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，波多黎各裔拉丁裔儿童哮喘发病率和死亡率增加。中学生的发病率高于其他任何年龄组的儿童。本R21应用程序的目标是开发和测试一个4期，同伴促进哮喘自我管理干预拉美裔，初中（6 -8年级）儿童在城市公立学校设置。我们的干预措施ASMAS（学校哮喘自我管理）将被设计为由受过培训和监督的拉丁裔哮喘高中生和高年级学生对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裔儿童哮喘高发地区实施：波多黎各的圣胡安和罗德岛的普罗维登斯。本申请的第一个目的是开发哮喘自我管理干预和干预程序，使其与拉丁裔学生的背景文化一致，并适用于学校环境，为RCT/R01。焦点小组将在两个地点与学生、HS同伴和学校工作人员进行，具有哮喘教育和自我管理、校本干预和适合文化的治疗方面专业知识的调查人员将提供投入。第二个目标是通过一项先导随机对照试验来测试干预措施，以提供效应大小的估计，这将用于通知RCT/R01的样本量（每个站点6组；每个站点每种情况3组）。我们将在每个站点招募30名患有哮喘的拉丁裔儿童，并将他们随机分配到ASMAS干预组或哮喘教育加儿童健康控制组（每种情况3组，每个站点）。我们期望ASMAS干预的参与者相对于对照组有更好的哮喘自我管理（改善自我管理技能，哮喘知识和自我效能，可用的救援吸入器和与学校护士的哮喘行动计划）。我们还预计，与对照组相比，ASMAS干预的参与者将有更好的哮喘结局（症状减轻更大，哮喘相关缺勤更少，哮喘控制和哮喘相关生活质量得到改善）。

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.