Puerto Rico Asthma Integrated Response Program (PR-AIR)

波多黎各哮喘综合应对计划 (PR-AIR)

• 批准号: 10705253
• 负责人: GLORISA J CANINO
• 金额: $ 69.51万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-15 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10705253
• 关键词: Address; Adoption; Affect; Age; Algorithms; Area; Asthma; Behavior; Care given by nurses; Caregivers; Caring; Characteristics; Child; Childhood Asthma; Clinic; Collaborations; Communication; Communities; Consolidated Framework for Implementation Research; Development; Disease Management; Disparity; Effectiveness; Eligibility Determination; Enrollment; Ethnic Population; Evidence based intervention; Face; Family; Health Personnel; Healthcare; Home; Hybrids; Individual; Insurance; Intervention; Interview; Investments; Island; Knowledge; Latino; Maintenance; Maps; Methods; Modification; Morbidity - disease rate; Outcome; Pattern; Persons; Pharmaceutical Preparations; Phase; Physicians; Prevalence; Puerto Rican; Puerto Rico; Quality of life; Randomized; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Research; Resources; Rhode Island; Risk; School Nursing; Schools; Services; Severity of illness; Structure; System; design; effectiveness evaluation; effectiveness outcome; effectiveness/implementation design; evidence base; experience; family management; formative assessment; health care service utilization; high risk; implementation barriers; implementation strategy; improved; intervention program; preference; programs; randomized trial; remote delivery; response; screening; success; technology platform; trial design; uptake; urban area; virtual; virtual intervention

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.

项目摘要/摘要 波多黎各人（PR）下降的儿童的哮喘患病率和发病率比儿童更高 来自任何其他种族。住在公关岛上的儿童的哮喘患病率更高 大陆公关子女。我们建议实施和评估波多黎各雅芳的整合 响应计划（PR-AIR）解决PR的圣胡安儿科哮喘差异 哮喘负担。 PR-AIR将基于证据的干预措施整合在家庭和学校环境中，并增强 家庭，学校和医疗保健提供者之间的沟通。在第1阶段，我们将召集 利益相关者的社区合作组织将在整个项目中提供意见，并深入使用 访谈以确定社区需求，障碍和促进者，以实现PR-AIR实施。我们将 确定我们在家庭中现有的基于证据的虚拟和面对面干预的特征以及 学校设置需要忠诚度的修改，并使用利益相关者的意见和障碍匹配 实施策略选择以确定增强PR-AIR摄取的方法。在第二阶段，我们将使用 杂交III型有效性实施设计，评估低强度（虚拟）和高强度 （面对面）实施PR-AIR的方法。我们将依次向12个社区提供PR-Air 使用随机的阶梯楔形物的聚类通过地理空间映射，哮喘负担很高 试验设计，向400名哮喘儿童2-12岁儿童提供PR-AIR。我们将使用混合方法 评估我们的实施策略对PR-AIR覆盖，采用，实施和 维护和评估PR-AIR对个体水平（哮喘控制，生活质量）和 社区级别（医疗保健利用，学校缺席）的结果。 PR-Air建立20年 我们在RI和PR的研究团队之间的合作，并投资于促进知识 影响小儿哮喘差异并通过证据降低儿童发病率的多层次因素 - 基于可持续的干预措施。