Racial/ethnic differences in symptom perception in childhood asthma

儿童哮喘症状感知的种族/民族差异

• 批准号: 7663154
• 负责人: JONATHAN M. FELDMAN
• 金额: $ 8.3万
• 依托单位: YESHIVA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7663154
• 关键词: Accident and Emergency department; Acculturation; Acute; Adult; Affect; African American; Age; Asthma; Behavioral; Belief; Caregivers; Caring; Child; Child health care; Childhood Asthma; Chronic Disease; Development; Diagnostic; Disease; Emergency Situation; Emotions; Esthesia; Ethnic group; Failure; Family; Goals; Grant; Guidelines; Health Status; Healthcare; Impairment; International; Interview; Latino; Lead; Literature; Lung; Major Depressive Disorder; Measures; Mediating; Mediator of activation protein; Medical; Mental Health; Mexican Americans; Mission; Monitor; Morbidity - disease rate; New York; Parents; Pathway interactions; Pattern; Perception; Pharmaceutical Preparations; Pilot Projects; Play; Prevalence; Provider; Psyche structure; Puerto Rican; Reaction; Recruitment Activity; Reporting; Research; Risk Factors; Role; Severities; Side; Site; Stress; Subgroup; Symptoms; Testing; Time; United States; United States National Institutes of Health; Urban Hospitals; Visit; aged; cultural values; depression; design; ethnic minority population; family influence; family management; follow-up; health belief; health disparity; health related quality of life; inner city; low socioeconomic status; maternal depression; mortality; physical conditioning; programs; psychologic; racial and ethnic; racial and ethnic disparities; racial/ethnic difference; therapy design

DESCRIPTION (provided by applicant): The greatest racial/ethnic disparity in pediatric asthma exists between the two largest Latino ethnic groups in the United States. Puerto Rican children have the highest asthma prevalence, morbidity, and mortality rates, and Mexican-American children have the lowest rates. African-American children are also disproportionately affected by asthma and have high levels of morbidity. Identification of mechanisms that may contribute to these disparities is a critical goal for asthma research. At the present time, there is a surprising gap in the literature regarding children's asthma symptom perception accuracy among specific racial/ethnic groups. Additionally, little is known about how racial/ethnic differences in parental beliefs and mental health may affect children's symptom perception and asthma morbidity. The research plan will involve a cross-sectional comparison of 40 African-American, 40 Puerto Rican, and 40 Mexican-American children with asthma between ages 7-11 and their primary caregivers. Families will be recruited from two city hospitals that predominantly serve families of low SES in the Bronx, NY. The study will involve a baseline session followed by 5 weeks of monitoring of children's asthma symptom perception ability and use of asthma medications in naturalistic settings. A second testing session will occur at a 5-week follow- up. Parent measures will include asthma beliefs, family support, acculturation, and assessment of major depression and abridged somatization using the Composite International Diagnostic Interview. Child measures will include depression, somatization, emotions during asthma attacks, and acculturation. Dependent measures will include use of PRN medication, functional morbidity, and asthma-related emergency room visits. Groups will be matched on clinician-rated asthma severity documented in medical charts. The primary aims of this small grant are to: a) examine children's asthma symptom perception and PRN medication use among African-American, Puerto Rican, and Mexican-American children, and b) compare parents' mental health, health beliefs, and family support across racial/ethnic groups, and c) examine the relationship between parents' level of acculturation and children's asthma symptom perception and morbidity among Puerto Rican and Mexican-American families. An exploratory aim is to examine whether pathways involving children's psychological symptoms, children's asthma symptom perception, and parent factors mediate racial/ethnic differences on PRN medication use and asthma morbidity. This study is designed to identify parent and child factors that may contribute to asthma morbidity and symptom perception in a differential manner among African-American, Puerto Rican, and Mexican-American children. The long-term objective of this research program is the development of culturally sensitive family interventions designed to reduce asthma morbidity and hence, disparities among ethnic minority children. This research will help support the NIH mission to reduce health disparities by focusing on asthma among inner-city, ethnic minority children. Examining behavioral predictors of disparities among African-American, Puerto Rican, and Mexican-American families may help inform culturally sensitive guidelines for provider care and family management of asthma.

