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要的公共卫生问题。患有哮喘的少数种族和族裔儿童，特别是拉丁裔和非洲裔美国儿童，发病率（例如急诊使用率）和死亡率增加的风险更大。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；父母对孩子疾病的适应），家庭对哮喘的看法和照顾者哮喘状态。特别是，照顾者的生活质量可能是解释ED使用的种族和民族差异的关键因素。此外，基于文化的关于哮喘的信念很可能是护理人员生活质量的重要方面，而目前的护理人员生活质量测量并未捕捉到这些方面。护理人员生活质量的评估为卫生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对家庭日常生活造成的负担以及有效控制哮喘的障碍的关键知识。本研究旨在调查有哮喘儿童的拉丁裔（多米尼加和波多黎各）、非裔美国人和非拉丁裔白人（NLW）家庭的照护者生活质量。首先，将分析罗德岛/波多黎各哮喘中心为NHLBI资助的研究收集的数据，“儿科哮喘差异：感知和管理”（U01- HI072438， G. Fritz， G. Canino, PIs）。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人员生活质量问卷（PACQLQ; Juniper et al., 1996）的有效性将在罗德岛和波多黎各的拉丁裔和NLW护理人员中进行检验。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。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裔哮喘儿童的发病率。！

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. !