Peer-Administered Asthma Self-Management Intervention in Urban Middle Schools

描述（由申请人提供）：儿童哮喘存在健康差异，波多黎各血统的拉丁裔儿童表现出哮喘发病率和死亡率增加。中学生的发病率高于其他年龄组的儿童。该R21应用程序的目标是为城市公立学校环境中的拉丁美洲中学生（6 - 8年级）儿童开发和测试一种4节、同伴促进的哮喘自我管理干预。我们的干预措施ASMAS（学校哮喘自我管理）将由受过培训和监督的高中三年级和四年级的拉丁裔哮喘患者向一组患有哮喘的年轻同龄人（11-13岁）进行管理。ASMAS干预措施将在两个城市和拉丁美洲儿童哮喘高发地区实施：波多黎各的圣胡安和罗得岛的普罗维登斯。本申请的第一个目的是为RCT/R 01开发哮喘自我管理干预和干预程序，使其在文化上与拉丁美洲学生的背景一致，并适用于学校环境。将与两个研究中心的学生、HS同伴和学校工作人员进行焦点小组讨论，具有哮喘教育和自我管理、基于学校的干预和文化定制治疗专业知识的研究者将提供意见。第二个目的是通过初步随机对照试验测试干预措施，以提供效应量估计值，用于确定RCT/R 01的样本量（每个研究中心6组;每个研究中心每种疾病3组）。我们将在每个研究中心招募30名患有哮喘的拉丁裔儿童，并将他们随机分配到ASMAS干预或哮喘教育加儿童健康控制条件下（每个研究中心每种条件3组）。我们预计，与对照组相比，ASMAS干预组的参与者将改善哮喘自我管理（改善自我管理技能、哮喘知识和自我效能、可用的急救吸入器和学校护士制定的哮喘行动计划）。我们还预计，与对照组相比，ASMAS干预组的参与者将改善哮喘结局（症状减少更多，哮喘相关缺勤减少更少，哮喘控制和哮喘相关生活质量改善）。

DESCRIPTION (provided by applicant): Health disparities in pediatric asthma exist, with Latino children of Puerto Rican descent demonstrating increased asthma morbidity and mortality. The morbidity levels of middle school children are higher than children from any other age group. The goal of this R21 application is to develop and test a 4-session, peer- facilitated asthma self-management intervention for Latino, middle school-aged (6th-8th graders) children in urban public school settings. Our intervention, ASMAS (Asthma Self-Management in Schools) will be designed to be administered by trained and supervised High School juniors and seniors of Latino descent with asthma to a group of younger peers with asthma (11-13 years of age). The ASMAS intervention will be implemented in two areas that contain a high prevalence of urban and Latino children with asthma: San Juan, Puerto Rico and Providence, Rhode Island. The first AIM of this application is to develop the asthma self-management intervention and intervention procedures to make them culturally consistent with Latino students' background, and applicable to the school setting, for the RCT/R01. Focus groups will be conducted with students, HS Peers, and school personnel in both sites, and Investigators with expertise in asthma education and self- management, school-based interventions, and culturally tailored treatments, will provide input. The second AIM is to test the intervention through a Pilot Randomized Control Trial to provide estimates of effect size that will be used to inform the sample size for the RCT/R01 (6 groups per site; 3 groups of each condition, per site). We will recruit 30 Latino children with asthma per site, and randomly assign them to the ASMAS intervention or the Asthma Education plus Child Health control condition (3 groups of each condition, per site). We expect that participants in the ASMAS intervention will have improved asthma self-management (improved self- management skills, asthma knowledge and self-efficacy, available rescue inhaler and asthma action plan with school nurse), relative to the control condition. We also anticipate that participants in the ASMAS intervention will have improved asthma outcomes (greater reduction of symptoms, fewer asthma-related absences, improved asthma control and asthma-related quality of life), relative to the control condition.