Asthma Management and Ethnic Disparities at the Adolescent Transition

描述（由申请人提供）：本修订后的K24申请提出了一项以儿童哮喘患者为导向的研究指导计划，特别关注医疗保健差异和疾病管理行为。K24候选人是布朗大学Warren Alpert医学院精神病学和人类行为系的副教授（研究），具有资助行为干预以改善疾病管理和解决儿童哮喘健康差异的历史。培训计划：候选人将获得纵向数据分析、行为遗传学、健康教育评估和评估以及拉丁裔移民获得医疗保健方面的额外培训，以丰富她在未来医疗保健差异研究中的技能和指导能力。研究计划：对拉丁裔和非拉丁裔白人（NLW）青少年哮喘患者的药物依从性进行纵向研究，以评估跨文化过渡到青春期的药物依从性的差异过程。三组50名持续性哮喘青年（共150人，25名拉丁裔，每组25名非拉丁裔）将完成哮喘状态、家庭因素、用药信念和控制者用药情况的多方法评估。评估将在八年级进行，然后在十年级再次进行，并在整个过程中持续监测药物依从性。分析将评估药物信念和家庭联系在支持患有持续性哮喘的拉丁裔和非拉丁裔青年哮喘管理中的作用，并评估不同种族群体药物使用的不同轨迹。指导计划：建议的指导计划提供参与一项随机对照试验，以解决哮喘药物使用方面的差异，获得正在进行的哮喘教育计划，该计划每年为700多个家庭提供服务，并提供一个档案数据集，其中包括Rl和波多黎各800多名拉丁裔和非拉丁裔儿童疾病管理行为的大量数据。另外，还计划为初级教员举办一个正在进行的研讨会，主题包括招募和保留文化多样性样本，以及准备研究经费申请。这一总体计划充分利用了布朗大学博士后和初级教师的丰富资源和培训机会，包括7个T32奖学金项目，众多获得K奖和小额赠款的初级教师，研究设计、伦理和统计方面的研讨会，以及已建立的评估基础设施。

DESCRIPTION (provided by applicant): This revised K24 application proposes a mentorship program in patient-oriented research in pediatric asthma, with a specific focus on health care disparities and disease management behaviors. The K24 Candidate is an Associate Professor (Research) in the Department of Psychiatry and Human Behavior of the Warren Alpert Medical School at Brown University, with a history of funding in behavioral interventions to improve disease management and address health disparities in pediatric asthma. Training Plan: The candidate will obtain additional training in longitudinal data analysis, behavioral genetics, evaluation and assessment in health education, and health care access for Latino immigrants to enrich her skills and mentoring capacity in future health care disparities research. Research Plan: A longitudinal study of medication adherence for Latinos and non-Latino white (NLW) youth with asthma is proposed to assess the differential course of medication adherence by culture across the transition to adolescence. Three waves of 50 youth with persistent asthma (150 total, 25 Latino, 25 NLW in each wave) will complete a multimethod assessment of asthma status, family factors, medication beliefs, and controller medication use. Assessments will occur in eighth grade, then again in tenth grade, with continuous monitoring of medication adherence throughout. Analyses will evaluate the role of medication beliefs and family connectedness in supporting asthma management in Latino and NLW youth with persistent asthma, and assess differential trajectories of medication use by ethnic group over time. Mentoring Plan: The proposed mentoring plan offers participation in an RCT to address asthma disparities in medication use, access to an ongoing educational program for asthma that serves over 700 families a year, and an archival dataset that includes a wealth of data on disease management behavior in over 800 Latino and NLW children in Rl and Puerto Rico. An additional ongoing seminar is planned for junior faculty on topics such as recruiting and retaining culturally diverse samples, and preparing research grant applications. This overall plan capitalizes on the rich resources and training opportunities available to postdoctoral fellows and junior faculty at Brown, including seven T32 fellowship programs, numerous junior faculty with K awards and small grants, seminars in research design, ethics, and statistics, and established infrastructure for evaluation. PUBLIC HEALTH RELEVANCE: Public Health Significance: Asthma is a common chronic illness in which minority children are disproportionately affected. Facilitating mentorship and execution of high quality patient-oriented research in this area is critical to address health care disparities. PROJECT/