EFFECT OF EDUCATIONAL INTERVENTION ON ASTHMA MORBIDITY IN INNER CITY CHILDREN

哮喘发病率和死亡率，包括住院率 急诊室就诊人数在美国急剧上升， 特别是在少数民族和贫困人口中。我们的研究将 评估双语哮喘教育项目的有效性 让儿童、父母和医疗保健提供者参与进来，这将是 在附属三园地纪念医院实施 以社区为导向的初级保健诊所。患有哮喘的儿童 曾住院或曾去急诊室就诊 过去五年内的哮喘将随机分配给一名 两组中的一组：接受医生治疗的组 已根据NIH哮喘管理指南接受过培训 或参与教育计划的团体，包括 内科医生和双语护士教育人员，其中包括 由儿童定期监测肺功能的峰值流量。一 诊所将作为对照，患者将不会收到 干预。要评估的成果衡量标准包括： 哮喘加重的频率，因哮喘而住院的次数 哮喘，哮喘急诊室就诊次数，药物治疗 用药量由用药分数、哮喘严重程度决定 由“哮喘严重程度评分”和自我管理决定 练习。所有患者将在术后一年内接受随访。 干预。由哮喘引起的发病率是中国的一个严重问题 我们的达拉斯市中心人口和其他城市地区的人口一样。我们 打算解决社会和经济因素以及健康问题 参与该项目的护理提供和管理问题 这一人群的发病率。同时我们将尝试确定是否 只要对诊所进行教育就能减少发病率。 医生根据NIH哮喘管理指南，它是 更有可能的是，我们只会在 实施密集的自我管理方案， 包括由患者进行客观的肺功能监测。

Asthma morbidity and mortality, including rates of hospitalizations and emergency room visits, is rising dramatically in the US, particularly in minority, indigent populations. Our study will assess the effectiveness of a bilingual asthma education program involving children, parents and healthcare providers that will be implemented at three Parkland Memorial Hospital-affiliated Community Oriented Primary Care clinics. Asthmatic children who have been hospitalized or who have had an emergency room visit for asthma within the last five years will be randomly assigned to one of two groups: a group that receives treatment by a physician who has been educated according to the NIH Asthma Management Guidelines or a group that participates in an educational program involving the physician and a bilingual nurse educator and that incorporates regular peak flow monitoring of lung function by the child. One clinic will serve as a control where patients will receive no intervention. The outcome measures to be assessed include: frequency of asthma exacerbations, number of hospitalizations for asthma, number of emergency room visits for asthma, medication usage as determined by a medication score, asthma severity as determined by an "asthma severity score" and self-management practices. All patients will be followed for one year after the intervention. Morbidity caused by asthma is a serious problem in our Dallas inner-city population as it is in other urban areas. We intend to address the social and economic factors and the health care delivery and management issues that participate in the morbidity of this population. While we will attempt to determine if a reduction in morbidity will occur by simply educating the clinic physicians according to the NIH Asthma Management Guidelines, it is more likely that we will see significant improvement only upon implementation of an intensive self-management program that includes objective pulmonary function monitoring by the patient.