Asthma and Physical Activity in Urban Children: Cultural and Contextual Factors

城市儿童的哮喘和体育活动：文化和背景因素

基本信息

批准号：
8548055
负责人：
ELISSA JELALIAN
金额：
$ 40.41万
依托单位：
RHODE ISLAND HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-07-20 至 2015-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8548055
关键词：
Accounting Address Affect African American Allergic rhinitis Ancillary Study Area Asthma Behavior Behavior Control Belief Cardiovascular system Caregivers Characteristics Child Childhood Coupled Cross-Sectional Studies Data Development Ethnic Origin Exercise Exercise-Induced Bronchospasm Family Fright Goals Health Inflammation Mediators Intervention Latino Life Life Style Measures Morbidity - disease rate Neighborhoods Nocturnal Asthma Obesity Overweight Patient Self-Report Pattern Perception Performance Physical activity Process Research Research Infrastructure Respiratory physiology Rhinitis Risk Sampling Schools Sleep Symptoms Time Weight Weight Gain aged conditioning contextual factors elementary school ethnic minority population fitness health disparity improved instrument neighborhood safety novel obesity risk public health relevance sedentary standard of care stressor therapy development

项目摘要

DESCRIPTION (provided by applicant): Pediatric health disparities in the area of asthma, obesity and cardiovascular fitness continue to exist. Specifically, asthma and obesity are highly prevalent co-morbid conditions that disproportionately affect ethnic minority and urban children. These conditions share pathophysiological (e.g., inflammatory mediators) and contextual (living in an urban neighborhood) correlates, which may increase the risk for both conditions. A key lifestyle behavior implicated in both asthma morbidity and obesity risk is physical activity. Some children with asthma tend to restrict overall activities, including physical activity, when symptoms are in poor control. Although stressors related to urban living may also serve as barriers to physical activity among this group, we know little about the potential cultural and contextual mechanisms that help explain the association between asthma and physical activity in ethnic minority children. This ancillary study offers a unique opportunity to examine the association between asthma, physical activity and cultural and contextual factors in a group of urban children who are followed as part of their participation in Project NAPS (Nocturnal Asthma and Performance in School (R01 HD057220; Koinis Mitchell, PI). Project NAPS includes three, 4-week assessment periods (Session 1, S2, & S3) over the course of one academic year. In this ancillary study, we will incorporate objectively measured physical activity, and perceptions of asthma, physical activity and context to the third assessment period (S3), and add a fourth assessment period (S4) to occur at the start of the following academic year. This additional time point will provide: 1) an opportunity to examine the co-occurrence of asthma and allergic rhinitis symptoms, physical activity, and sedentary behavior, and 2) an in depth examination (at S3 and S4) of potential cultural and contextual influences on physical activity in a sample of 150 children with persistent asthma who are overweight/obese or healthy weight. We hypothesize that children with more asthma and allergic rhinitis symptoms will participate in less moderate to vigorous physical activity (MVPA) and more sedentary activities. These associations will be more pronounced in children from Latino and AA backgrounds than in Non-Latino White children. We further hypothesize that fear related to asthma and perceptions of neighborhood safety will each be independent predictors of MVPA, and will predict activity levels beyond actual asthma symptom level and measured neighborhood characteristics. We also expect these associations will be more pronounced in caregivers from Latino and AA backgrounds. Finally, we hypothesize that caregivers' perception of exercise as a trigger for asthma will be related to less MVPA and more sedentary behavior. This association will be apparent even when accounting for children's actual exercise-induced brochospasm status (EIB). A similar pattern will be found for children's perceptions. This association will be more pronounced in caregivers and children of Latino and AA backgrounds. This line of research has significant implications for the development of cultural tailored interventions to: increase physical activity n urban children with persistent asthma; and improve caregiver understanding of asthma symptoms and exercise induced-bronchospasm. Ultimately, study findings could have implications for improving the standard of care for urban and ethnic minority children with persistent asthma.

描述（由申请人提供）：哮喘、肥胖和心血管健康领域的儿科健康差异仍然存在。具体来说，哮喘和肥胖是非常普遍的共病，对少数民族和城市儿童的影响尤为严重。这些病症具有病理生理学（例如炎症介质）和环境（生活在城市社区）相关性，这可能会增加这两种病症的风险。与哮喘发病率和肥胖风险相关的一个关键生活方式行为是体力活动。当症状控制不佳时，一些患有哮喘的儿童往往会限制整体活动，包括体力活动。尽管与城市生活相关的压力源也可能成为该群体体育活动的障碍，但我们对有助于解释少数民族儿童哮喘与体育活动之间关联的潜在文化和背景机制知之甚少。这项辅助研究提供了一个独特的机会来研究一组城市儿童的哮喘、体力活动以及文化和环境因素之间的关系，这些儿童是参与 NAPS 项目（夜间哮喘和学校表现（R01 HD057220；Koinis）的一部分）的一部分。 Mitchell，PI）。项目 NAPS 在本辅助学年中包括三个为期 4 周的评估期（第 1 节、第 2 节和第 3 节）。研究中，我们将把客观测量的体力活动以及对哮喘、体力活动和环境的感知纳入第三个评估期 (S3)，并在下一学年开始时添加第四个评估期 (S4)。时间点将提供：1）有机会检查哮喘和过敏性鼻炎症状、体力活动和久坐行为同时发生的情况，以及 2）深入检查（在 S3 和 S4）对身体的潜在文化和背景影响活动于150 名患有持续性哮喘且体重超重/肥胖或健康体重的儿童作为样本。我们假设患有更多哮喘和过敏性鼻炎症状的儿童将参加较少的中等到剧烈体力活动（MVPA）和更多的久坐活动。这些关联在拉丁裔和 AA 背景的儿童中比在非拉丁裔白人儿童中更为明显。我们进一步假设与哮喘相关的恐惧和对社区安全的看法将各自成为 MVPA 的独立预测因子，并将预测超出实际哮喘症状水平和测量的社区特征的活动水平。我们还预计这些关联在拉丁裔和 AA 背景的护理人员中会更加明显。最后，我们假设护理人员认为运动会引发哮喘，这与 MVPA 减少和久坐行为增多有关。即使考虑到儿童实际的运动诱发的支气管痉挛状态（EIB），这种关联也会很明显。儿童的感知也存在类似的模式。这种关联在拉丁裔和 AA 背景的看护者和儿童中更为明显。这一系列研究对于制定文化定制干预措施具有重要意义：增加患有持续性哮喘的城市儿童的体力活动；并提高护理人员对哮喘症状和运动诱发的支气管痉挛的了解。最终，研究结果可能对提高患有持续性哮喘的城市和少数民族儿童的护理标准产生影响。