Comparison of Asthma Programs for Schools

学校哮喘项目比较

• 批准号: 7874553
• 负责人: EILEEN KAE KINTNER
• 金额: $ 45.81万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7874553
• 关键词: 18 year old; Absenteeism; Acute; Address; Affect; Age; American Lung Association; Area; Asthma; Behavior; Behavioral; Biological Factors; Caregivers; Characteristics; Child; Chronic; Clinic; Cognition; Cognitive; Collaborations; Communities; Computers; Control Groups; Counseling; Data; Development; Diagnosis; Discipline of Nursing; Dose; Education; Eligibility Determination; Enrollment; Equation; Extended Family; Family Caregiver; Family member; Fostering; Friends; Goals; Growth; Guidelines; Health; Health Personnel; Health Professional; Health Promotion; Health behavior; Health education; Healthcare; Healthcare Systems; Healthy People 2010; Home environment; Hospitals; Hour; Human Resources; Inhalators; Knowledge; Laws; Left; Life; Link; Long-Term Effects; Longevity; Michigan; Mission; Modeling; Monitor; Morbidity - disease rate; National Heart, Lung, and Blood Institute; National Institute of Allergy and Infectious Disease; National Institute of Child Health and Human Development; Outcome; Parents; Participant; Patients; Pharmaceutical Preparations; Prevention Guidelines; Quality of life; Randomized; Reading; Recruitment Activity; Research; Sampling; Schedule; School-Age Population; Schools; Scientific Advances and Accomplishments; Self Management; Services; Severities; Severity of illness; Single-Blind Study; Specific qualifier value; Sports; Students; Surveys; Symptoms; System; Telephone; Testing; Time; Training; Universities; Update; Vision; Voice; adverse outcome; age group; base; cohort; college; community setting; comparative efficacy; comparison group; design; disorder prevention; elementary school; experience; fifth grade; health disparity; improved; junior high school; laptop; meetings; member; mortality; outreach; peer; post intervention; pressure; programs; prospective; psychosocial; public health relevance; racial and ethnic; respiratory; socioeconomics; theories

DESCRIPTION (provided by applicant): The purpose of the Comparison of Asthma Programs for Schools (CAPS) study is to evaluate efficacy of a new developmentally-appropriate, school-based academic and counseling asthma health education program compared to a low-dose control, well-established, non-academic program. The new program for diverse fifth- grade students with asthma and their family caregivers is entitled, "Staying Healthy Asthma Responsible & Prepared" (SHARP). SHARP is a comprehensive, theory-driven, evidenced-guided program developed in collaboration with school personnel and members of one community asthma coalition that has two components: (a) a Student Component and (b) Community Component. The low-dose comparison group will receive Open Airways for Schools (OAS) that is widely disseminated through the American Lung Association. Specific Aim 1: Evaluate the efficacy of SHARP compared to the low-dose OAS control group for fifth-grade students on cognitive, psychosocial, and behavioral aspects of asthma management immediately post- and at 12 and 24 months post-intervention. Specific Aim 2: Evaluate the long-term effect of SHARP compared to the low-dose OAS control group for fifth-grade students on condition characteristics, use of healthcare services, and quality of life at 12 and 24 months post intervention. A two-group, longitudinal, prospective, cluster- randomized, single-blinded trial will be used. Schools will be matched based on fifth-grade enrollment numbers, standardized reading and math scores, free/reduced lunch eligibility, and racial/ethnic proportions prior to randomization. The unit of analysis will be the student. The sample will consist of 2 cohorts of fifth- grade students, ages 9-12 years, with asthma and their caregivers. Two cohorts of student/caregiver dyads will be recruited over 2 years (N=152 dyads per year for a total of 304 dyads over two years) and analyzed separately. A minimum of 5-6 dyads will be recruited from 30 elementary schools located in three communities with 10 schools selected from each community. Participants will represent varying socioeconomic, cultural, racial, and ethnic backgrounds. Recently retired certified elementary schoolteachers identified by the areas' school districts will be trained to serve as interveners to deliver SHARP or OAS during school hours. Evaluators will collect pre- and post-intervention data from dyads in the home using audio-linked data entry systems loaded on laptop computers at four time points. A bi-monthly automated voice recorded telephone survey will be placed to caregivers to monitor symptom days, medication use, use of healthcare services, and school absenteeism. To adjust for non-independence of observations within schools, hypotheses will be tested using the generalized estimating equations approach for categorical or ordinal variables and linear mixed models for continuous outcomes. After efficacy is demonstrated, this study would advance scientific knowledge through the offering of a comprehensive, developmentally-appropriate, school-based academic and counseling education program for older school age students with asthma that is not currently available. PUBLIC HEALTH RELEVANCE: Nine million U.S. children under 18 years of age have been diagnosed with asthma at some point in their lives and approximately 4 million children have had an asthma episode in the last 12 months. This project seeks to compare efficacy of two school-based asthma education programs for fifth-grade students with asthma aimed at improving cognitive, behavioral, and psychosocial outcomes; decreasing severity of illness; and improving quality of life. After efficacy is demonstrated, this study would advance scientific knowledge through the offering of a comprehensive, developmentally-appropriate, school-based academic and counseling education program for older school age students with asthma that is not currently available.

