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

哮喘和肥胖症之间的患病率和发病率的相关性表明，干预措施 针对哮喘和肥胖并存的目标可能会在控制这两种疾病方面取得更大的成功。该队 这项提议的调查人员已经与当地低收入组织建立了强有力的合作伙伴关系 芝加哥的少数民族社区，那里的哮喘和肥胖率明显高于全国 费率。社区哮喘和肥胖症患病率已确定，已开展定性试点工作 目前正在进行这方面的工作，社区现在已准备好对这些疾病采取行动。 这项提议旨在开发一种对哮喘和肥胖症共病的干预措施。这个项目的第一阶段 研究的目的是界定干预措施。具体目标1是对合并哮喘进行定性探讨。 还有肥胖症。研究结果将为后续干预措施的设计提供依据。第二阶段是进行 几项试验性研究，以确定个人层面干预的可行性和有效性 改善超重/肥胖少数民族儿童哮喘控制和肥胖的社区干预 患有哮喘，年龄在5-12岁。具体目标2将以一项试点行为随机对照试验开始 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。 在这项为期一年的试验中，100名参与者的结果包括哮喘控制、体重指数、 体力活动和压力/苦恼。第二年，一项针对教师的全校干预， 家长和孩子将在学校环境中进行试点测试。这一试点的成果包括学校层面的 衡量因哮喘、体力活动和学校膳食内容而缺勤的情况。50名参与者 还将跟踪目标学校中患有哮喘的超重/肥胖儿童的队列以评估 哮喘控制和体重指数的个体变化。因为社区的流行程度 芝加哥的暴力和市中心儿童普遍遭受的高水平性虐待和暴力，以及 探索性目的是评估所报告的照顾者主要因素和创伤应激源之间的关系， 照顾者的压力生物标记物，儿童报告的主要和创伤应激源，以及 患有哮喘和肥胖症的儿童。在这些干预措施完成后。第三阶段将进行评估 结果，并可能进行进一步的小规模定性研究，以确定哪些元素应该 包括在未来的干预工作中。结果的干预设计将是未来NIH的重点 批准城市健康公平拉什中心提出的建议。

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.