COMMUNITY PARTNERSHIP TO REDUCE ASTHMA DISPARITIES

社区合作减少哮喘差异

• 批准号: 7033098
• 负责人: ELIZABETH L MCQUAID
• 金额: $ 36.84万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-04-01 至 2009-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7033098
• 关键词: African American; Hispanic Americans; asthma; behavioral /social science research tag; clinical research; clinical trials; community health services; culture; data collection methodology /evaluation; disease /disorder prevention /control; family structure /dynamics; health behavior; health care quality; health care service availability; health disparity; health economics; health education; health services research tag; human subject; inhalation drug administration; longitudinal human study; oral administration; outcomes research; patient care management; respiratory disease /disorder therapy; therapy compliance

DESCRIPTION (provided by applicant): Pediatric asthma is increasingly common among minority children, and results in considerable healthcare disparity. This application seeks to establish a Community Partnership between Rhode Island Hospital and the Providence Community Health Centers to conduct a randomized, controlled trial to increase use of controller medications for asthma among Latino and African-American children. A Community Advisory Board of parents and key informants will provide ongoing input regarding treatment implementation. Families with children who have persistent asthma symptoms will be enrolled. Three groups will be recruited (N=240 total): African-American families, Latino families who prefer health care in Spanish, and Latino families who prefer health care in English. All families will be enrolled in a brief baseline period. Children who are prescribed oral or inhaled controller medications will have medication use monitored electronically. Research staff will also collect data regarding baseline medication use from pharmacy records and insurance claims. Asthma knowledge, medication beliefs, medication adherence, and asthma morbidity will be assessed at baseline, end of treatment, and at 3-month intervals until 1 year post-treatment. After completing a baseline, all families will attend a group-based asthma education class in their own Community Health Center (one of five CHC's). Families will the be randomized to one of two nurse delivered interventions, either 1) a Standard Care (SC) condition, which emphasizes use of symptom monitoring, peak flow meter, trigger control measures, and a written action plan, or 2) a Medication Adherence (MA) condition, which assesses use of alternative medications, addresses concerns regarding use of controller medications, and uses problem-solving techniques to address barriers to medication use. Follow-up is conducted by researcher assistants at 3-, 6-, 9-, and 12-month time points post-intervention. It is expected that both interventions will increase asthma knowledge, but the MA intervention will yield greater controller medication use and decreased morbidity. It is further expected that differences in medication adherence post-treatment will be mediated by medication beliefs. Lastly, it is anticipated that within the Latino groups, Latinos with low English proficiency will demonstrate the greatest changes from baseline on medication adherence and morbidity. A Sustainability Advisory board will provide guidance regarding project implementation in the community beyond the life of the grant.

描述(申请人提供)：儿童哮喘在少数族裔儿童中越来越常见，并导致相当大的医疗保健差距。这项申请寻求在罗德岛医院和普罗维登斯社区卫生中心之间建立社区合作伙伴关系，以进行一项随机对照试验，以增加拉丁裔和非裔美国儿童中哮喘控制剂的使用。由家长和主要信息提供人组成的社区咨询委员会将就治疗执行情况提供持续的意见。有持续性哮喘症状的儿童家庭将被纳入。将招募三个群体(N=240)：非洲裔美国家庭，喜欢西班牙语医疗保健的拉美裔家庭，以及喜欢英语医疗保健的拉美裔家庭。所有家庭将在一个简短的基准期内登记。服用口服或吸入控制剂药物的儿童将通过电子方式监测用药情况。研究人员还将从药房记录和保险索赔中收集有关基线用药的数据。哮喘知识、用药信念、用药依从性和哮喘发病率将在基线、治疗结束时进行评估，并每隔3个月进行一次评估，直至治疗后1年。完成基线后，所有家庭将在自己的社区卫生中心(五个社区卫生中心之一)参加以小组为基础的哮喘教育课程。家属将随机接受以下两种护士提供的干预措施之一：1)标准护理(SC)状况，强调使用症状监测、峰值流量计、触发控制措施和书面行动计划；或2)服药依从性(MA)状况，评估替代药物的使用情况，解决对控制性药物使用的担忧，并使用解决问题的技术来解决用药障碍。由研究人员助理在干预后3、6、9和12个月的时间点进行随访。预计这两种干预措施都将增加哮喘知识，但MA干预措施将产生更多的控制性药物使用和降低发病率。进一步预计，治疗后服药依从性的差异将受到药物信念的调节。最后，预计在拉丁裔群体中，英语水平较低的拉丁裔将在服药依从性和发病率方面与基线相比变化最大。可持续发展咨询委员会将就赠款有效期后社区项目的执行情况提供指导。