权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

A Pilot Stress Management Intervention for High Risk Children with Asthma

针对哮喘高危儿童的试点压力管理干预措施

基本信息

批准号：
8242940
负责人：
ANNA L MARSLAND
金额：
$ 22.45万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-05-01 至 2015-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8242940
关键词：
12 year old Absenteeism Accounting Acute Adherence Affect Anxiety Asthma Attention Behavior Biological Child Childhood Childhood Asthma Chronic Chronic Disease Chronic stress Clinic Clinical Trials Clinical Trials Design Cognitive Therapy Coping Skills Data Development Disadvantaged Drops Economically Deprived Population Education Effectiveness Elements Evaluation Event Exhalation Exposure to Future Health Health Benefit Health behavior Individual Inflammatory Inflammatory Response Intervention Intervention Trial Knowledge Learning Life Light Link Lung Inflammation Measures Mediating Medical Methods Minority Morbidity - disease rate Nitric Oxide Outcome Outpatients Participant Pathway interactions Pharmaceutical Preparations Phase Physicians Physiological Pilot Projects Play Prevalence Problem Solving Process Psychological Stress Psychosocial Assessment and Care Psychosocial Factor Psychosocial Stress Public Health Randomized Recruitment Activity Research Respiratory physiology Risk Factors Role Sampling Schools Self Efficacy Self Management Severities Severity of illness Social Environment Socioeconomic Status Spirometry Stress Stress and Coping Symptoms Training Programs United States Up-Regulation Visit Work abstracting airway inflammation base control trial coping cost effective depressive symptoms health belief high risk improved low socioeconomic status modifiable risk mortality novel peer physical conditioning pilot trial post intervention primary outcome programs psychologic psychosocial pulmonary function satisfaction skills skills training socioeconomics standard care stress management urban area

项目摘要

DESCRIPTION (provided by applicant): Asthma is the most common chronic illness among children in the United States, with disproportionately high morbidity and mortality among minority and socioeconomically disadvantaged children living in urban areas. These disparities are not fully accounted for by differences in asthma prevalence, highlighting a need for interventions targeting factors associated with poorer asthma control. Converging evidence suggests that psychosocial factors that accompany socioeconomic disadvantage contribute to the marked disparities in childhood asthma morbidity, with psychological stress predicting future asthma exacerbations in children. Chronic stress and lower socioeconomic status also are associated with the exacerbation of airway inflammatory responses to environmental triggers and the upregulation of inflammatory processes directly implicated in asthma exacerbation. Evidence that stress accentuates airway inflammation and predicts asthma morbidity raises the possibility that psychological interventions aimed at helping children manage stress could improve the physical health of high risk children with asthma. To date, studies of psychosocial interventions for pediatric asthma have been of poor general quality, highlighting a need for further more rigorous research. Accordingly, we have developed a stress management and coping skills training program based on the principles of cognitive behavioral therapy ("I Can Cope"). Preliminary trials provide initia support for the feasibility of offering this supplemental intervention to 8-12 year old asthmatics n urban schools and provide initial evidence for intervention-related decreases in perceived stress and improvements in lung function, as measured by spirometry. The primary objective of the proposed research is to conduct a critical randomized controlled pilot evaluation of the effectiveness of this school-based intervention to obtain data that is necessary to develop a full-scale clinical trial. For this purpose, we propose randomly assigning 108 economically disadvantaged urban 3rd through 6th graders with physician-confirmed asthma to the school-based intervention or an education only control condition. Primary outcomes will include (1) psychological function and (2) asthma health, as assessed at the end of the intervention period. If future work confirms our initial feasibility findings, this will be the first study to demonstrae the health benefit of a school-based asthma stress management intervention for high risk children living in urban settings, providing a novel means of intervening to reduce disparities in asthma morbidity. Furthermore, it will provide a more efficient and cost-effective means of accessing vulnerable children than individual clinic based intervention, which we have not found to be feasible. PUBLIC HEALTH RELEVANCE: Minority and socioeconomically disadvantaged children living in urban areas in the US are at disproportionately high risk for asthma morbidity, with disparities in asthma severity being larger than those in asthma prevalence. Growing evidence shows that psychosocial factors that accompany socioeconomic disadvantage may play a role in these disparities, with psychological stress predicting future asthma exacerbations in children. The current application proposes a pilot study examining the first school-based intervention to target this modifiable risk factor. Thus, the public health implications of the project are considerable and include the identification of a method of intervening to reduce disparities in asthma morbidity. In addition, we anticipate that the intervention will be cost effective, reducing medical visits, use of as needed medications, and school absenteeism. (End of Abstract)

描述（由申请人提供）：