Puerto Rico Asthma Integrated Response Program (PR-AIR)

项目摘要/摘要 波多黎各(PR)后裔儿童的哮喘患病率和发病率高于儿童 来自任何其他种族的人。居住在PR岛上的儿童哮喘患病率甚至高于 大陆公关小朋友。我们建议实施和评估波多黎各-哮喘综合项目 应对计划(PR-AIR)，以解决PR圣胡安儿童哮喘的差异，圣胡安是一个高发病率地区 哮喘负担。公关-AIR整合了家庭和学校环境中的循证干预措施，并增强了 家庭、学校和医疗保健提供者之间的沟通。在第一阶段，我们将召开 利益相关者的社区协作，将在整个项目中提供投入，并使用深入的 面谈，以确定社区需求、障碍和促进者，以实现公关-AIR实施。我们会 确定我们现有的以循证为基础的虚拟和面对面家庭干预的哪些特征 学校设置需要进行保真度一致的修改，并使用利益相关者的意见和障碍的匹配 实施战略选择，以确定提高PR-空气摄取的方法。在第二阶段，我们将使用 混合型III型效能--实施设计，评估低强度(虚拟)和高强度 (面对面)实施PR-AIR的方法。我们将按顺序向12个社区提供PR-AIR 通过使用集群随机阶梯楔形绘制地理空间图来确定患有高哮喘负担 试验设计，为400名2-12岁的哮喘儿童提供PR-AIR。我们将使用混合方法 评估我们的实施战略对公关-空中覆盖、采用、实施和 维护和评估PR-AIR在个人层面(哮喘控制、生活质量)和 社区一级(卫生保健利用、缺课)的结果。公关-AIR建立在20年的基础上 我们在国际扶轮和公关领域的研究团队之间的合作，并投资于促进以下方面的知识 影响儿童哮喘差异的多层次因素，通过证据减少儿童发病率- 基于可持续的干预措施。

Project Summary/Abstract Children of Puerto Rican (PR) descent have higher rates of asthma prevalence and morbidity than children from any other ethnic group. Children residing on the Island of PR have even higher asthma prevalence than Mainland PR children. We propose to implement and evaluate the Puerto Rico-Asthma Integrated Response Program (PR-AIR) to address pediatric asthma disparities in San Juan, PR, an area of high asthma burden. PR-AIR integrates evidence-based interventions in home and school settings, and enhances communication between families, schools, and health care providers. During Phase 1, we will convene a community collaborative of stakeholders that will provide input throughout the project, and use in-depth interviews to identify community needs, barriers, and facilitators to enable PR-AIR implementation. We will identify which characteristics of our existing evidence-based virtual and in-person interventions in home and school settings require fidelity-consistent modifications and use stakeholder input and matching of barriers to implementation strategy selection to identify methods to enhance PR-AIR uptake. During Phase 2, we will use a hybrid type III effectiveness-implementation design, evaluating low-intensity (virtual) and high-intensity (in-person) methods of implementation of PR-AIR. We will provide PR-AIR sequentially to 12 communities identified with high asthma burden through geospatial mapping using a cluster randomized, stepped wedge trial design, delivering PR-AIR to 400 children with asthma ages 2-12. We will use a mixed-methods approach to assess the impact of our implementation strategies on PR-AIR reach, adoption, implementation, and maintenance, and evaluate effectiveness of PR-AIR on individual-level (asthma control, quality of life) and community-level (health care utilization, school absences) outcomes. PR-AIR builds on a 20-year collaboration between our research teams in RI and PR, with an investment in advancing knowledge of multi-level factors affecting pediatric asthma disparities and reducing morbidity in children through evidence- based, sustainable interventions.