Asthma Management and Ethnic Disparities at the Adolescent Transition

描述（由申请人提供）：此修订后的K24申请提出了一项以患者为导向的儿科哮喘研究的导师计划，特别关注医疗保健差异和疾病管理行为。K24候选人是布朗大学沃伦·阿尔珀特医学院精神病学和人类行为系的副教授（研究），曾资助行为干预措施，以改善疾病管理和解决儿童哮喘的健康差异。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，以及拉丁裔移民的医疗保健机会的额外培训，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：一项关于拉丁裔和非拉丁裔白色（NLW）哮喘青年药物依从性的纵向研究，旨在评估过渡到青春期的不同文化对药物依从性的影响。三波50名持续性哮喘青年（共150名，每波25名拉丁裔，25名NLW）将完成哮喘状态，家庭因素，药物信仰和控制药物使用的多方法评估。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。分析将评估药物信仰和家庭联系在支持拉丁裔和NLW持续性哮喘青年的哮喘管理中的作用，并评估不同种族群体随时间推移的药物使用轨迹。指导计划：拟议的指导计划提供参与RCT以解决药物使用中的哮喘差异，获得每年为700多个家庭提供服务的哮喘持续教育计划，以及包括RI和波多黎各800多名拉丁裔和NLW儿童疾病管理行为丰富数据的档案数据集。计划为初级教师举办一个额外的持续研讨会，主题包括招募和保留文化多样性样本，以及准备研究补助金申请。这个整体计划利用丰富的资源和培训机会提供给博士后研究员和初级教师在布朗，包括七个T32奖学金计划，众多的初级教师与K奖和小额赠款，研讨会在研究设计，道德和统计，并建立基础设施进行评估。 公共卫生相关性：公共卫生意义：哮喘是一种常见的慢性疾病，少数民族儿童受到不成比例的影响。在这一领域促进指导和执行高质量的以患者为导向的研究对于解决医疗保健差距至关重要。项目/

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/