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Child Asthma Exacerbation: Role of Caregiver Risk Beliefs

儿童哮喘加重：看护者风险信念的作用

基本信息

批准号：
10227109
负责人：
JAMES A SHEPPERD
金额：
$ 57.55万
依托单位：
WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-01 至 2023-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10227109
关键词：
Address Adrenal Cortex Hormones Adult Affect Affective African American Anthropology Asthma Behavior Belief Caregivers Caring Cessation of life Child Child Health Childhood Childhood Asthma Cognitive Cognitive Science Color Data Data Set Decision Making Development Dissemination and Implementation Education Emergency department visit Equilibrium Food Future Goals Health Health Psychology Health behavior Healthy People 2020 Hospitalization Housing Income Individual Interdisciplinary Study Intervention Interview Judgment Knowledge Lead Life Methods Monitor Motivation Nature Outcome Parents Pharmaceutical Preparations Probability Process Proxy Psychometrics Public Health Pulmonology Regimen Reporting Research Resources Risk Risk Reduction Behavior Role Sampling Schools Scientific Advances and Accomplishments Self Efficacy Shapes Smoking Social Environment Social Psychology Structure Surveys Symptoms Testing Time Tobacco use Translating Work analytical method asthma exacerbation asthmatic base caregiver interventions cognitive process contextual factors coping effective intervention environmental tobacco smoke family influence follow-up heuristics implementation intervention mindfulness negative affect optimism prevent psychologic public health relevance recruit risk perception social social factors statistics success symptom management therapy development underserved community

项目摘要

ABSTRACT/PROJECT SUMMARY Asthma affects over 6.2 million children in the U.S., particularly children who are African American and children whose parents have limited incomes and formal education. Yet, interventions that attempt to reduce asthma exacerbation by educating caregivers of asthmatic children are time and resource intensive and largely have enjoyed only modest success. We propose pausing intervention implementation and dissemination efforts to gain a thorough understanding of the basic scientific nature of caregivers' proxy risk beliefs and how the beliefs interact with the social context to shape caregivers' risk-reducing actions. By doing so, we can address three barriers to creating effective childhood asthma exacerbation interventions: (1) limited understanding of how caregivers think about asthma and the heuristics (judgment shortcuts) and biases that color caregiver beliefs, (2) limited evidence about how caregiver risk beliefs interact with the social context to influence decision making, and (3) limited evidence about how caregiver risk beliefs translate into their risk reduction behaviors and their child's health. We propose filling these gaps in scientific knowledge by employing a mixed methods approach. We will conduct qualitative interviews of caregivers of children with asthma who reside in one of two underserved communities (N=40) and a quantitative survey of caregivers recruited from a panel comprised of a probability-based random sample of adults in the US (N=801). The unique features of this project are that it (a) combines multiple methods to understand caregiver beliefs, (b) examines beliefs at three stages of the asthma exacerbation continuum (triggers, symptoms, and symptom management), (c) explores how beliefs interact with the social context to influence decisions about engaging in behaviors that reduce exacerbation risk, (d) uses psychometric analytic methods to understand the cognitive structures underlying caregivers' risk beliefs, and (e) capitalizes on an interdisciplinary research team with experts in health, social, and cognitive psychology, anthropology, health behavior intervention development and implementation, pediatric pulmonology, and statistics. This project is significant because elucidating the structures, heuristics, biases, and social and contextual factors that drive caregivers' decisions for their child will illuminate strategies for directly intervening on the most proximal determinants of behavior. This targeted approach will inform the development of a highly effective caregiver-based intervention that is time- and resource-efficient while accommodating the social and contextual features that may constrain or facilitate caregivers' risk-reducing behavior. We will also make a significant scientific advance by extending basic risk perception research through considering both the caregiver-child relationship and the broader social context.

摘要/项目总结在美国，哮喘影响着超过620万儿童，尤其是非裔美国儿童和他们的父母收入有限，受过正规教育。然而，试图减少哮喘的干预措施通过教育哮喘儿童的照顾者来加重哮喘是时间和资源密集型的，并且在很大程度上只取得了适度的成功。我们建议暂停干预措施的实施和传播工作，深入了解照顾者的代理风险信念的基本科学性质，以及信念如何与社会环境互动，以塑造护理人员的减少风险行动。通过这样做，我们可以解决三个建立有效的儿童哮喘急性发作干预措施的障碍：（1）对如何进行干预的了解有限。照顾者思考哮喘和判断捷径（判断捷径）以及影响照顾者信念的偏见， (2)关于照顾者风险信念如何与社会背景相互作用以影响决策的证据有限制作，以及（3）有限的证据如何照顾者的风险信念转化为他们的风险降低行为和孩子的健康我们建议通过采用混合方法来填补科学知识中的这些空白 approach.我们将对居住在以下两个地区之一的哮喘儿童的照顾者进行定性访谈：服务不足的社区（N=40）和从一个小组招募的护理人员的定量调查，美国成年人随机抽样（N=801）。该项目的独特之处在于：（a）结合多种方法来了解照顾者的信念，（B）检查哮喘三个阶段的信念加重连续体（触发因素，症状和症状管理），（c）探索信念如何相互作用与社会背景一起影响关于参与降低恶化风险的行为的决定，（d）运用心理测量分析方法，了解照顾者风险信念的认知结构，以及（e）利用由健康、社会和认知领域专家组成的跨学科研究团队心理学，人类学，健康行为干预的发展和实施，儿科肺科和统计学。这个项目是有意义的，因为阐明结构，化学，偏见，社会和背景因素，驱动照顾者的决定，为他们的孩子将阐明战略，直接干预行为的最接近的决定因素。这种有针对性的方法将告知制定一项高效的、以预防为主的干预措施，既节省时间，又节省资源，适应可能限制或促进护理人员降低风险的社会和背景特征行为我们还将通过扩大基本风险认知研究，通过考虑父母与子女的关系和更广泛的社会背景。

项目成果

期刊论文数量（7）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Breathing Together: Children Co-constructing Asthma Self-Management in the United States.

DOI：
10.1007/s11013-022-09766-5
发表时间：
2023-06
期刊：
Culture, medicine and psychiatry
影响因子：
0
作者：
Spray J;Hunleth J
通讯作者：
Hunleth J

Exploring Caregiver Interest in and Preferences for Interventions for Children With Risk of Asthma Exacerbation: Web-Based Survey.

DOI：
10.2196/46341
发表时间：
2023-08-02
期刊：
JMIR FORMATIVE RESEARCH
影响因子：
2.2
作者：
Pogge, Gabrielle;Fedele, David A.;Waters, Erika A.;Maki, Julia;Hunleth, Jean M.;Prabhakaran, Sreekala;Bowen, Deborah J.;Shepperd, James A.
通讯作者：
Shepperd, James A.

Where Have All the Children Gone? Against Children's Invisibility in the Covid-19 Pandemic.

DOI：
10.1080/19428200.2020.1824856
发表时间：
2020
期刊：
Anthropology now
影响因子：
0
作者：
Spray J;Hunleth J
通讯作者：
Hunleth J

Examining commonsense epidemiology: The case of asthma.

检查流行病学常识：哮喘病例。

DOI：
10.1177/13591053211064986
发表时间：
2022
期刊：
Journal of health psychology
影响因子：
3.2
作者：
Pogge,Gabrielle;Waters,ErikaA;Webster,GregoryD;Fedele,David;Prabhakaran,Sreekala;Shepperd,JamesA
通讯作者：
Shepperd,JamesA

Not Breathing Easy: "Disarticulated Homework" in Asthma Management.