NATIONAL COOPERATIVE INNER-CITY ASTHMA STUDY

全国城市内哮喘合作研究

• 批准号: 2457862
• 负责人: GAIL G SHAPIRO
• 金额: $ 54.9万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-08-01 至 2000-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2457862
• 关键词: adolescence (12-20); asthma; behavior modification; behavioral /social science research tag; bronchodilators; clinical research; clinical trials; controlled environment; cooperative study; culture; emergency care; family structure /dynamics; functional ability; health education; hospital utilization; human morbidity; human subject; human therapy evaluation; longitudinal human study; medical outreach /case finding; nursing intervention; patient care management; preschool child (1-5); quality of life; respiratory airway volume; respiratory disorder chemotherapy; respiratory function; self care; statistics /biometry; urban area; urinalysis

DESCRIPTION (adapted from applicant's Abstract): Asthma is the most common chronic illness of childhood, a burden disproportionately shared by inner-city, African-American children. Factors that may decrease asthma morbidity are high-quality comprehensive medical care, culturally-sensitive outreach which emphasizes self-management skills, environmental and behavioral modification, and a more coordinated approach to care delivery. The applicants propose a prospective, randomized controlled trial to evaluate the effectiveness of a culturally-sensitive, coordinated approach to asthma care in inner-city children with moderate or severe asthma. Children will be randomized into three groups: (1) augmented usual care (Group I); (2) coordinated care (Group II); and (3) coordinated care plus environmental modification (Group III), each of 24-months duration. Providers for all groups will be trained in National Heart Lung and Blood Institute (NHLBI) asthma management guidelines and will have several educational and management enhancements. Group II will receive bi-monthly home visits by a lay asthma outreach worker and weekly assessments by the school nurse. The pediatricians caring for these children will use this information during scheduled clinic visits, which will include an asthma education curriculum. Group III will receive the coordinated care intervention plus specific interventions designed to minimize the child's exposure to dust mites and environmental tobacco smoke (ETS). The impact of the interventions in Groups II and III will be assessed according to the following four domains: (1) physiologic measures (methacholine challenge, forced expiratory volume in one second (FEV-1), peak expiratory flow rate; (2) health care use (asthma hospitalizations and acute visits to clinics and emergency rooms); and (3) environmental measures (household dust mite concentrations, nitrogen dioxide (N02) and fine particulate matter concentrations, urinary cotinine levels, and household dampness); and (4) functional status measures (medication use, quality of life, and family function).

描述（改编自申请人的摘要）：哮喘是最常见的疾病 儿童时期的慢性疾病，这是一个不成比例地分担的负担 内城区的非洲裔美国儿童。 可能减少哮喘的因素 发病率高，综合医疗护理质量高，文化敏感 强调自我管理技能、环境和 行为改变，以及更加协调的护理服务方法。 申请人提出一项前瞻性、随机对照试验 评估文化敏感、协调一致的方法的有效性 为患有中度或重度哮喘的市中心儿童提供哮喘护理。 儿童将被随机分为三组：(1) 强化常规护理 （第一组）； (2) 协调护理（第二组）； (3) 协调护理加 环境改造（第三组），每组为期 24 个月。 所有团体的提供者都将接受国家心肺和血液培训 研究所（NHLBI）哮喘管理指南，并将有几个 教育和管理水平不断提高。 第二组将收到双月刊 哮喘非专业人士家访 外展工作人员和学校护士的每周评估。 这 照顾这些儿童的儿科医生将在治疗期间使用此信息 定期就诊，其中包括哮喘教育课程。 第三组将接受协调护理干预加上特定的 旨在最大程度地减少儿童接触尘螨和 环境烟草烟雾（ETS）。 将评估第二组和第三组干预措施的影响 根据以下四个领域： (1) 生理测量 （乙酰甲胆碱挑战，一秒用力呼气量 (FEV-1)， 呼气峰值流速； (2) 医疗保健用途（哮喘住院和 紧急前往诊所和急诊室）； (3) 环境措施 （家庭尘螨浓度、二氧化氮（N02）和细颗粒物 颗粒物浓度、尿可替宁水平和家庭 湿气）； (4) 功能状态测量（药物使用、治疗质量） 生活和家庭功能）。