Multimedia Asthma Self-Management Program

描述（由申请人提供）：哮喘是一种气道慢性炎症性疾病，影响超过2000万美国人。如果没有适当的治疗，它可能会危及生命。0-17岁儿童的哮喘患病率最高，估计有890万儿童受到影响。儿童哮喘患病率存在种族差异；非裔美国儿童(a)患哮喘的可能性最大，(b)住院的可能性是欧美儿童的三倍，(c)死于哮喘的可能性是欧美儿童的四倍。患有哮喘的儿童报告哮喘发作、急诊室就诊和住院的发生率高于成人；这些都是哮喘不受控制的指标。伴随着疾病的负担，患有哮喘的儿童更有可能表现出焦虑和压力障碍，并且比他们的非哮喘同龄人在学校表现更差。缺课和旷工加重了家长的经济负担。本提案的目标是通过互联网/CD-ROM和DVD格式为儿童及其父母创建哮喘自我管理技能培训计划。这个以行为为基础的项目将强调增加：(a)关于哮喘和正确使用药物的知识，(b)有效使用预防方法的动机，(c)管理哮喘的自我效能，以及(d)遵守卫生保健提供者的指示。内容将以临床实践指南（NHLBI）为基础，包括：(a)了解哮喘，(b)预防哮喘发作，(c)制定哮喘管理计划。儿童项目中的材料将针对受哮喘影响最大的三个种族/族裔群体（欧美人、非裔美国人和西班牙人）进行定制，以提高相关性和有效性，并打算与父母一起观看。将为家长制定一个单独的、更详细的计划，并为学校和护理提供者提供额外的材料。公共卫生相关性：本研究对公共卫生的潜在益处包括提高对儿童哮喘自我管理的文化因素的理解，提高儿童的自我管理技能，以及改善其父母的哮喘管理技能。这可以减轻数百万儿童及其家庭的痛苦并改善其生活质量，还可以减轻社会以医疗支出和生产力损失的形式承担的经济负担。

DESCRIPTION (provided by applicant): Asthma is a chronic inflammatory disease of the airway, affecting more than 20 million Americans. Without proper management it can be life-threatening. Children aged 0-17 have the highest prevalence of asthma, impacting an estimated 8.9 million children. Racial disparities exist in asthma prevalence for children; African- American children are (a) the most likely to suffer from asthma, (b) three times more likely to be hospitalized, and (c) four times more likely to die from asthma than Euro-American children. Children with asthma report higher incidences of asthma attacks, emergency room visits, and hospitalizations than adults; these are all indicators of uncontrolled asthma. Along with the burden of the disease, children with asthma are more likely to exhibit anxiety and stress disorders and have lower school performance than their non-asthmatic peers. Missed school and work days add to the financial burden of the disease for parents. The goal of this proposal is to create an asthma self-management skills training program for children and their parents in Internet/CD-ROM and DVD formats. This behaviorally based program will emphasize increasing: (a) knowledge regarding asthma and proper use of medications, (b) motivation to use prevention methods effectively, (c) self-efficacy in managing asthma, and (d) compliance with health care provider directions. Content will be based on clinical practice guidelines (NHLBI) and will include: (a) understanding asthma, (b) preventing asthma attacks, and (c) creating an asthma management plan. Materials in the child program will be tailored to the three largest racial/ethnic groups impacted by asthma (Euro-American, African- American and Hispanic) to increase relevance and efficacy, and intended for viewing with a parent. A separate and more detailed program for parents will be created with additional materials for schools and care providers. PUBLIC HEALTH RELEVANCE: The potential benefits of this research to public health include improved understanding of cultural factors in pediatric asthma self-management, improved self-management skills for children, and better asthma management skills for their parents. This could result in eased suffering and improved quality of life for millions of children and their families, and also reduce the economic burden borne by society in the forms of medical expenditures and lost productivity.