A Community-Engaged Approach to Reducing Pediatric Asthma Disparities in Richmond

 描述（由申请人提供）：本U34申请是为响应RFA-HL-15-028：创建哮喘授权合作以减少儿童哮喘差异而提交的，其目的是进行基于社区的需求评估，为开展随机临床试验提供信息，以降低里士满市城市哮喘儿童（5-17岁）的哮喘发病率和医疗保健利用率。里士满是一个城市中心，被哮喘和过敏基金会命名为哮喘首都（即，最具挑战性的地方生活在美国与哮喘）三次在过去fou年。我们将与参与里士满，现有的社区大学合作伙伴关系在VCU（NCATS UL 1 TR 000058）进行我们的需求评估和制定哮喘护理实施计划（ACIP）的儿童。我们将从规划年度开始采用社区参与模式，让社区居民参与我们从招聘到传播的需求评估的每一步。社区需求评估将包括六项内容：照顾者和青年咨询小组;每月与利益攸关方举行会议;照顾者和儿童重点小组;对哮喘儿童照顾者的社区调查;模式综合;与关键知情人的访谈。我们形成性混合方法需求评估的目标包括：1）确定促进或抑制城市家庭有效哮喘管理的因素，2）确定与哮喘儿童治疗相关的特定社区问题，3）让社区利益相关者参与确定哮喘儿童家庭的需求并优先考虑这些需求，以及4）利用我们的需求评估的反馈来修改拟议的ACIP，并制定一项协议来评估ACIP。利益相关者和关键信息提供者包括来自里士满市卫生区的代表、地区哮喘联盟、政策制定者、社区组织中的个人、哮喘儿童的照顾者、哮喘儿童和地区医院的哮喘临床医生。我们提出的ACIP包括3个循证干预组成部分：1）以社区为基础的倡议，减少家庭环境暴露，2）由社区卫生工作者提供哮喘自我管理教育，3）与儿童哮喘护理提供者协调，以确保适当的循证医学治疗。我们的ACIP的整合是新颖的，因为一个案件管理委员会（例如，社区卫生工作者、儿科护士、心理学家）将直接询问照顾者他们在管理孩子的哮喘时所面临的挑战;这些挑战可能根植于家庭文化或家庭社区。我们将使用我们的需求评估的结果，以确保我们的干预措施满足里士满家庭的需求，并解决这些家庭与儿童哮喘有关的最高优先事项。通过创新地使用“参与里士满”，我们将能够更好地考虑家庭生活的文化背景和里士满家庭在ACIP中取得成功所需的资源。 (End摘要）

 DESCRIPTION (provided by applicant): The goal of this U34 application, submitted in response to RFA-HL-15-028: Creating Asthma Empowerment Collaborations to Reduce Childhood Asthma Disparities, is to conduct a community-based needs assessment to inform the development of a randomized clinical trial to decrease asthma morbidity and healthcare utilization among urban children with asthma (5-17 years) in Richmond City. Richmond, an urban center, has been named by the Asthma and Allergy Foundation as the Asthma Capital (i.e., most challenging place to live in the United States with asthma) three times in the last fou years. We will partner with Engaging Richmond, an existing community-university partnership at VCU (NCATS UL1TR000058) in conducting our needs assessment and developing an Asthma Care Implementation Program (ACIP) for children. We will use a model of community engagement from the beginning of our planning year that involves community residents in every step of our needs assessment from recruitment to dissemination. The community needs assessment will include six elements: caregiver and youth advisory groups; monthly meetings with stakeholders; caregiver and child focus groups; community survey of caregivers of children with asthma; model synthesis; interviews with key informants. Goals of our formative mixed-methods needs assessment include: 1) identifying factors that promote or inhibit effective asthma management in urban families, 2) identifying specific community concerns related to the treatment of children with asthma, 3) engaging community stakeholders in identifying and prioritizing the needs of families of children with asthma, and 4) using feedback from our needs assessment to modify the proposed ACIP and develop a protocol to assess the ACIP. Stakeholders and key informants include representatives from the Richmond City Health District, an area asthma coalition, policy makers, individuals in community-based organizations, caregivers of children with asthma, children with asthma, and asthma clinicians at area hospitals. Our proposed ACIP includes 3 evidence-based intervention components: 1) a community-based initiative that reduces home environmental exposures, 2) asthma self-management education delivered by community health workers, and 3) coordination with the child's asthma care provider to ensure appropriate evidence-based medical treatment. The integration of our ACIP is novel in that a case management committee (e.g., community health worker, pediatric nurse, psychologist) will ask caregivers directly about challenges they face in managing their child's asthma; these challenges may be embedded within the family's culture or within the family's community. We will use the results of our needs assessment to ensure that our interventions meet the needs of families in Richmond and address the highest priority items related to childhood asthma for these families. Through the innovative use of Engaging Richmond, we will be better able to consider the cultural context in which families live and the resources families in Richmond would need to succeed in the ACIP. (End of Abstract)