A Family Approach to Managing Asthma in Early Teens

描述(由申请人提供)：没有报告提供证据证明哮喘教育在11至14岁儿童中的效果，或父母培训的优势，尽管该年龄段的哮喘患病率和发病率很高，而且数据表明父母的养育行为影响哮喘管理。这项研究的总体目标是测试一个由两个互补部分组成的计划的有效性：(A)以学校为基础的课程，使中学生能够管理他们的哮喘；(B)家长培训课程，教授儿童养育技能，支持年轻人日益增长的自主性和自我管理他们的疾病的需要。具体目标是：(1)实施筛查，以确定6-8年级学生是否患有持续性哮喘；以及(2)提供健康教育和家长培训，帮助儿童和家长更有效地管理哮喘。学生计划是基于在家庭和学校应对哮喘，这是在荷兰开发的一个成功的计划。家长项目是对茁壮成长的青少年的适应，是调查人员开发的有效的家长培训项目。这项随机对照试验的参与者将是来自纽约市16所为低收入少数族裔服务的公立学校的384名哮喘儿童和他们的照顾者。据假设，与对照组相比，随机接受干预的学生将在三个主要结果方面有所改善：(1)症状严重程度降低；(2)生活质量提高；(3)更好的哮喘管理技能。此外，与对照组相比，干预学生将在以下次要结果中表现出改善：(4)紧急卫生保健利用；(5)限制活动的天数；(6)亲子互动。照顾者和儿童将在基线时、干预后立即以及6个月和12个月完成评估这些结果的全面调查。这项研究的意义在于：(1)首次对中学生哮喘教育的效果进行评估；(2)首次将哮喘教育与家长培训结合起来，作为加强哮喘管理的手段。

DESCRIPTION (provided by applicant): No reports provide evidence of the effects of asthma education in 11- to 14-year olds, or the advantages of parent training despite the significant asthma prevalence and morbidity in this age group and data indicating that parenting behaviors influence asthma management. The overall goal of this study is to test the efficacy of a program with two complementary components: (a) a school-based curriculum to empower middle school students to manage their asthma and (b) a parent training curriculum to teach childrearing skills that support the youth's growing autonomy and need to self-manage their disease. The specific aims are: (1) to implement screening to identify 6th - 8th grade students with persistent asthma; and (2) to provide health education and parent training to help children and parents manage asthma more effectively. The student program is based on Coping with Asthma at Home and at School, a successful program developed in Holland. The parent program is an adaptation of Thriving Teens, an effective parent training program developed by the investigators. Participants in this randomized control trial will be 384 children with asthma and their caregivers from 16 NYC public schools serving low-income, ethnic minorities. It is hypothesized that students randomized to the intervention will have, relative to controls, improvements in three primary outcomes: (1) reduced symptom severity; (2) improved quality of life; and (3) better asthma management skills. Also, when compared to controls, intervention students will show improvement in the following secondary outcomes: (4) urgent health care utilization; (5) days with activity restriction; and (6) parent-child interactions. Caregivers and children will complete comprehensive surveys assessing these outcomes at baseline, and immediately and 6- and 12-months after the intervention. This study is significant because: (1) it will be among the first to evaluate the impact of asthma education in middle school students; and (2) it is the first to couple asthma education with parent training as a means of enhancing asthma management.