NATIONAL COOPERATIVE INNER CITY ASTHMA STUDY

这项研究的目的是确定人口的具体决定因素， 哮喘发病率和死亡率，并阐明其相互关系， 为了制定针对内城人口的干预战略， 儿童，4-11岁。 这将由一个全国性的合作社完成。 由哮喘研究单位组成的研究。 目标是估计 哮喘在东哈莱姆的患病率， 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。 第一阶段将确定一个 研究人群包括来自市中心的150例哮喘病例 社区，东哈莱姆，纽约，150例来自西奈山 医疗中心患者人群。 非哮喘儿童 选择社区作为对照。 病例对照和纵向 研究设计方法将用于评估生理，心理社会， 和环境因素，有助于哮喘发病率的目标 人口 环境卫生数据将以次样本形式收集 病例和对照组。 在第二阶段，我们将实施和评估以社区为基础的 旨在降低哮喘发病率的中心干预措施 在第一阶段确定的病例中。 随机析因研究设计 将被用来评估基于社区的 教育，基于学校或医院急诊的病例管理 室，并使用临床治疗方案。 具体内容和 干预方法将根据以下信息得出： 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.