BACKGROUND: Bettering Asthma Care in Kids - Geographic Social Determinants Data to Understand Disparities

背景：改善儿童哮喘护理 - 地理社会决定因素数据以了解差异

• 批准号: 9445277
• 负责人: John Heintzman
• 金额: $ 54.4万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-26 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9445277
• 关键词: Address; Adolescence; Affect; Air Pollution; Ambulatory Care; Asthma; Caring; Child; Child health care; Childhood Asthma; Clinic; Clinical; Clinical Data; Code; Communities; Community Health Centers; Community Health Education; Community Health Networks; Cross-Sectional Studies; Data; Data Linkages; Data Set; Data Sources; Databases; Diagnosis; Disease; Economics; Electronic Health Record; Environmental Risk Factor; Geography; Health Personnel; Health Services; Health Services Accessibility; Healthcare; Hispanics; Housing; Income; Individual; Insurance Coverage; Knowledge; Language; Latino; Link; Literature; Low income; Measures; Medical; Methodology; Methods; Mexican; Morbidity - disease rate; Nature; Nomads; Not Hispanic or Latino; Obesity; Outcome; Patients; Pharmaceutical Preparations; Policies; Policy Maker; Poverty; Prevalence; Preventive service; Provider; Puerto Rican; Quality of Care; Research; Research Personnel; Risk; Severity of illness; Subgroup; Surveys; Symptoms; System; Time; Vulnerable Populations; asthmatic; base; built environment; data resource; ethnic disparity; evidence base; health care disparity; health care service; health care service utilization; health data; healthcare community; improved; innovation; longitudinal dataset; mortality; novel; point of care; preference; programs; response; segregation; social; social health determinants

Project Summary/Abstract Latino children with asthma have worse outcomes from their asthma than non-Hispanic white children. In the medical literature, the degree to which these outcomes are the result of limited access, underutilization, poor quality of care, or social & environmental factors is unclear. A fuller understanding of asthma outcomes in Latino children is hampered by scientific evidence that has relied upon cross-sectional studies with a limited time capture, or subjective surveys vulnerable to response biases. Additionally, some evidence in the health services literature suggests that social determinants of health (individual- and community-level economic, social, and environmental factors), including Hispanic subgroup (Mexican ancestry, Puerto Rican ancestry, etc) affect asthma care and outcomes. It is uncertain, however, which social determinants are most strongly associated with Latino children's asthma care. The proposed project intends to fill these gaps in knowledge regarding the nature of asthma care disparities in Latino children and the relative contribution of social determinants of health to these disparities, by utilizing an objective, longitudinal, and robust linkage of data sources encompassing thousands of vulnerable children across multiple states. We will leverage a unique data resource from a large, national network of community health centers with shared electronic health record data that is linked to community-level social determinants of health data. This large, longitudinal dataset contains unprecedented data linkages which will let us assess disparities in asthma care, evaluate which social determinants affect utilization and disparities, and determine which of these may do so most significantly over time. We will also specifically develop methods to use community Hispanic subgroup information to estimate the individual subgroups of patient seen in our clinics (which is information not usually present in electronic health records), and how preventive service use differs among these groups Understanding the relative impact of social determinants of health on asthma care in Latino children will: 1. Enable more informed policy decisions to improve the care of this vulnerable population, 2. facilitate strategic partnerships between healthcare providers and community agencies poised to intervene in social factors in the lives of Latino children, and 3. help clinical providers understand their patients' barriers to care utilization, and further point-of-care efforts to address the barriers that influence children's utilization of recommended health care services for their asthma.

项目总结/摘要 拉丁裔哮喘儿童的哮喘预后比非西班牙裔白色儿童差。 在医学文献中，这些结果在多大程度上是由于有限的获取，利用不足， 护理质量差，或社会和环境因素尚不清楚。更全面地了解哮喘的结果， 拉丁裔儿童受到科学证据的阻碍，这些证据依赖于有限的横断面研究。 时间捕捉，或主观调查容易受到回应偏差。此外，一些证据表明， 服务文献表明，健康的社会决定因素（个人和社区一级的经济， 社会和环境因素），包括西班牙裔亚组（墨西哥血统、波多黎各血统等） 影响哮喘治疗和结果。然而，目前还不确定哪些社会决定因素是最强烈的 与拉丁裔儿童哮喘护理有关。 拟议的项目旨在填补有关哮喘护理性质的知识空白 拉丁美洲儿童的差异以及健康的社会决定因素对这些差异的相对贡献， 通过利用客观的，纵向的和强大的数据源链接，包括数千个 多个州的弱势儿童我们将利用来自全国性大型数据中心的独特数据资源， 社区健康中心网络，共享电子健康记录数据， 健康数据的社会决定因素。这个大型的纵向数据集包含了前所未有的数据链接， 将让我们评估哮喘治疗的差异，评估哪些社会决定因素影响使用， 差异，并确定其中哪些可能随着时间的推移而最显着。我们还将具体 开发方法，使用社区西班牙裔亚组信息来估计 在我们的诊所看到的患者（这是电子健康记录中通常不存在的信息），以及如何 预防性服务的使用在这些群体之间存在差异 了解健康的社会决定因素对拉丁美洲儿童哮喘护理的相对影响 意志：1.实现更明智的政策决策，以改善对这一弱势群体的护理，2.促进 医疗保健提供者和社区机构之间的战略伙伴关系，准备干预社会 拉丁裔儿童生活中的因素，以及3。帮助临床提供者了解患者的护理障碍 使用，并进一步的护理点努力，以解决影响儿童使用的障碍， 为他们的哮喘提供推荐的医疗保健服务。