Reducing Asthma Morbidity in High Risk Minority Preschool Children

降低高危少数学龄前儿童的哮喘发病率

基本信息

批准号：
9045691
负责人：
CYNTHIA S RAND
金额：
$ 65.64万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-07-01 至 2018-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9045691
关键词：
6 year old Adherence Adoption Age Asthma Baltimore Caregivers Caring Characteristics Child Cities Clinic Clinical Communities Control Groups Day Care Development Disadvantaged Education Educational Curriculum Educational Intervention Effectiveness Emergency department visit Emotional Enrollment Environmental Exposure Evaluation Expectancy Exposure to Family Family Characteristics Funding Guidelines Head Start Program Health Home environment Hospitalization Intervention Knowledge Low income Maintenance Measures Mediating Mediator of activation protein Medical Mental Depression Minority Mission Morbidity - disease rate Motivation National Heart, Lung, and Blood Institute Neighborhoods Nursery Schools Oral Outcome Outcome Measure Parents Participant Poverty Practice Management Preschool Child Preventive Preventive Health Services Public Health Quality of life Randomized Controlled Trials Research Risk Role Schools Self Efficacy Smoking Steroids Structure Students Symptoms Testing Violence base caregiver depression cohesion community setting demographics early childhood effective intervention family management health disparity health literacy high risk improved inner city literacy minority children mortality novel programs screening secondary outcome social therapy design treatment as usual treatment planning urgent care

项目摘要

DESCRIPTION (provided by applicant): Despite advances in asthma therapies and the wide-spread dissemination of asthma clinical guidelines, low-income, minority children have disproportionately high morbidity and mortality from asthma. The National Center for Children in Poverty has strongly argued that effective interventions to improve asthma health disparities and reduce harm must begin in early childhood. Previous efficacy studies have suggested that asthma education programs can be effective in improving overall management of asthma for preschool children. However, for these promising asthma intervention strategies to have sustainable public health impact for low-income, minority children they must be integrated within those medical, educational and social structures that serve these young high risk children, such as community clinics, schools and day care programs. Because one of the core missions of federally- funded Head Start programs is to provide preventive health services and screening to their low-income preschool students, Head Start represents an ideal community setting for disseminating early asthma education. We propose to draw on our established health and research partnership with Head Start programs in Baltimore City to test the effectiveness of this home-based asthma education intervention with demonstrated efficacy, when delivered in the context of a Head Start-wide asthma education program. We further propose to partner with Head Start to support and evaluate adoption, maintenance and dissemination of new knowledge gained from this project. Specifically we hypothesize that participants receiving the ABC intervention combined with a HS-level asthma education will have more symptom free days at the 6-, 9-, and 12-month evaluation when compared with participants in the HS- level asthma education alone. We plan to enroll of 406 children age 2-6 years old enrolled in Head Start with symptomatic asthma. Secondary outcome measures include other measures of asthma morbidity (i.e., hospitalizations, ED visits, oral steroid bursts, school absences, and caregiver quality of life). We will also evaluate the mediating effects of outcomes expectancies, self-efficacy, asthma knowledge, motivation, and asthma management practices, as well as moderator effects, such as health literacy, caregiver depression, neighborhood cohesion, family management of asthma, and Head Start adoption and dissemination of an asthma education curriculum.

描述（由申请人提供）：尽管哮喘疗法进展以及哮喘临床指南的广泛传播，低收入，少数族裔儿童的发病率和死亡率高于哮喘。国家贫困儿童中心强烈认为，改善哮喘健康差异和减少伤害的有效干预措施必须从幼儿开始。先前的功效研究表明，哮喘教育计划可以有效地改善学龄前儿童哮喘的总体管理。但是，对于这些有前途的哮喘干预策略，对低收入的少数民族儿童产生可持续的公共卫生影响，它们必须纳入为这些年轻高风险儿童（例如社区诊所，学校和日托计划）服务的医学，教育和社会结构中。由于联邦资助的Head Start计划的核心任务之一是为其低收入学前教育学生提供预防性健康服务和筛查，因此Head Start代表了传播早期哮喘教育的理想社区环境。我们建议在巴尔的摩市与Head Start计划建立的健康和研究合作伙伴关系，以测试这种基于家庭的哮喘教育干预措施的有效性，该干预效果在范围内启动哮喘教育计划的背景下提供了有效性。我们进一步建议与Head Start Ins Gate合作，以支持和评估从该项目中获得的新知识的采用，维护和传播。具体而言，我们假设接受ABC干预措施以及HS级哮喘教育的参与者与仅在HS水平哮喘教育中的参与者相比，在6、9、9和12个月的评估中将有更多的无症状日子。我们计划招收406名2-6岁儿童，开始患有症状性哮喘。次要结局措施包括其他哮喘发病率的措施（即住院，急诊就诊，口服类固醇爆发，学校缺勤和护理人员的生活质量）。我们还将评估预期结果，自我效能感，哮喘知识，动机和哮喘管理实践的中介作用，以及主持人效应，例如健康素养，照料者抑郁症，邻里凝聚力，哮喘的家庭管理以及哮喘教育课程的领先和开始采用和交易。

项目成果

期刊论文数量（3）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Evaluating the implementation of a multicomponent asthma education program for Head Start staff.

DOI：
10.1080/02770903.2018.1443467
发表时间：
2019-03
期刊：
The Journal of asthma : official journal of the Association for the Care of Asthma
影响因子：
0
作者：
Ruvalcaba E;Chung SE;Rand C;Riekert KA;Eakin M
通讯作者：
Eakin M

Family Caregiver Marginalization is Associated With Decreased Primary and Subspecialty Asthma Care in Head Start Children.