Aggravating Factors of Asthma in a Rural Environment

项目摘要 哮喘和在农村环境中加重哮喘的因素是确定的关键健康优先事项 在一个持续的社区-学术伙伴关系中，Proyecto Bienestar(PB)。这个由来已久的 合作伙伴关系是西北社区教育中心与 (NCEC)/KDNA电台，亚基马山谷农场工人诊所(YVFWC)，传统大学 和华盛顿大学(UW)。预防病情恶化是最重要的 哮喘治疗面临的挑战和国家指南承认室内空气的作用 环境因素和交通相关污染物。该项目涉及一个重要的数据 在影响农村拉美裔人口的环境因素的作用方面存在差距， 那里哮喘发病率高得不成比例。在项目的第一阶段，我们将对 在临床确诊的一组队列中暂时定位哮喘加重的发作 利用地理信息软件绘制农业病区分布图 可能负责触发这些事件的过程。最常见的嫌疑人 环境触发器将按优先顺序排列。以可疑农业过程的时间为指导 而报道的剧集，将使用创新的多通道采样器进行采样 一个以社区为基础的监测网，将为可疑的加重者采样空气。这个 哮喘队列将继续跟踪到第三年。分析将重点放在 可疑诱因的浓度将与新哮喘报告进行比较 按受试者加重。基于已确认和/或 将开发出疑似严重的加重者，通过KDNA电台、YVFWC发送 和华盛顿大学。基于农村管理的临床医生培训课程设置 将开发哮喘患者，并将其提供给YVFWC临床提供者及其哮喘患者 外展计划社区卫生工作者。评估将包括PB的过程评估， 加强数据收集和哮喘管理及产品的结果评估 量化，包括论文、演示文稿和学生参与者以及对 改变了社区的反应。

Project Abstract Asthma and factors that aggravate asthma in the rural setting are key health priorities identified in an ongoing community-academic partnership, Proyecto Bienestar (PB). This longstanding partnership is a collaboration between the Northwest Community Education Center (NCEC)/KDNA Radio, the Yakima Valley Farm Workers Clinic (YVFWC), Heritage University and the University of Washington (UW). Preventing exacerbations is the most important challenge in asthma treatment and national guidelines recognize the role of indoor environmental factors and traffic-related pollutants. This project addresses an important data gap regarding the role of ambient environmental factors that affect a rural Hispanic population, where asthma morbidity is disproportionately high. In the first phase of the project we will geo- temporally locate episodes of asthma aggravation among a cohort of clinically confirmed asthmatics and utilize geographic information software to map the distribution of agricultural processes that may be responsible for triggering these episodes. The most common suspected ambient triggers will be prioritized. Guided by the timing of the suspected agricultural processes and the reported episodes, sampling with an innovative multi channel sampler will be done with a grid of community-based monitors which will sample air for the suspected aggravators. The asthmatic cohort will continue to be followed into year three. Analysis will focus on concentrations of the suspected triggers which will be compared to reports of new asthma exacerbations by subjects. An educational outreach program based on confirmed and/or strongly suspected aggravators will be developed for delivery through Radio KDNA, the YVFWC and the University of Washington. A clinician training curricula based on management of rural asthmatics will be developed and delivered to the YVFWC clinical providers and their Asthma Outreach Program community health workers. Evaluation will include process evaluation of PB, outcome evaluation of enhanced data collection and asthma management and product quantification including papers, presentations and student participants and impact evaluation of changes community response.