A Community-Academic Partnership to Improve Asthma Management in Latino Children

描述（由申请人提供）：波多黎各儿童在美国的哮喘患病率和发病率是所有种族/族裔群体中最高的，而且这些发病率正在上升。诸如严重程度和敏感性的生物学差异、环境条件、获得护理的机会和社会经济地位等因素有助于但不能完全解释这些患病率和发病率。不充分的自我管理行为，这是可能改变的，也有助于这些哮喘发病率的结果。这项探索性的R21应用程序将开发和测试一种干预措施，以改善这一高危人群的哮喘自我管理。这项干预措施的独特之处在于，向所有参与者提供的标准化核心课程的教育和支持可以根据个人需求和优势使用工具包进行修改。教育包括环境改造、解决问题、自我监督和争取社会支持方面的具体技能培训。具体目标1是探讨哮喘自我管理行为（包括哮喘信念模式、民间疗法的使用、社会支持、压力、获得护理和社会经济地位）对波多黎各哮喘儿童父母的影响。具体目标2将把这些影响纳入社区卫生工作者哮喘干预措施，并使用一项小型行为随机对照试验来测试这种干预措施改善波多黎各哮喘儿童父母哮喘自我管理行为的能力。长期目标是将这些试点数据应用于设计和实施更大规模的行为随机对照试验，以测试旨在改善哮喘控制的类似哮喘干预措施。本应用程序的调查人员在为目标人群服务的社区机构方面拥有丰富的经验，并利用基于社区的参与式研究原则扩大了这些关系，为本应用程序做准备。一个著名的社区服务机构和一所当地的社区学院为这个应用程序的设计做出了贡献，并承诺为研究的实施和结果的传播提供服务。这项研究产生的数据将提高我们对哮喘自我管理对波多黎各哮喘儿童父母的具体影响的理解，该研究将为干预提供重要的试点数据，该干预可能最终改善哮喘控制，这一高危人群患有不成比例的哮喘。参与式设计有助于建立社区研究能力，提高研究质量和有效性。公共卫生相关性：本研究产生的数据将提高我们对哮喘自我管理对波多黎各哮喘儿童父母的具体影响的理解，该研究将为干预措施提供重要的试点数据，该干预措施可能最终改善这一哮喘高危人群的哮喘控制。参与式设计有助于建立社区研究能力，提高研究质量和有效性。

DESCRIPTION (provided by applicant): Puerto Rican children in the United States experience the highest asthma prevalence and morbidity rates of all racial/ethnic groups and these rates are increasing. Factors such as biological differences in severity and sensitivity, environmental conditions, access to care, and socioeconomic status contribute to, but do not fully explain, these prevalence and morbidity rates. Inadequate self-management behaviors, which are potentially modifiable, also contribute to these asthma morbidity outcomes. This exploratory R21 application will develop and test an intervention to improve asthma self-management for this high-risk population. The intervention is unique in that the education and support provided to all participants from the standardized Core Curriculum can be modified using a Toolkit based on individual needs and strengths. The education incorporates specific skills training in environmental modification, problem solving, self-monitoring, and enlisting social support. Specific Aim 1 is to explore influences of asthma self-management behaviors (including asthma belief models, the use of folk remedies, social support, stress, access to care, and socio-economic status) for Puerto Rican parents of children with asthma. Specific Aim 2 will incorporate these influences into a community health worker asthma intervention and use a small behavioral randomized controlled trial to test the ability of this intervention to improve asthma self-management behaviors for parents of Puerto Rican children with asthma. The long-term goal is to apply these pilot data in the design and implementation of a larger behavioral randomized controlled trial that will test a similar asthma intervention aimed at improving asthma control. The investigators in this application have significant experience with community agencies serving the target population and have expanded these relationships to prepare for this application using the principles of community-based participatory research. A prominent community service agency and a local community college contributed to the design of this application and have committed their services in the study implementation and results dissemination. The data generated from this research will improve our understanding of the specific influences of asthma self-management for Puerto Rican parents of children with asthma and the study will provide important pilot data on an intervention that may ultimately improve asthma control for this high-risk population that suffers disproportionately from asthma. The participatory design serves to build community capacity for research and improve research quality and effectiveness. PUBLIC HEALTH RELEVANCE: The data generated from this research will improve our understanding of the specific influences of asthma self-management for Puerto Rican parents of children with asthma and the study will provide important pilot data on an intervention that may ultimately improve asthma control for this high-risk population that suffers disproportionately from asthma. The participatory design serves to build community capacity for research and improve research quality and effectiveness.