FAMILY PROCESS, ADHERENCE, AND CHILD ASTHMA OUTCOME

描述：这个多措施，多信息提供者， 纵向研究的目的是为了阐明在何种程度上和机制 由此，特定的家庭过程可能是保护性的或有害的， 3组儿童的依从行为和治疗结果 轻中度哮喘：80名儿童参加了 丹佛儿童哮喘管理项目（CAMP）网站，80 在一个大型的，最先进的， 国家认可的健康维护组织，以及60名儿童 通过使用学校记录来识别哮喘儿童 在各种不同的医疗保健系统中接受治疗 在丹佛市区 CAMP研究是由NHLBI赞助的， 不同类型哮喘的纵向、多中心、随机试验 治疗儿童设计，以确定影响的 治疗对哮喘结果指标如肺功能、支气管 高反应性和哮喘发病率。 此外，另一个NHLBI- 受资助的辅助研究将收集有关治疗的详细数据， 参加夏令营的孩子们。 这项研究提出， 应用程序增加了家庭过程的测量， 丹佛营地正在进行其他数据收集工作。 这 大大增加了CAMP评估的重要科学目标， 一个相当适度的成本。 此外，对两者的平行研究 比较样本不仅增加了这项研究的力量，以澄清 家庭过程、依从性和哮喘结局之间的关系， 同时也让我们能够评估参与 像CAMP这样的大型临床试验改变了观察到的 这些因素。 本研究有三个具体目标：1）检查在多大程度上， 族过程变量在横截面上与 纵向影响哮喘治疗的依从性，以及 三个站点之间的这种关系的一致性; 2）检查 族过程变量在横截面上 与哮喘治疗结果相关并长期影响哮喘治疗结果， 以及这三个站点之间的关系的一致性： 3)以确定是否坚持治疗介导了 特定家庭过程与哮喘治疗的关系 结果，以及这种关系在整个 三个网站。 这项研究是一个合乎逻辑的下一步， 研究者正在进行的研究项目， 具体的家庭过程，医疗保健实践，医疗结果，以及 对患有慢性疾病的儿童进行心理社会调整， 具有重要的治疗意义。

DESCRIPTION: The central aim of this multi-measure, multi-informant, longitudinal study is to clarify the extent to which and the mechanisms whereby specific family processes may be protective or deleterious in the adherence behaviors and treatment outcome in 3 groups of children with asthma of mild-moderate severity: 80 children participating in the Denver site of the Childhood Asthma Management Program (CAMP), 80 children receiving asthma-related care in a large, state-of-the-art, nationally recognized health maintenance organization, and 60 children recruited by using school records to identify children with asthma receiving their care in a variety of different health care systems across the Denver metro area. The CAMP study is an NHLBI-sponsored, longitudinal, multicenter, randomized trial of differing asthma treatments in children designed to determine the influence of the treatments on such asthma outcome measures as lung function, bronchial hyper-responsiveness, and asthma morbidity. Additionally, another NHLBI- funded ancillary study will gather detailed data concerning the treatment adherence of children participating in CAMP. The study proposed in this application adds measurements of family processes that dovetail into other data collection efforts underway at the Denver CAMP site. This greatly increases the important scientific aims evaluated by CAMP for a quite modest cost. Furthermore, the parallel study of the two comparison samples not only increases the power of this study to clarify the relationships among family process, adherence, and asthma outcome, but also allows us to evaluate the extent to which participation in a major clinical trial like CAMP alters the relationships observed across these factors. This study has three specific aims: 1) to examine the extent to which family process variables are cross-sectionally associated with and longitudinally influence adherence to asthma treatment, as well as the consistency of this relationship across the three sites; 2) to examine the extent to which family process variables are cross-sectionally associated with and Iongitudinally influence asthma treatment outcome, as well as the consistency of this relationship across the three sites: 3) to determine whether adherence with treatment mediates the relationship between specific family processes and asthma treatment outcome, as well as the consistency of this relationship across the three sites. This study represents a logical next step for The investigator s ongoing research program examining the relationships among specific family processes, health care practices, medical outcomes, and psychosocial adjustment of children with chronic medical illnesses, and has important treatment implications.