A Family Approach to Managing Asthma in Early Teens

描述（由申请人提供）：没有报告提供证据证明哮喘教育对11至14岁奥尔兹的影响，或父母培训的优势，尽管该年龄组的哮喘患病率和发病率很高，数据表明父母的行为影响哮喘管理。本研究的总体目标是测试一个具有两个互补组成部分的项目的有效性：（a）以学校为基础的课程，使中学生能够管理他们的哮喘和（B）家长培训课程，教授育儿技能，支持年轻人不断增长的自主性和自我管理疾病的需要。具体目标是：（1）进行普查，以识别六至八年级的学生是否有持续哮喘;及（2）提供健康教育及家长训练，以协助儿童及家长更有效地处理哮喘。学生计划是基于应对哮喘在家里和学校，一个成功的计划在荷兰开发。家长计划是一个适应蓬勃发展的青少年，一个有效的家长培训计划开发的调查人员。这项随机对照试验的参与者将是来自16所纽约公立学校的384名哮喘儿童及其照顾者，这些学校为低收入少数民族提供服务。假设随机分配到干预组的学生相对于对照组在三个主要结果方面有所改善：（1）症状严重程度降低;（2）生活质量改善;（3）哮喘管理技能提高。此外，与对照组相比，干预学生将在以下次要结果方面表现出改善：（4）紧急医疗保健利用;（5）活动限制天数;（6）亲子互动。护理人员和儿童将在基线、干预后立即、6个月和12个月完成评估这些结果的综合调查。这项研究意义重大，因为：（1）它将是第一个评估哮喘教育在中学生中的影响;（2）它是第一个将哮喘教育与家长培训结合起来，作为加强哮喘管理的手段。

DESCRIPTION (provided by applicant): No reports provide evidence of the effects of asthma education in 11- to 14-year olds, or the advantages of parent training despite the significant asthma prevalence and morbidity in this age group and data indicating that parenting behaviors influence asthma management. The overall goal of this study is to test the efficacy of a program with two complementary components: (a) a school-based curriculum to empower middle school students to manage their asthma and (b) a parent training curriculum to teach childrearing skills that support the youth's growing autonomy and need to self-manage their disease. The specific aims are: (1) to implement screening to identify 6th - 8th grade students with persistent asthma; and (2) to provide health education and parent training to help children and parents manage asthma more effectively. The student program is based on Coping with Asthma at Home and at School, a successful program developed in Holland. The parent program is an adaptation of Thriving Teens, an effective parent training program developed by the investigators. Participants in this randomized control trial will be 384 children with asthma and their caregivers from 16 NYC public schools serving low-income, ethnic minorities. It is hypothesized that students randomized to the intervention will have, relative to controls, improvements in three primary outcomes: (1) reduced symptom severity; (2) improved quality of life; and (3) better asthma management skills. Also, when compared to controls, intervention students will show improvement in the following secondary outcomes: (4) urgent health care utilization; (5) days with activity restriction; and (6) parent-child interactions. Caregivers and children will complete comprehensive surveys assessing these outcomes at baseline, and immediately and 6- and 12-months after the intervention. This study is significant because: (1) it will be among the first to evaluate the impact of asthma education in middle school students; and (2) it is the first to couple asthma education with parent training as a means of enhancing asthma management.