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An Asthma Collaboration to Reduce Childhood Asthma Disparities on the Navajo Nation

哮喘领域的合作旨在减少纳瓦霍族儿童哮喘的差异

基本信息

批准号：
10237947
负责人：
Bruce George Bender
金额：
$ 59.43万
依托单位：
NATIONAL JEWISH HEALTH
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-08-15 至 2023-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10237947
关键词：
19 year old Address Admission activity Adoption Adrenal Cortex Hormones Advisory Committees African American Alaska Native American Indians Arizona Asthma Caring Child Child Health Childhood Asthma Cities Clinic Collaborations Collection Colorado Communities Data Databases Education Educational workshop Effectiveness Emergency department visit Environmental Exposure Environmental Pollutants Epidemiology Event Evidence based program Family Feedback Funding Future General Population Government Guidelines Health Health Care Costs Health Personnel Health Services Accessibility Healthcare Healthcare Systems Home Hospitalization Human Indian reservation Inpatients Intervention Interview Interviewer Intubation Leadership Low Income Population Maintenance Medical Methods Monitor Morbidity - disease rate Native Americans Navajo New Mexico Odds Ratio Oral Outcome Parents Perception Pharmaceutical Preparations Phase Population Poverty Prevalence Primary Health Care Privatization Process Provider Quality of Care Quality of life Reach, Effectiveness, Adoption, Implementation, and Maintenance Recommendation Reporting Research Research Design Research Personnel Reservations Resources Rural School Nursing School Teachers Schools Severities Surveys Symptoms Testing Time Training Transportation Travel United States United States Indian Health Service United States National Institutes of Health Universities asthma exacerbation base care coordination caucasian American community planning cost design dissemination strategy effectiveness measure evidence base health disparity implementation evaluation implementation facilitation implementation process impression improved informant intervention program meetings member mortality primary outcome programs satisfaction secondary outcome success tribal member

项目摘要

PROJECT SUMMARY/ABSTRACT Asthma prevalence among children on the Navajo Nation, the largest tribal reservation in the United States, is 2-3 times that of the general population and fueled by health disparities that include devastating poverty, multiple environmental pollutants, and large travel distances to obtain healthcare. Delivery of evidence-based asthma care through the Indian Health Service (IHS), the only healthcare system on the reservation, is inconsistent. While schools and communities identify pediatric asthma as a strong concern, no comprehensive asthma care implementation plan has been previously introduced. Therefore, this proposed study will combine two previously tested programs, one focused on training providers and one on school-based education and monitoring, to build a comprehensive, integrated, team-based Asthma Care Implementation Program to address medical care, family, home, and community to improve the health of Navajo children with asthma. A one-year engagement phase has resulted in strong support from Navajo Nation organizations including the President and Vice President of the Navajo Nation, governmental organizations, healthcare centers, schools, and communities in the three participating agencies (Fort Defiance, Chinle, and Tuba City). Approval of the proposed study by the Navajo Nation Human Research Review Board has been obtained. Key recommendations from communities including use of existing resources such as the Navajo Epidemiology Center, Navajo Health Department, local media, lay health workers, and ongoing involvement of stakeholders are included in this plan. Using a stepped-wedge design, the intervention will be introduced sequentially into three agencies. A mixed-methods analysis strategy will be employed that includes annual examination of asthma exacerbations through the IHS database (primary outcome), interviews with 300 families with a child with asthma, and key informant interviews with healthcare providers and school teachers and nurses. During the sustainability phase, meetings will be held with multiple organizations including local chapter houses to share outcome data, gather feedback, and plan for future dissemination to other agencies and reservations. The RE-AIM framework will be employed to evaluate the implementation process and facilitate dissemination to other tribal populations.

项目总结/文摘