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

描述（由申请人提供）：儿童哮喘的健康差异仍然是一个重大的公共卫生问题。患有哮喘的种族和少数民族儿童，特别是拉丁裔和非裔美国儿童，发病率增加的风险更大（例如，急诊（艾德）利用率）和死亡率。由于儿童哮喘是在家庭环境中管理的，解释这种差异的机制可能包括父母的生活质量（QOL;父母对儿童疾病的适应），家庭对哮喘的信念，以及照顾者的哮喘状态。特别是，照顾者的生活质量可能是一个关键因素的途径，解释种族和民族差异的艾德利用。此外，很可能是基于文化的信念，哮喘的照顾者的生活质量的重要方面，没有捕获目前的测量照顾者的生活质量。评估照顾者的生活质量提供了关键的知识，卫生保健提供者和临床医生的负担，儿童的哮喘和治疗方案可以对家庭的日常生活和障碍，有效的哮喘控制。本研究是一项调查照顾者的生活质量在拉丁美洲（多米尼加和波多黎各），非洲裔美国人，和非拉丁美洲白色（NLW）家庭与儿童哮喘。首先，从罗得岛/波多黎各哮喘中心收集的数据用于NHLBI资助的研究，“儿科哮喘差异：感知和管理”（U 01-HI 072438，G。Fritz，G. Canino，PI）进行分析。RIPRAC是NHLBI资助的四个研究哮喘健康差异的中心之一。通过这些分析，广泛使用的儿科哮喘护理者生活质量问卷（PACQLQ; Juniper等人，1996年）将在罗得岛和波多黎各的拉丁美洲人和NLW照顾者中进行审查。其次，将收集150个有哮喘儿童的拉丁裔、非裔美国人和NLW家庭的数据。将评估哮喘信念、照顾者哮喘、照顾者QOL和艾德使用之间相关性的种族和民族差异。本研究的结果将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，降低非洲裔美国人和拉丁美洲哮喘儿童的发病率。! 公共卫生相关性：儿童哮喘的健康差异是一个日益增长的公共卫生问题，特别是与非拉丁裔白人相比，拉丁裔和非洲裔美国儿童的急诊利用率增加。由于儿童哮喘是在家庭内管理的，与利用紧急服务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，并降低拉丁美洲和非洲裔美国儿童的发病率。!

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. !