HomeBASE (Home-Based Asthma Support and Education for Adults)

描述（由申请人提供）：在过去的二十年里，美国受哮喘影响的成年人数量急剧增长，哮喘现在影响了1400万成年人。对他们中的许多人来说，哮喘控制不足，导致大量发病率和经济负担。我们建议的主要目标是开发和评估一种名为HomeBASE（基于家庭的哮喘支持和教育）的家庭教育和支持干预的价值，以降低18-65岁的低收入、种族多样化的哮喘成年人的哮喘发病率。家庭干预的价值，虽然对患有哮喘的儿童有效，理论上有吸引力，但尚未对成人进行评估。具体来说，该项目将测试这样一个假设，即社区卫生工作者在一年的时间里为哮喘自我管理提供教育和支持，评估家庭环境诱因，哮喘控制资源，并协助与医疗提供者进行有效沟通，将减少哮喘发病率，哮喘相关的紧急医疗保健使用和室内哮喘诱因。采用参与式研究方法的随机对照试验。420名参与者将被招募并随访两年。主要结局包括哮喘无症状天数、哮喘相关生活质量和紧急卫生服务使用情况。全部数据将在基线时亲自收集，并在一年后和两年后收集。临时数据将通过电话访问获得。暴露于哮喘诱因将通过面谈、家访和分析室内灰尘中的螨虫过敏原来评估。增量成本效益（每无症状日美元）将被测量。其他目标包括：(1)确保社区参与研究设计、实施、评估和传播；(2)如果HomeBASE证明是成功的，传播项目复制的协议和工具。该提案是由当地哮喘联盟金县哮喘论坛发起并赞助的。它是通过HomeBASE指导委员会成员之间的现有合作关系制定的：哮喘患者、私营部门诊所和医院、社区诊所、地方公立医院、地方卫生部门、社区组织和华盛顿大学。由哮喘患者组成的社区咨询小组就提案的制定提供咨询意见。

DESCRIPTION (provided by applicant): The number of adults affected by asthma in the United States has grown dramatically in the past two decades and asthma now affects 14 million adults. Control of asthma is inadequate for many of them, leading to substantial morbidity and economic burden. The primary goal of our proposal is to develop and assess the value of a home-based education and support intervention called HomeBASE (Home-Based Asthma Support and Education) for reducing asthma morbidity among low-income, ethnically diverse adults with asthma ages 18-65. The value of an in-home intervention, while effective among children with asthma and theoretically appealing, has not been assessed among adults. Specifically, the project will test the hypothesis that community health workers providing education and support for self-management of asthma, assessment of the home for environmental triggers, resources for asthma control, and assistance in effective communication with medical providers over the course of one year will reduce asthma morbidity, asthma- related urgent health care use and exposure to indoor asthma triggers. A randomized controlled trial using participatory research methods will be used. Four hundred twenty participants will be enrolled and followed for two years. Primary outcomes include asthma symptom-free days, asthma-related quality of life and urgent health service use. Full data will be collected in person at baseline, and one and two years later. Interim data will be obtained through telephone interviews. Exposure to asthma triggers will be assessed through interviews, home inspection and analysis of house dust for mite allergen. The incremental cost- effectiveness (dollars per symptom-free day) will be measured. Other aims include (1) ensuring community participation in study design, implementation, evaluation and dissemination and (2) and disseminating protocols and tools for program replication should HomeBASE prove successful. The proposal was initiated by and is sponsored by the King County Asthma Forum, the local asthma coalition. It has been developed through existing collaborative relationships among partners who are members of the HomeBASE Steering Committee: people with asthma, private sector clinics and hospitals, community clinics, the local public hospital, the local health department, community-based organizations and the University of Washington. The Community Advisory Group, consisting of people with asthma, has advised on proposal development.