描述（由申请人提供）：美国两个最大的拉丁裔族群之间存在儿童哮喘的最大种族/民族差异。波多黎各儿童的哮喘患病率、发病率和死亡率最高，墨西哥裔美国儿童的发病率最低。非洲裔美国儿童也不成比例地受到哮喘的影响，发病率很高。识别可能导致这些差异的机制是哮喘研究的关键目标。目前，关于儿童哮喘症状感知准确性在特定种族/民族群体中的文献存在令人惊讶的差距。此外，关于父母信仰和心理健康方面的种族/民族差异如何影响儿童的症状感知和哮喘发病率，我们知之甚少。该研究计划将涉及40名非洲裔美国人，40名波多黎各人和40名墨西哥裔美国人7-11岁哮喘儿童及其主要照顾者的横断面比较。家庭将从两个城市医院招募，主要服务于纽约布朗克斯的低社会经济地位家庭。该研究将包括一个基线阶段，随后是5周的监测儿童的哮喘症状感知能力和在自然环境中使用哮喘药物。第二次测试将在5周随访时进行。父母的措施将包括哮喘的信念，家庭支持，文化适应，并评估严重抑郁症和简化的躯体化使用复合国际诊断访谈。儿童测量将包括抑郁，躯体化，哮喘发作时的情绪，和文化适应。依赖性指标将包括PRN药物的使用、功能性发病率和哮喘相关急诊室访视。将根据病历中记录的临床医生评定的哮喘严重程度对各组进行匹配。这笔小额赠款的主要目的是：a）检查非裔美国人、波多黎各人和墨西哥裔美国人儿童的哮喘症状感知和PRN药物使用，以及B）比较不同种族/民族的父母的心理健康、健康信念和家庭支持，以及c）研究波多黎各人和墨西哥人父母的文化适应水平与儿童哮喘症状感知和发病率之间的关系，美国家庭一个探索性的目的是检查是否涉及儿童的心理症状，儿童的哮喘症状感知，和父母的因素介导的PRN药物使用和哮喘发病率的种族/民族差异的途径。本研究的目的是确定父母和儿童的因素，可能有助于哮喘发病率和症状感知的差异方式在非洲裔美国人，波多黎各人和墨西哥裔美国儿童。这项研究计划的长期目标是发展文化敏感的家庭干预措施，旨在减少哮喘发病率，从而减少少数民族儿童之间的差异。这项研究将有助于支持美国国立卫生研究院的使命，以减少健康的差距，重点是在内城，少数民族儿童哮喘。研究非洲裔美国人、波多黎各人和墨西哥裔美国人家庭之间差异的行为预测因素可能有助于为哮喘的提供者护理和家庭管理提供文化敏感的指导方针。

项目成果

Obesity-related pediatric asthma: relationships between pulmonary function and clinical outcomes.

肥胖相关的小儿哮喘：肺功能与临床结果之间的关系。

• DOI: 10.1080/02770903.2022.2152351
• 发表时间: 2023
• 期刊: The Journal of asthma : official journal of the Association for the Care of Asthma
• 作者: Starr,Sheena;Wysocki,Matthew;DeLeon,JesenyaD;Silverstein,Gabriella;Arcoleo,Kimberly;Rastogi,Deepa;Feldman,JonathanM
• 通讯作者: Feldman,JonathanM

The relationship between caregivers' post-traumatic stress disorder and their asthma health beliefs in an ethnic minority inner-city sample.

在少数族裔市中心样本中，护理人员的创伤后应激障碍与其哮喘健康信念之间的关系。

• DOI: 10.3109/02770903.2012.696169
• 发表时间: 2012
• 期刊: The Journal of asthma : official journal of the Association for the Care of Asthma
• 作者: Steinberg,DaraM;Sidora-Arcoleo,Kimberly;Serebrisky,Denise;Feldman,JonathanM
• 通讯作者: Feldman,JonathanM

Asthma in children of Caribbean descent living in the inner-city: comparing Puerto Rican and Afro-Caribbean children.

居住在城市内部的加勒比裔儿童的哮喘：比较波多黎各人和非洲加勒比儿童。

• DOI: 10.1080/13548506.2016.1238490
• 发表时间: 2017-07
• 期刊: Psychology, health & medicine
• 作者: Steinberg DM;Serebrisky D;Feldman JM
• 通讯作者: Feldman JM