A COMMUNITY UNITED TO REDUCE DISPARITIES IN COMORBID PEDIATRIC ASTHMA AND OBESITY

哮喘和肥胖之间患病率和发病率的相关性表明，干预措施 针对哮喘和肥胖症的共病可能会导致在控制这两种疾病方面取得更大的成功。球队 这项提案的调查人员与低收入国家的当地组织建立了牢固的伙伴关系。 芝加哥的一个少数民族社区，那里的哮喘和肥胖率明显高于全国 rates.已确定社区哮喘和肥胖症的患病率，定性试点工作已完成， 目前，社区已做好准备，对这些疾病采取行动。 该提案旨在开发一种针对哮喘和肥胖共病的干预措施。的第一阶段 研究的目的是确定干预措施。具体目标1是对共病哮喘进行定性研究 和肥胖。结果将为后续干预措施的设计提供信息。第二阶段是进行 几项试点研究，以确定个人层面干预的可行性和有效性， 社区干预改善超重/肥胖少数民族儿童的哮喘控制和肥胖 5-12岁的哮喘患者具体目标2将开始与试点行为随机对照试验，以测试 为家庭提供自我管理技能教育的家庭干预的可行性和有效性。 在为期一年的100名参与者的试验中测量的结果包括哮喘控制，体重指数， 体力活动和压力/痛苦。第二年，一项针对教师的全校性干预措施， 家长和儿童在学校环境中进行试验。这一试点的成果包括学校一级 哮喘缺勤、体育活动和学校膳食内容的测量。50名参与者 此外，亦会跟进目标学校的一组超重/肥胖哮喘儿童， 哮喘控制和体重指数的个体变化。由于社区的流行程度 芝加哥的暴力事件以及市中心儿童普遍遭受的高水平性虐待和暴力， 探索性目的是评估报告的主要照顾者和创伤性压力源之间的关系， 照顾者的压力生物标志物，儿童报告的主要和创伤性压力源，以及照顾者的压力生物标志物。 患有哮喘和肥胖症的儿童。在这些干预措施完成后。第三阶段将评估 结果，并可能进行进一步的小型定性研究，以确定哪些要素应 包括在今后的干预工作中。结果的干预设计将是未来NIH的重点 Rush Centerfor Urban Health Equity（拉什城市健康公平中心）的拨款提案。

The associations in prevalence and morbidity between asthma and obesity suggest that interventions targeting comorbid asthma and obesity may lead to greater success in controlling both conditions. The team of investigators for this proposal has developed strong partnerships with local organizations in a low-income minority community in Chicago where asthma and obesity rates are significantly higher than the national rates. Community prevalence of asthma and obesity has been determined, qualitative pilot work has been conducted, and the community is now prepared for action on these diseases. This proposal aims to develop an intervention for comorbid asthma and obesity. The first phase of this study is to define the intervention. Specific Aim 1 is to conduct a qualitative exploration of comorbid asthma and obesity. The results will inform the design of the subsequent interventions. Phase 2 is to conduct several pilot studies to determine the feasibility and efficacy of an individual-level intervention and a community-level intervention to improve asthma control and obesity in overweight/obese minority children with asthma ages 5-12. Specific Aim 2 will begin with a pilot behavioral randomized controlled trial to test the feasibility and efficacy of a home intervention that provides self-management skills education to families. Outcomes measured in the one-year trial of 100 participants include asthma control, body mass index, physical activity, and stress/distress. The following year, a school-wide intervention that targets teachers, parents, and children in the school environment will be pilot tested. Outcomes for this pilot include schoollevel measures of absenteeism from asthma, physical activity, and school meal content. A 50 participant cohort of overweight/obese children with asthma in the target school will also be followed to assess individual changes in asthma control and body mass index. Because of the epidemic levels of community violence in Chicago and the high levels of sexual abuse and violence for inner-city children in general, an Exploratory Aim is to assess the relationships between reported caregiver major and traumatic stressors, biomarkers of stress in caregivers, child reported major and traumatic stressors, and biomarkers of stress in children with comorbid asthma and obesity. After completion of these interventions. Phase 3 will evaluate the outcomes and possibly conduct further small qualitative studies to determine which elements should be included in future intervention efforts. The intervention design that results will be the focus of future NIH grant proposals emanating from the Rush Centerfor Urban Health Equity.