A Coping Skills Intervention for Low-SES Latino Families of Children with Asthma

针对低社会经济地位拉丁裔哮喘儿童家庭的应对技巧干预

基本信息

批准号：
10399650
负责人：
Erin M. Rodriguez
金额：
$ 66.76万
依托单位：
UNIVERSITY OF TEXAS AT AUSTIN
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-18 至 2025-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10399650
关键词：
13 year old Address Affect Age Asthma Behavior Belief Buffers Child Childhood Asthma Clinic Cognitive Communities Control Groups Coping Skills Educational Curriculum Effectiveness Elements Emergency department visit Empirical Research Enrollment Family Financial Hardship Goals Health Hospitalization Household Immigration Intervention Knowledge Latino Lead Link Mediating Mediator of activation protein Moods Outcome Parents Pathway interactions Patients Pilot Projects Population Populations at Risk Poverty Primary Health Care Problem behavior Process Psychosocial Stress Public Health Quality of life Randomized Randomized Controlled Trials Records Reporting Research Risk Role Sampling School-Age Population Schools Self Management Site Societies Spirometry Stress Stress and Coping Symptoms Testing Underserved Population Work Youth arm base bilingualism clinical decision-making compare effectiveness coping cost cost effective depressive symptoms disparity reduction effective therapy effectiveness testing evidence base experience follow-up functional outcomes health disparity implementation trial improved insight low socioeconomic status post intervention programs psychobiologic psychosocial pulmonary function recruit social health determinants stressor translational research program

项目摘要

PROJECT SUMMARY Latino children experience disparities in asthma control and have worse functional outcomes related to poorly controlled asthma compared to non-Latino White children, including more school absences, emergency department visits, and hospitalizations for asthma. These disparities persist despite the benefits of asthma self- management interventions. A significant and growing percentage of Latino children live in poverty, which further increases their risk for uncontrolled asthma. For low-SES Latino children, psychosocial stress is an unaddressed factor in asthma disparities. Existing interventions rarely target psychosocial processes to address the role of stress in asthma control. However, research on coping offers insight into potential intervention approaches that would buffer the effects of stress and reduce asthma disparities for low-SES Latino children. Coping is a key modifiable factor that lies “midstream” between upstream social determinants of health and downstream disparities in health outcomes. In particular, secondary control coping (i.e., efforts to accommodate/adapt to stressors, such as acceptance and cognitive restructuring) has been linked to better asthma control for children in low-SES contexts. Therefore, the purpose of the current R01 proposal is to test the effectiveness and mediators of Adapt 2 Asthma (A2A), a bilingual family-based coping skills + asthma management intervention tailored to the stressors, strengths, and cultural beliefs of low-SES Latino families. 280 low-SES Latino families of children ages 9-13 years old with asthma will be identified and enrolled from community primary care clinics and randomly assigned to either A2A or a standard asthma self-management (AM) control arm. We will assess children’s asthma control, quality of life, lung function, school absences, and emergency department visits as the outcomes of the intervention. We will also examine child mediational pathways (child coping and mood and behavior symptoms) and parent mediational pathways (parent coping and depressive symptoms) of the intervention. Assessments will occur at pre- and post-intervention and at 6 and 12-month follow-up timepoints using child and parent report, spirometry, and school records. The successful completion of this R01 would provide evidence of the effectiveness and mediators of A2A for low-SES Latino children, a population underserved by current intervention approaches. Our results are expected to lead to a subsequent multi-site implementation trial of A2A in primary care. The long-term goal of this line of research is to reduce disparities in asthma control and its health consequences affecting low-SES Latino children and similar underserved youth populations. The knowledge gained would improve the health of low-SES Latino children and reduce the public health burden related to pediatric asthma, a condition with a significant cost to society.

项目概要拉丁裔儿童在哮喘控制方面存在差异，并且与不良相关的功能结果较差与非拉丁裔白人儿童相比，哮喘得到控制，包括更多缺课、紧急情况尽管哮喘自我治疗有好处，但这些差异仍然存在。相当一部分拉丁裔儿童生活在贫困之中，这进一步加剧了管理干预措施。对于社会经济地位低的拉丁裔儿童来说，社会心理压力是一个未得到解决的问题。现有的干预措施很少针对心理社会过程来解决哮喘差异的作用。然而，应对压力的研究提供了对潜在干预方法的见解。缓解压力的影响并减少社会经济地位低的拉丁裔儿童的哮喘差异应对是关键。位于上游健康社会决定因素和下游社会决定因素之间“中游”的可修改因素特别是，次要控制应对措施（即努力适应/适应）。压力源（例如接受和认知重建）与更好地控制儿童哮喘有关因此，当前 R01 提案的目的是测试有效性和有效性。 Adapt 2 Asthma (A2A) 的调解者，一种基于双语的家庭应对技巧 + 哮喘管理干预针对低 SES 拉丁裔家庭的压力源、优势和文化信仰量身定制。 280 个低 SES 拉丁裔家庭。的 9-13 岁哮喘儿童将从社区初级保健诊所进行识别和登记并分配给 A2A 或标准哮喘自我管理 (AM) 对照组，我们将进行评估。儿童哮喘控制、生活质量、肺功能、缺课和急诊就诊等我们还将检查儿童的中介途径（儿童的应对方式和情绪）。行为症状）和父母中介途径（父母应对和抑郁症状）评估将在干预前和干预后以及 6 个月和 12 个月的随访时间点进行。使用儿童和家长报告、肺活量测定法和学校记录成功完成此 R01 将。提供 A2A 对社会经济地位低的拉丁裔儿童的有效性和中介因素的证据目前的干预方法服务不足，我们的结果预计将导致随后的多站点。 A2A 在初级保健中的实施试验这一系列研究的长期目标是减少差异。哮喘控制及其对社会经济地位低的拉丁裔儿童和类似的服务不足的青少年的健康影响所获得的知识将改善社会经济地位低的拉丁裔儿童的健康并减少公众的健康。与小儿哮喘相关的健康负担是一种给社会造成巨大损失的疾病。