Food Allergy Outcomes Related to White and African American Racial Differences (FORWARD)

与白人和非裔美国人种族差异相关的食物过敏结果（转发）

基本信息

批准号：
9922208
负责人：
Ruchi S Gupta
金额：
$ 91.2万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-05-11 至 2022-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9922208
关键词：
Address Adherence Affect African American Allergens Allergic Allergic Reaction Allergic rhinitis Anaphylaxis Anxiety Asthma Behavior Biological Assay Biological Markers Child Child Care Childhood Clinic Visits Clinical Cohort Studies Data Diagnosis Eczema Emergency department visit Eosinophilia Epinephrine Family Food Food Hypersensitivity Future Geography Goals Guidelines Health Health Policy Home environment Hospitalization IgE IgG4 Impairment Intervention Knowledge Laboratories Life Literature Longitudinal cohort Medical Medical Records Methodology Methods Outcome Parents Patient Self-Report Patients Peripheral Pharmaceutical Preparations Phenotype Physicians Policies Practice Management Prevalence Prospective Studies Public Health Quality of life Reaction Recording of previous events Reporting Research Sampling Schools Self Management Severities Site Skin Survey Methodology Surveys Symptoms Techniques Testing Time United States Visit bullying caucasian American cohort comorbidity cost design dietary adherence experience food allergen health care service utilization improved microbiome peer prospective psychosocial racial difference racial disparity recruit sample collection socioeconomics stool sample symptom management therapy design tool treatment optimization

项目摘要

PROJECT SUMMARY/ABSTRACT Background: Food allergy (FA) is a potentially life-threatening condition that affects an estimated 8% of children in the United States. Although differences between African American (AA) and White children in the prevalence and severity of other atopic conditions such as asthma and eczema have been well described, little is known about such differences in FA. The limited existing literature indicates that AA children may have worse clinical outcomes, including rates of FA-related fatal anaphylaxis and FA-related emergency department (ED) visits, than their White peers. Phenotypic and endotypic differences, including rates of sensitization and co-morbidities, between AA and White children are beginning to be examined. Data on racial differences in FA management practices are incomplete; preliminary data suggest that AA families spend significantly less on allergen-free foods and FA medications than do White families. Families caring for children with FA experience significant impairments in psychosocial outcomes, including FA-related quality of life (FAQoL); however, these data come primarily from White, privately insured families, and little is known about psychosocial outcomes in AA families. Two recent reviews concluded that existing studies examining racial disparities in FA are far too methodologically limited to draw definitive conclusions, primarily due to reliance on self-report of FA diagnosis and cross-sectional designs. Specific Aims and Methods: Our goal is to prospectively study a cohort of 600 AA and White children (0-12 years) with FA in order to: 1) Determine variability in clinical FA outcomes between AA and White patients via bimonthly remote assessments, biannual clinic visits, and medical chart review over a two-year period; 2) Examine phenotypic and endotypic differences between AA and White children with FA using specific laboratory specimen collection techniques and assays; 3) Identify differences between AA and White children in FA management practices by parent report (e.g. allergen avoidance and epinephrine carriage); and 4) Determine differences between AA and White children in psychosocial FA-related outcomes (e.g., FA-related quality of life, bullying, anxiety, and worry) via the above survey methods. Hypotheses and Expected Results: We hypothesize that compared to White children, AA children will: have higher rates of food-allergic reactions and FA-related healthcare utilization; demonstrate unique FA phenotypes and endotypes; have poorer knowledge of FA management and worse adherence to preventative behaviors; have limited access to medications and allergen-free foods; and report better quality of life. Significance and Effects on Other Research: Confirming and further characterizing differences between AA and White children with FA will provide the data required to develop clinical guidelines, optimize treatment, and build health policies that meet the needs of both AA and White children.

项目概要/摘要背景：食物过敏 (FA) 是一种可能危及生命的疾病，影响估计 8% 的人在美国的孩子们。尽管非裔美国人 (AA) 和白人儿童之间的差异哮喘和湿疹等其他特应性疾病的患病率和严重程度已得到充分描述，但很少 FA 中的这种差异是众所周知的。有限的现有文献表明 AA 儿童可能有更糟糕的临床结果，包括与 FA 相关的致命过敏反应和与 FA 相关的急诊科发生率（ED）访问量高于白人同龄人。表型和内型差异，包括致敏率和 AA 儿童和白人儿童之间的共存疾病正在开始受到检查。 FA 中种族差异的数据管理规范不完善；初步数据表明，AA 家庭在以下方面的支出明显减少与白人家庭相比，他们使用不含过敏原的食品和 FA 药物。照顾具有 FA 经验的儿童的家庭心理社会结果显着受损，包括 FA 相关的生活质量 (FAQoL)；然而，这些数据主要来自白人、私人保险家庭，人们对心理社会结果知之甚少。 AA家庭。最近的两项评论得出的结论是，现有的研究 FA 种族差异的研究太过分了。方法论上仅限于得出明确的结论，主要是由于 FA 诊断的自我报告的依赖和横截面设计。具体目标和方法：我们的目标是前瞻性研究 600 名 AA 和白人儿童（0-12 岁）的队列年）与 FA 合作，以便： 1）确定 AA 和白人患者之间临床 FA 结果的变异性通过每两个月一次的远程评估、每两年一次的门诊就诊以及两年内的病历审查； 2）使用特定的方法检查 AA 和患有 FA 的白人儿童之间的表型和内型差异实验室标本采集技术和化验； 3）识别AA和White之间的差异家长报告中儿童的 FA 管理实践（例如避免过敏原和携带肾上腺素）； 4) 确定 AA 儿童和白人儿童在 FA 相关社会心理结果方面的差异（例如，与 FA 相关的生活质量、欺凌、焦虑和担忧）通过上述调查方法进行。假设和预期结果：我们假设与白人儿童相比，AA 儿童将：食物过敏反应和 FA 相关医疗保健利用率更高；展示独特的FA 表型和内型；对 FA 管理的了解较差，对预防措施的遵守程度较差行为；获得药物和无过敏原食品的机会有限；并报告更好的生活质量。对其他研究的意义和影响：确认并进一步表征差异 AA 和患有 FA 的白人儿童之间的研究将提供制定临床指南所需的数据，优化治疗并制定满足 AA 和白人儿童需求的健康政策。