Reducing Asthma Morbidity in High Risk Minority Preschool Children

降低高危少数学龄前儿童的哮喘发病率

基本信息

批准号：
8444431
负责人：
CYNTHIA S RAND
金额：
$ 66.08万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-07-01 至 2017-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8444431
关键词：
6 year old Adherence Adoption Age Asthma Baltimore Caregivers Caring Characteristics Child Cities Clinic Clinical Communities Control Groups Day Care Development Disadvantaged Education Educational Curriculum Educational Intervention Effectiveness Emotional Enrollment Environmental Exposure Evaluation Expectancy Exposure to Family Family Characteristics Funding Guidelines Head Start Program Health Home environment Hospitalization Intervention Knowledge Low income Maintenance Measures Mediating Mediator of activation protein Medical Mental Depression Minority Mission Morbidity - disease rate Motivation National Heart, Lung, and Blood Institute Neighborhoods Nursery Schools Oral Outcome Outcome Measure Parents Participant Poverty Practice Management Preschool Child Preventive Preventive Health Services Public Health Quality of life Randomized Controlled Trials Relative (related person)Research Risk Role Schools Self Efficacy Smoking Steroids Structure Students Symptoms Testing Violence Visit base cohesion community setting demographics early childhood effective intervention family management health disparity health literacy high risk improved inner city literacy mortality novel programs screening secondary outcome social therapy design treatment as usual treatment planning urgent care

项目摘要

DESCRIPTION (provided by applicant): Despite advances in asthma therapies and the wide-spread dissemination of asthma clinical guidelines, low-income, minority children have disproportionately high morbidity and mortality from asthma. The National Center for Children in Poverty has strongly argued that effective interventions to improve asthma health disparities and reduce harm must begin in early childhood. Previous efficacy studies have suggested that asthma education programs can be effective in improving overall management of asthma for preschool children. However, for these promising asthma intervention strategies to have sustainable public health impact for low-income, minority children they must be integrated within those medical, educational and social structures that serve these young high risk children, such as community clinics, schools and day care programs. Because one of the core missions of federally- funded Head Start programs is to provide preventive health services and screening to their low-income preschool students, Head Start represents an ideal community setting for disseminating early asthma education. We propose to draw on our established health and research partnership with Head Start programs in Baltimore City to test the effectiveness of this home-based asthma education intervention with demonstrated efficacy, when delivered in the context of a Head Start-wide asthma education program. We further propose to partner with Head Start to support and evaluate adoption, maintenance and dissemination of new knowledge gained from this project. Specifically we hypothesize that participants receiving the ABC intervention combined with a HS-level asthma education will have more symptom free days at the 6-, 9-, and 12-month evaluation when compared with participants in the HS- level asthma education alone. We plan to enroll of 406 children age 2-6 years old enrolled in Head Start with symptomatic asthma. Secondary outcome measures include other measures of asthma morbidity (i.e., hospitalizations, ED visits, oral steroid bursts, school absences, and caregiver quality of life). We will also evaluate the mediating effects of outcomes expectancies, self-efficacy, asthma knowledge, motivation, and asthma management practices, as well as moderator effects, such as health literacy, caregiver depression, neighborhood cohesion, family management of asthma, and Head Start adoption and dissemination of an asthma education curriculum.

描述（由申请人提供）：尽管哮喘治疗取得了进步，哮喘临床指南也得到了广泛传播，但低收入、少数族裔儿童的哮喘发病率和死亡率却异常高。国家贫困儿童中心强烈主张，改善哮喘健康差异和减少伤害的有效干预措施必须从幼儿期开始。先前的功效研究表明，哮喘教育计划可以有效改善学龄前儿童哮喘的整体管理。然而，为了使这些有前景的哮喘干预策略对低收入少数民族儿童产生可持续的公共卫生影响，必须将其纳入为这些年轻高危儿童服务的医疗、教育和社会结构中，例如社区诊所、学校和日托中心程序。由于联邦政府资助的启蒙计划的核心任务之一是向低收入学前学生提供预防性健康服务和筛查，因此启蒙计划代表了传播早期哮喘教育的理想社区环境。我们建议利用我们与巴尔的摩市 Head Start 计划建立的健康和研究合作伙伴关系，来测试这种家庭哮喘教育干预措施的有效性，并在 Head Start 哮喘教育计划的背景下进行验证，并证明其效果。我们进一步建议与 Head Start 合作，支持和评估从该项目中获得的新知识的采用、维护和传播。具体来说，我们假设与单独接受 HS 级哮喘教育的参与者相比，接受 ABC 干预与 HS 级哮喘教育相结合的参与者在 6、9 和 12 个月的评估中将有更多的无症状天数。我们计划招募 406 名 2-6 岁的患有症状性哮喘的儿童参加 Head Start。次要结果指标包括哮喘发病率的其他指标（即住院治疗、急诊就诊、口服类固醇爆发、缺勤和护理人员的生活质量）。我们还将评估结果预期、自我效能、哮喘知识、动机和哮喘管理实践的中介效应，以及调节效应，例如健康素养、照顾者抑郁、邻里凝聚力、哮喘家庭管理和启蒙采用和传播哮喘教育课程。