Enhancing Children's and Parents' Asthma Management

描述（由申请人提供）：哮喘是最常见的儿童慢性疾病，对少数民族和贫困儿童的影响尤为严重。很少有针对生活在农村地区的儿童或将墨西哥裔美国儿童纳入样本的儿童进行的儿童哮喘研究。在NIH/NINR资助的一项研究（加强儿童和父母的哮喘管理，R01 NR00770）中，儿童哮喘计划被用来教授农村学龄儿童如何管理他们的哮喘，父母在家访期间接受了个性化的教育课程。研究结果表明，干预可以改善儿童哮喘自我管理、哮喘知识、计量吸入器技能、哮喘严重程度以及父母的哮喘管理和获得护理。在这一竞争性的延续中，我们建议在当前的研究设计中增加第三组，将学校随机分为校内哮喘干预、校内注意力控制干预或5.5小时哮喘日营的替代干预交付形式。三种族样本将由320名患有哮喘的墨西哥裔美国人、非裔美国人和白人农村学龄儿童（2-5年级）及其父母组成。此外，我们建议增加慢性气道炎症（呼出一氧化氮）的非侵入性测量，以评估哮喘管理改变对气道炎症的影响。对家庭进行为期一年的随访，在基线和干预后1个月、4个月和7个月收集数据，以评估儿童哮喘发病率、哮喘严重程度、气道炎症、家庭哮喘管理和生活质量的改善情况。拟议的营地-讲习班形式可能是提供干预措施的一种更有效的方式，如果它被证明在改善哮喘管理和健康结果方面与学校-家庭形式同样有效，它可能具有更大的转化为实践的潜力，因为它增加了提供干预措施的选择。哮喘是儿童最常见的慢性疾病。哮喘管理主要发生在家庭环境中，因此需要有效改善儿童和父母哮喘管理的干预措施。

DESCRIPTION (provided by applicant): Asthma is the most common chronic childhood illness and disproportionately affects children who are ethnic minorities and poor. Few studies of childhood asthma have been conducted with children who live in rural areas or have included Mexican American children in their samples. In an NIH/NINR funded study (Enhancing Children's and Parents' Asthma Management, R01 NR00770), the Asthma Plan for Kids was used to teach rural school-age children how to manage their asthma and parents received an individualized educational session during a home visit. Study findings demonstrated the intervention could improve children's asthma self-management, asthma knowledge, metered dose inhaler skill, asthma severity, and parents' asthma management and access to care. In this competing continuation, we propose adding a third arm to the current research design with schools randomized into either an in-school asthma intervention, an in-school attention-control intervention, or an alternate intervention-delivery format of a single 5.5-hour asthma day camp. The tri-ethnic sample will be composed of 320 Mexican-American, African-American, and White rural school-aged children (grades 2-5) who have asthma and their parents. In addition, we propose adding a non-invasive measure of chronic airway inflammation (exhaled nitric oxide) to assess the impact of changes in asthma management on airway inflammation. Families will be followed for a full year with data collection at baseline and at 1-month, 4-months, and 7-months after the intervention to assess improvement in children's asthma morbidity, asthma severity, airway inflammation, family asthma management and quality of life. The proposed Camp-Workshop format may be a more efficient way to deliver the intervention and if it proves to be equally as effective as the School-Home format in improving asthma management and health outcomes it may have greater potential for translation to practice in that it increases the options for intervention delivery. PUBLIC HEALTH RELEVANCE Asthma is the most common chronic childhood illness. Asthma management occurs primarily in the context of the family and as such interventions that are effective in improving children's and parents' asthma management are needed.