Enhancing Children's and Parents' Asthma Management

描述(申请人提供)：哮喘是最常见的儿童慢性疾病，对少数族裔和贫困儿童的影响不成比例。很少有关于儿童哮喘的研究针对生活在农村地区的儿童，或者在他们的样本中包括墨西哥裔美国儿童。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的自我管理、哮喘知识、计量吸入器技能、哮喘严重程度以及父母对哮喘的管理和获得护理的机会。在这个相互竞争的延续中，我们建议在当前的研究设计中增加第三个手臂，将学校随机分为在校哮喘干预、在校注意力控制干预或单一5.5小时哮喘日营的替代干预-提供形式。三个民族的样本将由320名墨西哥裔美国人、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，我们建议增加慢性呼吸道炎症的非侵入性测量(呼出的一氧化氮)，以评估哮喘治疗的变化对呼吸道炎症的影响。将对家庭进行整整一年的跟踪调查，在基线以及干预后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、呼吸道炎症、家庭哮喘管理和生活质量的改善情况。拟议的夏令营-讲习班模式可能是提供干预措施的更有效的方式，如果事实证明它在改善哮喘管理和健康结果方面与学校-家庭模式同样有效，它可能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。

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.