Atopic dermatitis in an urban adult population: identifying the role of social and environmental factors

城市成年人中的特应性皮炎：确定社会和环境因素的作用

• 批准号: 10651605
• 负责人: Junko Takeshita
• 金额: $ 68.48万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10651605
• 关键词: Address; Adult; Affect; Air; Atopic Dermatitis; Behavior; Behavioral; Biology; Black race; Child; Childhood; Chronic Disease; Communities; Complex; Data; Dermatologist; Development; Diabetes Mellitus; Disease; Disease remission; Disparity; Emotional; Environmental Epidemiology; Environmental Risk Factor; Epidemiology; Ethnic Origin; Ethnic Population; Future; Genetic; Geographic Locations; Health; Heart Diseases; Hispanic; Housing; Hypertension; Impairment; Individual; Intervention; Interview; Knowledge; Left; Longitudinal cohort; Longitudinal cohort study; Measures; Mediation; Mediator; Medical; Methods; Modeling; Neighborhoods; Outcome; Pennsylvania; Persons; Philadelphia; Population; Prevalence; Race; Regimen; Reporting; Research Design; Research Methodology; Research Personnel; Role; Severities; Skin Care; Smoking History; Social support; Statistical Data Interpretation; Structure; Surveys; Urban Population; Work; burden of illness; chronic inflammatory disease; cohort; contextual factors; design; disparity elimination; ethnic difference; ethnic disparity; ethnic diversity; experience; future implementation; health care service utilization; health related quality of life; improved; innovation; medically underserved; medically underserved population; novel; psychosocial; racial difference; racial disparity; racial diversity; skin disorder; social; social factors; socioeconomic disadvantage

ABSTRACT Atopic dermatitis (AD) is a common, chronic inflammatory disease of the skin that affects 10% of adults. AD is associated with major health-related quality-of-life (QoL) and psychosocial impairments that exceed those of other serious chronic diseases such as heart disease, diabetes, and hypertension. Despite the major physical and emotional burdens that accompany AD, it remains an understudied skin disease among adults because, until recently, AD had been incorrectly considered a childhood disease that remits in adulthood. Importantly, our preliminary data reveal racial/ethnic differences in the severity of, QoL impact of, and health care utilization for AD that suggest the presence of disparities in AD outcomes that deserve further study. Considering the anticipated diversification of the U.S. population, such disparities are only expected to worsen if left unaddressed. However, a critical barrier to identifying, understanding, and ultimately eliminating racial/ethnic disparities in AD outcomes among adults exists due to the lack of adult AD cohorts with sufficient racial/ethnic diversity and individual-level social and environmental contextual data that are necessary to comprehensively evaluate the causes of such disparities. In order to address this barrier, we propose to create a cohort of racially and ethnically diverse adults with AD within the socioeconomically disadvantaged and medically underserved, urban neighborhood of North Philadelphia, Pennsylvania. North Philadelphia adult residents represent a population that is vulnerable to a large burden of AD. With this cohort, we aim to perform a longitudinal cohort study to: i) confirm and further characterize existing racial/ethnic disparities in AD outcomes and health care utilization for AD among adults, and ii) identify the individual behavioral, social, and environmental contextual factors that simultaneously contribute to racial/ethnic disparities in AD outcomes. We will address these aims utilizing a novel transdisciplinary approach and a sequential mixed methods study design in order to incorporate the lived experience of adults with AD in our studies. We hypothesize that specific and potentially modifiable behavioral, social, and environmental factors contribute to racial/ethnic disparities in AD outcomes. The new knowledge that will be gained from the proposed work is essential to informing future individual- and community-level interventions to reduce racial/ethnic disparities and improve AD outcomes among similar urban adult populations.

抽象的 特应性皮炎 (AD) 是一种常见的慢性皮肤炎症性疾病，影响 10% 的成年人。广告是 与健康相关的主要生活质量（QoL）和心理社会损害相关的程度超过了 其他严重的慢性疾病，如心脏病、糖尿病和高血压。尽管主要的体力 以及伴随 AD 而来的情绪负担，它仍然是成年人中一种未被充分研究的皮肤病，因为， 直到最近，AD 还被错误地认为是一种会在成年后缓解的儿童疾病。重要的是， 我们的初步数据揭示了医疗保健利用的严重程度、生活质量影响和医疗保健利用方面的种族/民族差异 表明 AD 结果存在差异，值得进一步研究。考虑到 由于美国人口预期多样化，如果不采取这种措施，这种差距预计只会进一步恶化 未解决。然而，识别、理解并最终消除种族/民族的一个关键障碍 由于缺乏具有足够种族/族裔特征的成人 AD 队列，因此成人 AD 结局存在差异 多样性和个人层面的社会和环境背景数据对于全面 评估造成这种差异的原因。为了解决这个障碍，我们建议创建一个队列 患有 AD 的不同种族和民族的成年人，其社会经济地位和医疗水平处于不利地位 宾夕法尼亚州北费城服务不足的城市社区。北费城成年居民 代表了容易遭受 AD 沉重负担的人群。通过这个队列，我们​​的目标是执行 纵向队列研究旨在： i) 确认并进一步描述 AD 结果中现有的种族/民族差异 和成人 AD 的医疗保健利用，以及 ii) 确定个人行为、社会和 同时导致 AD 结果中种族/民族差异的环境背景因素。我们 将利用新颖的跨学科方法和顺序混合方法研究来实现这些目标 设计的目的是为了将患有 AD 的成年人的生活经历纳入我们的研究中。我们假设 具体且可能可改变的行为、社会和环境因素导致种族/民族 AD 结果的差异。从拟议的工作中获得的新知识对于 为未来的个人和社区层面的干预措施提供信息，以减少种族/民族差异并改善 类似城市成年人群的 AD 结局。