IMPROVING ASTHMA CARE THROUGH PARENTAL EMPOWERMENT: EFFECT ON

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 哮喘是儿童最常见的慢性疾病，它对城市、少数民族和弱势儿童的影响不成比例。如果正确实施，国家心肺血液研究所(NHLBI)现有的循证指南可以改善儿童哮喘的护理和预后。这些指南的一个关键组成部分是纵向护理作为患者、父母和医疗保健提供者之间伙伴关系的一部分的重要性。这种伙伴关系依赖于父母向提供者有效地传达医疗保健状况。提高市中心父母的沟通技能可能会提高他们在初级保健机构内获得更有效的纵向哮喘护理的能力，从而改善他们孩子的哮喘健康结果。Impact DC(改善哥伦比亚特区儿童哮喘护理)是一种基于当地验证的急诊科(ED)干预措施，通过哮喘教育、医疗护理和护理协调的强化短期计划，改善哮喘护理的多种衡量标准和结果。尽管取得了这些成功，但在干预不成功后，在哮喘护理方面与初级保健提供者(PCP)的后续接触和伙伴关系有所增加。因此，在目前的研究中，我们建议评估由受过培训的哮喘教育人员进行短期病例管理的现有IMPACT DC干预措施的增强版本的有效性。这项研究的总体目标是进行一项包含短期病例管理的Impact DC干预措施的增强版的前瞻性随机临床试验，以促进PCP的后续预约，并为父母提供关于如何更有效地与其子女的PCP沟通的教育，以此作为一种手段：(1)提高持续哮喘护理的初级保健服务的利用率；(2)在Impact DC哮喘诊所转介的150名高危儿童的父母中，提高父母在与子女提供者互动时的自我效能。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Asthma is the most common chronic disease of childhood, and it disproportionately affects urban, minority, and disadvantaged children. When implemented correctly, existing evidence-based guidelines from the National Heart, Lung, and Blood Institute (NHLBI) improve pediatric asthma care and outcomes. One key component of these guidelines is the importance of longitudinal care as part of a partnership among patient, parents, and a healthcare provider. Such a partnership depends on effective communication of healthcare status by parents to providers. Improving the communication skills of inner-city parents may improve their ability to obtain more effective longitudinal asthma care within their primary care homes and thereby to improve their child's asthma health outcomes. IMPACT DC (Improving Pediatric Asthma Care in the District of Columbia) is a locally validated emergency department (ED) based intervention that improves multiple measures of asthma care and outcomes through an intensive short-term program of asthma education, medical care, and care coordination. In spite of these successes, achieving increased subsequent contact and partnership with primary care providers (PCPs) for asthma care after the intervention has not been successful. Therefore, for the current study, we propose to assess the effectiveness of an enhanced version of the existing IMPACT DC intervention consisting of short-term case management by trained asthma educators. The overall aim of this study will be to perform a prospective randomized clinical trial of an enhanced version of the IMPACT DC intervention involving short-term case management to facilitate PCP follow-up appointments and to provide education for parents about how to communicate more effectively with their children's PCPs as a means (1) to improve the rate of utilization of primary care services for ongoing asthma care and (2) to enhance the self-efficacy of parents in their interactions with their children's provider regarding the child's asthma care needs in 150 parents of high risk children referred within the IMPACT DC Asthma Clinic.