Enhancing Childrens' and Parents' Asthma Management

描述(申请人提供)：哮喘影响480万18岁以下儿童。自1985年以来，哮喘患病率在5-14岁儿童中增加了84%。他们对医疗资源的利用增加了128%，就诊增加了13%。从1980年到1996年，哮喘儿童的缺课率增加了50%以上，哮喘造成的经济影响估计为107亿美元，其中一半归因于与照顾哮喘儿童相关的间接成本。本研究的目的是：1)评价哮喘教育项目在改善儿童健康状况(ED就诊、住院、旷课)方面的有效性；2)评估哮喘教育项目在改善父母哮喘知识和管理行为、自我效能和获得护理的知觉、以及儿童哮喘知识、哮喘管理、计量吸入器(MDI)技术、自我效能和应对方面的有效性；3)探讨背景变量(社会经济地位、种族、性别、知识、自我效能、哮喘严重程度、学校)和干预过程因素(获得护理、应对、哮喘管理行为、MDI技术)对健康结局的影响。对276名墨西哥裔美国人、非裔美国人和盎格鲁-美国农村学龄儿童(8-11岁)及其父母的三个种族样本进行哮喘教育干预。准实验设计将包括随机分配控制和学校层面的实验条件，以防止校内污染。在研究登记和收集基线数据后(时间1)，将为试验组提供16个班级的哮喘课程，每组4-6名儿童(每所学校12-18名儿童)。同时，对照组将接受16个一般健康班的注意控制干预。在哮喘课程结束后一个月(时间2)，将进行家访，以(1)收集所有参与者的数据，(B)为试验组提供个性化的家庭教育。家庭教育包括：(A)完成家庭哮喘计划；(B)澄清哮喘药物的使用；(C)通过具体战略减少环境哮喘的触发因素 乡下的房子。在术后4个月(时间3)和8个月(时间4)收集随访数据并进行分析。

DESCRIPTION (provided by applicant): Asthma affects 4.8 million children under 18 years of age. Since 1985, asthma prevalence has increased 84% among children 5-14 years of age. Their utilization of health care resources have increased 128% for office visits and 13% for hospitalizations. School absences have increased more than 50% from 1980 to 1996 among children with asthma, and the economic impact of asthma is estimated to be $10.7 billion with half attributed to the indirect costs associated with caring for children with asthm. The purpose of this study is to: 1) Evaluate the effectiveness of an asthma education program in improving child health outcomes (ED visits, hospitalizations, absenteeism); 2) Evaluate the effectiveness of an asthma education program in improving parents' asthma knowledge and management behaviors, self-efficacy and perceptions of access to care, and children's asthma knowledge, asthma management, metered dose inhaler (MDI) technique, self-efficacy, and coping; and 3) Explore the effects of background variables (socioeconomic status, ethnicity, gender, knowledge, self-efficacy, asthma severity, school) and intervening process factors (access to care, coping, asthma management behaviors, MDI technique) on health outcomes. An asthma education intervention is proposed with a tri-ethnic sample of 276 Mexican American, African American, and Anglo American rural school-aged children (8-11 years) who have asthma and their parents. The quasi-experimental design will include random assignment to control and experimental conditions at the school level to prevent intra-school contamination. After study enrollment and collection of baseline data (Time 1), asthma classes will be provided to the experimental group in 16 classes with small groups of 4-6 children (12-18 children per school). At the same time, the control group will receive an attention control intervention with 16 general health classes. One month (Time 2) after the asthma classes, a home visit will be made to (1) collect data from all participants and (b) provide individualized family education to the experimental group. Family education includes (a) completing the Home Asthma Plan; (b) clarifying asthma medication use; and (c) reducing environmental asthma triggers with specific strategies for rural homes. Follow-up data will be collected 4 months (Time 3) and 8 months (Time 4) later and analyzed.