COMMUNITY INTERVENTION--MINORITY CHILDREN WITH ASTHMA

社区干预——少数民族哮喘儿童

• 批准号: 3364291
• 负责人: FLOYD J MALVEAUX
• 金额: $ 36.41万
• 依托单位: HOWARD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1990
• 资助国家: 美国
• 起止时间: 1990-08-01 至 1994-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3364291
• 关键词: African American; academic achievement; allied health personnel; asthma; chronic disease /disorder; community health services; continuing education; coping; education evaluation /planning; elementary school; emergency care; family medicine; health care service evaluation; health care service utilization; health education; hospital utilization; human morbidity; human subject; longitudinal human study; middle childhood (6-11); pediatrics; primary care physician; self care; self concept; urban poverty area

Asthma is a leading cause of childhood illness that disproportionately affects minority children. The causes of higher hospitalization and death rates among minority children with asthma are not understood. It is commonly assumed that barriers related to poverty underlie this public health issue. Two proposed causes of this increased morbidity and mortality are problems associated with effective asthma self-management and difficulties in establishing and maintaining continuity of medical care. In this study we will examine the separate and combined impact of asthma interventions designed to address these two specific problem areas. A school-based asthma self-management program will be developed to promote children's self-management skills within predominately minority schools. A community-based asthma health worker program will be developed to assist minority families in establishing and maintaining asthma health care within the community. It is hypothesized that the most effective control of asthma will be achieved with the combination of these two interventions. Twenty elementary schools each in inner-city Baltimore, Maryland and inner- city Washington D.C. will serve as our study sites. Asthmatic children grades 1-5 will be identified by school records and parent surveys. After obtaining consent schools will be randomly assigned to one of four intervention groups: 1) a control/minimal intervention, 2) a school-based asthma education program, 3) a community-based asthma health worker program, and 4) a combined intervention that includes both the school-based education program and the community-based health worker program. The duration of both the school program and the Community health worker program will be twelve months. Baseline measures will be collected after obtaining consent and prior to school randomization. Followup measures will be collected from children and families at 6, 12, 18, and 24 months. Data will be collected on hospitalization, emergency or urgent care, acute episodes, health care utilization, medications, school absences, academic performance, self-esteem, self and family asthma management, and family coping.

哮喘是儿童疾病的主要原因，其中不成比例地 影响少数民族儿童。 住院率和死亡率较高的原因 少数民族儿童哮喘的发病率尚不清楚。 这是 人们普遍认为，与贫困相关的障碍是这一公众的基础 健康问题。 发病率增加的两个拟议原因 死亡率是与有效的哮喘自我管理相关的问题 难以建立和维持医疗护理的连续性。 在这项研究中，我们将研究哮喘的单独和综合影响 旨在解决这两个具体问题领域的干预措施。 一个 将制定校本哮喘自我管理计划，以促进 主要是少数族裔学校儿童的自我管理技能。 一个 将制定以社区为基础的哮喘卫生工作者计划来协助 少数族裔家庭在国内建立和维持哮喘卫生保健 社区。 据推测，最有效的控制 结合这两种干预措施将实现哮喘治疗。 马里兰州巴尔的摩市中心和市中心各有 20 所小学 华盛顿特区将作为我们的研究地点。 哮喘儿童 1-5 年级将通过学校记录和家长调查来确定。 后 获得同意的学校将被随机分配到四所学校之一 干预组：1) 对照组/最低限度干预，2) 以学校为基础的干预组 哮喘教育计划，3) 社区哮喘卫生工作者 计划，以及 4) 综合干预，包括基于学校的干预 教育计划和以社区为基础的卫生工作者计划。 这 学校计划和社区卫生工作者计划的持续时间 将是十二个月。 基线测量将在获得后收集 同意并在学校随机分组之前。 后续措施将 在 6、12、18 和 24 个月时从儿童和家庭收集。 数据 将在住院、急诊或紧急护理、急性 发作次数、医疗保健利用、药物、缺勤、学业 表现、自尊、自我和家庭哮喘管理以及家庭 应对。