描述（由申请人提供）：比较学校哮喘计划（CAPS）研究的目的是评估与低剂量控制相比，新的，基于学校的新发展，基于学校的学术和咨询哮喘健康教育计划的功效，成熟的非学术计划。针对患有哮喘及其家庭护理人员的五年级学生的新计划的标题为“保持健康的哮喘负责人和准备”（Sharp）。夏普是一个全面，以理论为导向的，有证据的指导计划，与学校人员和一个社区哮喘联盟的成员合作开发了两个组成部分：（a）学生组成部分和（b）社区组成部分。低剂量比较组将获得通过美国肺部协会广泛传播的学校（OA）的露天道。具体目的1：与低剂量OA对照组相比，五年级学生在干预后12岁和24个月立即对五年级学生的认知，心理社会和行为方面的疗效进行评估。具体目的2：与低剂量OAS对照组相比，在干预后12到24个月时，与低剂量OAS对照组相比，五年级学生的长期效果与五年级学生相比。将使用两组，纵向，前瞻性，聚类随机的单叶试验。学校将根据五年级入学人数，标准化阅读和数学评分，免费/减少午餐资格以及随机分组之前的种族/种族比例进行匹配。分析单位将是学生。该样本将由2名9至12岁的五年级学生组成，哮喘及其护理人员。将在2年内招募两名学生/护理人员二元组（每年n = 152个二元组，总计304个二元组在两年内），并分别进行了分析。至少将从位于3个社区中的30所小学招募5-6个二元组，每个社区从每个社区中选出10所学校。参与者将代表各种社会经济，文化，种族和种族背景。最近，由该地区学区确定的最近退休的认证的小学老师将接受培训，以作为干预者在上学期间提供敏锐或OA的干预者。评估者将使用音频连接的数据输入系统从笔记本电脑上的四个时间点收集家用二元组的干预前和后干预数据。将对护理人员进行双月自动录制的电话调查，以监视症状日，用药，医疗保健服务的使用和学校缺席。为了调整学校内观察结果的非独立性，将使用分类或顺序变量的广义估计方程方法以及连续结果的线性混合模型对假设进行检验。在证明了疗效之后，这项研究将通过为年龄尚不可用的哮喘学生提供全面的，具有发展的学术和咨询教育计划来提高科学知识。公共卫生相关性：在生活的某个时候，有900万美国18岁以下的美国儿童被诊断出患有哮喘，过去12个月中，大约有400万儿童患有哮喘发作。该项目旨在比较五年级学生的两个基于学校的哮喘教育计划的疗效，旨在改善认知，行为和心理社会成果；疾病严重程度降低；并改善生活质量。在证明了疗效之后，这项研究将通过为年龄尚不可用的哮喘学生提供全面的，具有发展的学术和咨询教育计划来提高科学知识。