Puerto Rico Asthma Integrated Response Program (PR-AIR)

项目总结/摘要 波多黎各（PR）后裔的儿童哮喘患病率和发病率高于儿童 任何其他种族的人。居住在PR岛的儿童的哮喘患病率甚至高于 大陆公关儿童。我们建议执行和评估波多黎各哮喘综合方案， 响应计划（PR-AIR），以解决圣胡安，PR，一个高地区的儿科哮喘差异 哮喘负担PR-AIR整合了家庭和学校环境中基于证据的干预措施，并增强了 家庭、学校和卫生保健提供者之间的沟通。在第一阶段，我们将召开一个 利益相关者的社区协作，将在整个项目中提供投入，并深入使用 访谈，以确定社区的需求，障碍和促进者，使PR-AIR的实施。我们将 确定我们现有的以证据为基础的虚拟和面对面的家庭干预措施的哪些特征， 学校环境需要进行符合卫生标准的修改，并利用利益攸关方的投入和匹配的障碍， 选择执行战略，以确定加强PR-AIR吸收的方法。在第二阶段，我们将使用 混合型III有效性实施设计，评估低强度（虚拟）和高强度 （亲自）执行PR-AIR的方法。我们将向12个社区提供PR-AIR 通过使用聚类随机化、阶梯式楔形图进行地理空间映射， 试验设计，向400名2-12岁哮喘儿童提供PR-AIR。我们将使用混合方法 评估我们的实施战略对PR-AIR覆盖、采用、实施和 维持，并评估PR-AIR对个人水平（哮喘控制，生活质量）的有效性， 社区一级的结果（保健利用率、缺课率）。PR-AIR建立在20年的 我们在RI和PR的研究团队之间的合作，在推进知识的投资， 影响儿童哮喘差异和降低儿童发病率的多水平因素， 可持续的、可持续的干预措施。

Project Summary/Abstract Children of Puerto Rican (PR) descent have higher rates of asthma prevalence and morbidity than children from any other ethnic group. Children residing on the Island of PR have even higher asthma prevalence than Mainland PR children. We propose to implement and evaluate the Puerto Rico-Asthma Integrated Response Program (PR-AIR) to address pediatric asthma disparities in San Juan, PR, an area of high asthma burden. PR-AIR integrates evidence-based interventions in home and school settings, and enhances communication between families, schools, and health care providers. During Phase 1, we will convene a community collaborative of stakeholders that will provide input throughout the project, and use in-depth interviews to identify community needs, barriers, and facilitators to enable PR-AIR implementation. We will identify which characteristics of our existing evidence-based virtual and in-person interventions in home and school settings require fidelity-consistent modifications and use stakeholder input and matching of barriers to implementation strategy selection to identify methods to enhance PR-AIR uptake. During Phase 2, we will use a hybrid type III effectiveness-implementation design, evaluating low-intensity (virtual) and high-intensity (in-person) methods of implementation of PR-AIR. We will provide PR-AIR sequentially to 12 communities identified with high asthma burden through geospatial mapping using a cluster randomized, stepped wedge trial design, delivering PR-AIR to 400 children with asthma ages 2-12. We will use a mixed-methods approach to assess the impact of our implementation strategies on PR-AIR reach, adoption, implementation, and maintenance, and evaluate effectiveness of PR-AIR on individual-level (asthma control, quality of life) and community-level (health care utilization, school absences) outcomes. PR-AIR builds on a 20-year collaboration between our research teams in RI and PR, with an investment in advancing knowledge of multi-level factors affecting pediatric asthma disparities and reducing morbidity in children through evidence- based, sustainable interventions.