Asthma in the Lives of Families Today (ALOFT)

项目摘要/摘要 哮喘是美国儿童除感染外最常见的住院原因，以及 底特律等城市的哮喘死亡率高得令人不安。这一纵向计划的首要目标是 项目-哮喘在当今家庭的生活(高空)-是为了确定行为和生物学上的 家庭社会环境对青年产生影响的途径 哮喘。该项目使用自然主义观察来识别日常家庭行为，这些行为要么加剧 或改善哮喘发病机制，这比其他方法有了实质性的进步(例如， 问卷、访谈和实验室互动)，并提供了了解 在大样本城市青年中，随着时间的推移，家庭功能对儿童疾病的影响。我们的小说 自然观察法结合了电子激活记录器(EAR)以及调查， 日常日记、生物测量(包括昼夜皮质醇、炎症标志物和基因表达)，以及 哮喘临床评估。这个更新项目建立在最初高空研究的成功基础上。 在更新阶段，我们将首先用100名新参与者来“更新”(扩充)高空样本 从底特律招募的。刷新样本将允许我们(A)比较两组(原始样本和 刷新样本)，以了解底特律不断变化的经济环境的影响(所谓的“新的 (B)扩大高空项目的样本量，增加 用于分析的统计能力。第二，我们将在现有的高空启动新的第四波数据采集 样本。这一波来自原始高空样本的额外数据-最近一波之后的4年- 将使我们能够：(A)测试青春期早期的家庭环境如何影响哮喘发病率和健康- 青春期以后的相关生物学和(B)测试家庭关系随时间和非家庭关系的变化 人际关系(例如，同龄人、朋友、恋人)--在此期间，这些关系往往会变得更有影响力 时期--影响健康。最后，我们将利用下一代基因测序技术进行 对原始样本和刷新样本进行全基因组基因表达分析。这些新的分析 将使我们能够进一步了解家庭社会环境通过哪些分子途径 影响患有哮喘的青少年的健康。 在家庭中隔离特定的生物和心理过程，这些过程可能有助于或 缓冲，哮喘发病率将促进未来将该项目的关键发现转化为 新的和对发展敏感的干预措施，以减少哮喘发病率，并将告知和 加强家庭干预。最后，这个项目的发现将被用来告诉我们如何更好地 使用新技术和生物标志物准确评估家庭互动和压力，以更好地捕获 家庭干预研究中行为改变的潜在机制。

Project Summary / Abstract Asthma is the most common cause of hospitalization in children in the U.S. other than infections, and cities such as Detroit have troublingly high asthma mortality rates. The overarching goal of this longitudinal project—Asthma in the Lives of Families Today (ALOFT)—is to identify the behavioral and biological pathways through which family social environments “get under the skin” to exert their effects on youth asthma. This project uses naturalistic observation to identify everyday family behaviors that either exacerbate or ameliorate asthma pathogenesis, representing a substantial advance over other methods (e.g., questionnaires, interviews, and laboratory interactions) and provides a unique opportunity to understand the effects of family functioning on childhood disease over time in a large sample of urban youth. Our novel naturalistic observation approach incorporates the Electronically Activated Recorder (EAR), as well as surveys, daily diaries, biological measures (including diurnal cortisol, inflammatory markers and gene expression), and clinical asthma evaluations. This renewal project builds on the success of the original ALOFT study. In the renewal phase, we will first “refresh” (augment) the ALOFT sample with 100 new participants recruited from Detroit. The refresher sample will allow us to (a) compare the two groups (original sample and refresher sample) to see the effects of the changing economic environment in Detroit (the so-called “New Detroit” post-bankruptcy) on youth health and (b) augment the sample size of the ALOFT project, increasing statistical power for analyses. Second, we will initiate a new 4th wave of data collection on the existing ALOFT sample. This additional wave of data from the original ALOFT sample—4 years after the most recent wave— will allow us to: (a) test how family environments early in adolescence impact asthma morbidity and health- related biology later in adolescence and (b) test how changes in family relationships over time and non-family relationships (e.g., peers, friends, romantic partners)—which often become much more influential during this period—impact health. Finally, we will utilize next-generation genetic sequencing techniques to conduct genome-wide gene expression analyses on the original sample and the refresher sample. These new analyses will allow us to advance understanding of the molecular pathways through which family social environments impact the health of youth with asthma. Isolating specific biological and psychological processes in families that potentially contribute to, or buffer, asthma morbidity will foster future “bench to bedside” translation of key findings from this project into novel and developmentally sensitive interventions to reduce asthma morbidity, and will also inform and improve family interventions. Finally, the findings from this project will be used to inform how to more accurately assess family interactions and stress with new technology and biomarkers to better capture potential mechanisms of behavior change in family intervention research.