NATIONAL COOPERATIVE INNER CITY ASTHMA STUDY

这项研究的目标是确定人群特定的决定因素 哮喘发病率和死亡率，并阐明它们之间的相互关系 为了制定市中心人口的干预策略，在 4-11岁的儿童。这将由一个全国性的合作社来完成 由哮喘研究单位组成的研究。我们的目标是评估 东哈莱姆区哮喘的流行情况和生理特征， 心理社会和环境特征可能会影响 哮喘的患病率和严重程度。 建议的研究将分两个阶段进行。第一阶段将确定 来自市中心的150例哮喘患者组成的研究人群 纽约东哈莱姆区的社区和西奈山的150例 医疗中心患者群体。非哮喘儿童来自 社区将被选为控件。病例对照和纵向对照 研究设计方法将被用来评估生理、心理社会、 以及导致目标地区哮喘发病率的环境因素 人口。环境卫生数据将以分样本形式收集 病例和对照。 在第二阶段，我们将实施和评估以社区为基础的和医疗 旨在降低哮喘发病率的以中心为基础的干预 在第一阶段确定的病例中，一项随机析因研究设计 将被用来评估以社区为基础的 教育，以学校或医院紧急情况为基础的病例管理 房间，并使用临床治疗方案。具体内容和 干预的方法将根据以下信息得出 第一阶段。

The goals of this study are to identify population specific determinants of asthma morbidity and mortality and to clarify their interrelationships in order to develop intervention strategies for an inner city population, in children, ages 4-11. This will be accomplished by a national cooperative study consisting of Asthma Study Units. The objectives are to estimate the prevalence of asthma in East Harlem and to characterize the physiological, psychosocial and environmental characteristics that may affect the prevalence and severity of asthma. The proposed study will proceed in two phases. Phase I will identify a study population consisting of 150 asthma cases derived from an inner city community, East Harlem, New York, and 150 cases from the Mount Sinai Medical Center patient population. Non-asthmatic children from the community will be selected as controls. Case-control and longitudinal study design methods will be used to evaluate physiological, psychosocial, and environmental factors that contribute to asthma morbidity in the target population. Environmental hygiene data will be collected on a sub-sample of cases and controls. During Phase II, we will implement and evaluate community-based and medical center-based interventions that are intended to reduce asthma morbidity among the cases identified in Phase I. A random factorial study design will be used to evaluate the relative effectiveness of community-based education, case management based either in schools or a hospital emergency room, and use of clinical treatment protocols. The specific contents and methods of the interventions will be derived based on the information from Phase I.