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

描述（由申请人提供）：在美国，波多黎各儿童的哮喘患病率和发病率在所有种族/族裔群体中最高，并且这些比率正在上升。严重性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，这是潜在的修改，也有助于这些哮喘发病率的结果。这项探索性的R21应用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。这种干预措施的独特之处在于，可以根据个人的需要和长处，使用工具包对标准化核心课程向所有参与者提供的教育和支助进行修改。该教育包括环境改造、解决问题、自我监控和争取社会支持方面的特定技能培训。具体目标1是探索哮喘自我管理行为（包括哮喘信念模型，使用民间疗法，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，并使用一个小的行为随机对照试验，以测试这种干预措施的能力，以改善哮喘患儿的父母的哮喘自我管理行为。长期目标是将这些试点数据应用于设计和实施一项更大的行为随机对照试验，该试验将测试旨在改善哮喘控制的类似哮喘干预措施。本申请中的调查人员与为目标人群服务的社区机构有着丰富的经验，并利用基于社区的参与性研究原则扩大了这些关系，为本申请做好了准备。一个著名的社区服务机构和一所当地社区学院为该应用程序的设计做出了贡献，并承诺在研究实施和结果传播方面提供服务。从这项研究中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，这项研究将提供重要的干预试验数据，最终可能改善这一高风险人群的哮喘控制。参与性设计有助于建设社区研究能力，提高研究质量和效率。公共卫生相关性：从这项研究中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，这项研究将提供重要的干预试验数据，最终可能改善这一高风险人群的哮喘控制。参与性设计有助于建设社区研究能力，提高研究质量和效率。

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.