SOCIAL FACTORS & THE ENVIRONMENT IN PEDIATRIC ASTHMA

描述(摘自调查人员摘要) 哮喘是一种日益常见、复杂的疾病，发病率和 死亡率。儿童哮喘患病率和严重程度的种族差异 显示居住在城市的贫穷的非高加索人的发病率较高 社区。因哮喘死亡的最大比例增加是 发生在10-14岁年龄段。这项建议研究的是种族 低收入非裔美国人中儿童哮喘预后的差异， 拉丁裔和高加索小学适龄儿童。我们的目标是澄清 生物和环境，以及社会和行为， 导致这些差异的过程。 哮喘筛查将在三组六所小学作为一个 为学校服务。返回屏幕的家长将作为 人口中将有三批小学适龄儿童 招聘，在项目的头三年每年招聘一名。屏幕 在每个队列中产生三组孩子：一组以前 确诊的哮喘，第二组可能有未确诊的哮喘 (阳性筛查)，第三组没有哮喘症状的证据 (底片)。筛查呈阳性的儿童将每六年进行一次跟踪 12个月，以获得额外的三个点的数据。一个随机的 哮喘筛查阴性者的样本将被招募为 仅针对第一个数据点的比较组。 在三个时间点收集的信息包括1)关于 儿童哮喘控制(卫生服务利用情况和症状)和 一般身体健康，以及2)照顾者生活压力源，身体健康，以及 抑郁症。时间点1和3(T1和T3)是电话采访。也是 在T1，哮喘筛查呈阳性的儿童将在 普通呼吸道过敏的学校。时间点2(T2)的采访 是在家访期间进行的，此时家庭环境屏幕 采集了两个粉尘样本，然后进行了尘螨分析， 蟑螂和猫的抗原。也是在T3(筛查结果后一年 )，父母将接受采访，了解他们是如何做出这一决定的 是否寻求关怀，向谁寻求关怀，以何种方式取得成功。已选择 医疗保健提供者将收到一份关于儿童 关心。该项目的所有阶段都包括社区推广和教育 计划，最终在最后一年的社区会议上分享成果和 考虑下一步。

DESCRIPTION (Taken from the Investigators' Abstract) Asthma is an increasingly common, complex condition with rising morbidity and mortality. Racial disparities in pediatric asthma prevalence and severity indicate higher rates among indigent, non-Caucasians living in urban communities. The greatest proportional increase in deaths due to asthma has occurred in the 10-14 year-old age range. This proposal studies the racial disparities in pediatric asthma outcome among low income African American, Latino, and Caucasian elementary school-aged children. The goal is to clarify the biologic and environmental, as well as the social and behavioral, processes that lead to these disparities. Asthma screening will be done at three sets of six elementary schools as a service to the schools. Parents returning the screen will serve as the population from which three cohorts of elementary school-aged children will be recruited, one in each of the first three years of the project. The screen yields three groups of children in each cohort: one group that has previously diagnosed asthma, a second group that has possible, undiagnosed asthma (positive screens), and a third group that has no evidence of asthma symptoms (negative screen). The children screening positive will be followed every six months for 12 months to obtain three additional points of data. A random sample from those who screen negative for asthma will be recruited as a comparison group for the first data point only. Information gathered at the three time points include 1) information on childhood asthma control (health services utilization and symptoms) and general physical health, and 2) caregiver life stressors, physical health, and depression. Time points 1 and 3 (T1 and T3) are telephone interviews. Also at T1, children who screened positive for asthma will have allergy testing at school for common respiratory allergies. The interview at time point 2 (T2) is conducted during a home visit, at which time a home environmental screen is conducted and two dust samples collected and later analyzed for dust mite, cockroach, and cat antigens. Also at T3 (one year after the screening results are returned), parents will be interviewed about how they made the decision whether or not to seek care, from whom, and with what success. Selected healthcare providers will be sent a questionnaire regarding the children's care. All stages of the project include a Community Outreach and Education Plan, culminating in community meetings in the final year to share results and consider next steps.