Factors Influencing Pediatric Asthma (FIPA)

影响小儿哮喘的因素 (FIPA)

基本信息

批准号：
8579905
负责人：
Lyle Best
金额：
$ 18.75万
依托单位：
SANFORD RESEARCH/USD
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-26 至 2017-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8579905
关键词：
Accident and Emergency department Affect Age American Indians Area Asthma Attitude Baseline Surveys Biological Assay Biology Biomedical Research Blood capillaries Blood specimen Candidate Disease Gene Caring Child Childhood Asthma Chronic lung disease Clinic Clinical Communities Complex Consent DNA Data Data Analyses Databases Diagnosis Disadvantaged Disease Eagles Economics Education Enrollment Ensure Environment Environmental Exposure Environmental Risk Factor Epidemiologic Methods Exposure to Factor Analysis Gender General Population Genetic Genetic Polymorphism Genetic Research Genetic Variation Genotype Health Home environment Hour Human Resources Immunity Indian reservation Informed Consent Intention Intervention Investigation Knowledge Life Light Logistic Regressions Medical Medical Records Medical Research Methodology Methods Microsatellite Repeats Minority Monitor Morbidity - disease rate Natural History Odds Ratio Outcome Measure Participant Patient Education Patients Perceived quality of life Persons Pharmaceutical Preparations Physiological Population Prevalence Process Prognostic Factor Provider Psychosocial Factor Psychosocial Influences Public Health Quality of life Race Random Allocation Randomized Records Recruitment Activity Relative (related person)Reporting Research Research Ethics Research Methodology Research Personnel Resources Risk Risk Factors Rivers Role Running SSCP Analysis Salivary Sampling Self Management Severities Sioux Indians Social Conditions South Dakota Spirometry Students Surveys System Testing Teton Sioux Indian Time Training Translating Tribes Turtles United States Indian Health Service Visit base capillary career case control clinical care college disability empowerment experience follow-up genetic analysis genetic risk factor genetic variant health disparity improved interest meetings member mortality patient oriented policy implication population based posters programs psychologic randomized trial respiratory response social social implication treatment as usual tribal college university student

项目摘要

Asthma could serve as the poster child of multifactorial medical conditions. The pathogenetic mechanisms are complex and the interactions with environmental and psychosocial factors are numerous. Minority and disadvantaged groups often show increased prevalence of asthma and increased morbidity and mortality, which is not fully understood. This proposal will recruit a population-based sample of American Indians from the Cheyenne River Sioux Tribe at Eagle Butte, SD, 120 well-defined cases and 240 matched controls for a cross sectional investigation of a broad range of factors running from genetics, immunity, environmental exposures, educational ability, economic resources, access and utilization of medical care, to perceived quality of life. In addition, 1/2 ofthe cases will be recruited into a randomized trial of intensive education related to understanding, self-directed care and empowerment compared with usual care. The intervention will last for 2 years and a follow-up exam will be conducted at 3 years. Analysis will be on an "intention to treat" basis and the primary end point will be clinic and emergency room visits for respiratory complaints. It is anticipated that capture of endpoints will be very complete, as nearly all clinical care in this community is provided by the Indian Health Service or tribal clinics, both of which will cooperate with this study. An important component ofthis proposal is the enhancement of community human resources related to biomedical research and clinical care. Tribal college students will be engaged as part-time (but active) members ofthe research team, recruiting and educating participants, collecting and analyzing data, translating findings to community members and leaders, and hopefully becoming more interested and aware of health issues as they impact minority populations. Although this community has been accepting and involved in genetic research in the past, this component ofthe project will expand this experience, both for local tribal college students; but also for those at Turtle Mountain college, where genotyping is conducted. Another exciting aspect is the involvement of a young American Indian investigator and clinician from South Dakota in a prominent role.

哮喘可以作为多因素医疗状况的典型代表。发病机制是复杂的，与环境和社会心理因素的相互作用有很多。少数民族和弱势群体的哮喘患病率以及发病率和死亡率往往有所增加，这还没有完全理解。该提案将从美国印第安人中招募基于人口的样本南达科他州 Eagle Butte 的夏安河苏族部落，120 个明确的病例和 240 个匹配的对照对遗传、免疫、环境等一系列因素进行横断面调查接触、教育能力、经济资源、医疗保健的获取和利用，以感知生活质量。此外，1/2的病例将被纳入强化教育的随机试验与常规护理相比，与理解、自我导向护理和赋权有关。干预持续2年，3年后进行跟踪检查。分析将围绕“意图治疗”的基础，主要终点是因呼吸道疾病而到诊所和急诊室就诊。预计终点的捕获将非常完整，因为该社区中几乎所有的临床护理都是由印第安卫生服务机构或部落诊所提供，两者都将与本研究合作。该提案的一个重要组成部分是加强与以下方面相关的社区人力资源生物医学研究和临床护理。部落大学生将从事兼职（但活跃）研究团队成员，招募和教育参与者，收集和分析数据，将研究结果转化为社区成员和领导者，并希望变得更加感兴趣和了解影响少数民族人口的健康问题。尽管这个社会已经接受并过去参与过基因研究，该项目的这一部分将扩展这种经验，无论是当地部落大学生；也适用于进行基因分型的龟山学院的学生。另一个令人兴奋的方面是一位来自南方的年轻美国印第安人调查员和临床医生的参与达科他扮演着重要角色。