW caregivers in Rhode Island and Puerto Rico. Second, data on 150 Latino, African American, and NLW families with a child with asthma will be collected. Racial and ethnic differences in associations between asthma beliefs, caregiver asthma, caregiver QOL, and ED use will be assessed. Findings from this study will be used to identify modifiable targets of family-based interventions to improve caregiver QOL and decrease morbidity in African American and Latino children with asthma. ! PUBLIC HEALTH RELEVANCE: Health disparities in pediatric asthma are a growing public health concern, especially with respect to increased emergency care utilization in Latino and African American children as compared to Non-Latino Whites. As pediatric asthma is managed within families, pathways related to the utilization of emergency services might include the impact of culturally based asthma beliefs on caregiver quality of life. Ultimately, findings from this study will identify modifiable targets of family-based interventions to improve parent adaption to child asthma and decrease morbidity in Latino and African American children. !