Asthma Management and Ethnic Disparities at the Adolescent Transition

描述(由申请者提供)：这份修订后的K24申请提出了一个以患者为中心的儿童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·阿尔伯特医学院精神病学和人类行为系的副教授(研究)，有资助行为干预以改善疾病管理和解决儿童哮喘健康差距的历史。培训计划：候选人将在纵向数据分析、行为遗传学、健康教育评估和评估以及拉美裔移民的医疗机会方面获得额外培训，以丰富她在未来医疗差异研究中的技能和指导能力。研究计划：建议对患有哮喘的拉丁裔和非拉丁裔白人(NLW)青年进行一项纵向研究，以评估在过渡到青春期期间不同文化对药物依从性的不同过程。三波50名患有持续性哮喘的青年(总共150人，每波25名拉丁裔，25名NLW)将完成对哮喘状况、家庭因素、用药信念和控制性用药的多方法评估。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服药依从性。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NLW青年哮喘管理方面的作用，并评估不同种族群体随时间使用药物的不同轨迹。指导计划：建议的指导计划提供参与随机对照试验，以解决哮喘在药物使用方面的差异，获得每年服务于700多个家庭的持续哮喘教育计划，以及包括关于RL和波多黎各800多名拉丁裔和NLW儿童疾病管理行为的丰富数据的档案数据集。还计划为初级教员举办一次正在进行的研讨会，主题包括招聘和保留文化多样性的样本，以及准备研究补助金申请。这一总体计划充分利用了布朗大学为博士后研究员和初级教师提供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、伦理学和统计学方面的研讨会，以及已建立的评估基础设施。 公共卫生相关性：公共卫生意义：哮喘是一种常见的慢性病，少数族裔儿童受到的影响不成比例。促进指导和执行这一领域以患者为中心的高质量研究对于解决卫生保健差距至关重要。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/