Puerto Rico Asthma Integrated Response Program (PR-AIR)

波多黎各哮喘综合应对计划 (PR-AIR)

• 批准号: 10534086
• 负责人: GLORISA J CANINO
• 金额: $ 73.44万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-15 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10534086
• 关键词: Address; Adoption; Affect; Age; Algorithms; Area; Asthma; Behavior; Care given by nurses; Caregivers; Caring; Characteristics; Child; Childhood Asthma; Clinic; Collaborations; Communication; Communities; Consolidated Framework for Implementation Research; Development; Disease Management; Effectiveness; Enrollment; Ethnic group; Evidence based intervention; Face; Family; Health Personnel; Health Status; Healthcare; Home; Hybrids; Individual; Insurance; Intervention; Interview; Investments; Island; Knowledge; Latino; Maintenance; Maps; Methods; Modification; Morbidity - disease rate; Outcome; Pattern; Persons; Pharmaceutical Preparations; Phase; Physicians; Prevalence; Primary Schools; Puerto Rican; Puerto Rico; Quality of life; Randomized; Reach Effectiveness Adoption Implementation and Maintenance; Research; Resources; Rhode Island; Risk; School Nursing; Schools; Services; Severity of illness; Structure; System; Technology; base; design; effectiveness evaluation; effectiveness implementation design; effectiveness outcome; evidence base; experience; family management; formative assessment; health care service utilization; high risk; implementation barriers; implementation strategy; improved; intervention program; preference; programs; randomized trial; remote delivery; response; screening; success; trial design; uptake; urban area; virtual; virtual intervention

Project Summary/Abstract Children of Puerto Rican (PR) descent have higher rates of asthma prevalence and morbidity than children from any other ethnic group. Children residing on the Island of PR have even higher asthma prevalence than Mainland PR children. We propose to implement and evaluate the Puerto Rico-Asthma Integrated Response Program (PR-AIR) to address pediatric asthma disparities in San Juan, PR, an area of high asthma burden. PR-AIR integrates evidence-based interventions in home and school settings, and enhances communication between families, schools, and health care providers. During Phase 1, we will convene a community collaborative of stakeholders that will provide input throughout the project, and use in-depth interviews to identify community needs, barriers, and facilitators to enable PR-AIR implementation. We will identify which characteristics of our existing evidence-based virtual and in-person interventions in home and school settings require fidelity-consistent modifications and use stakeholder input and matching of barriers to implementation strategy selection to identify methods to enhance PR-AIR uptake. During Phase 2, we will use a hybrid type III effectiveness-implementation design, evaluating low-intensity (virtual) and high-intensity (in-person) methods of implementation of PR-AIR. We will provide PR-AIR sequentially to 12 communities identified with high asthma burden through geospatial mapping using a cluster randomized, stepped wedge trial design, delivering PR-AIR to 400 children with asthma ages 2-12. We will use a mixed-methods approach to assess the impact of our implementation strategies on PR-AIR reach, adoption, implementation, and maintenance, and evaluate effectiveness of PR-AIR on individual-level (asthma control, quality of life) and community-level (health care utilization, school absences) outcomes. PR-AIR builds on a 20-year collaboration between our research teams in RI and PR, with an investment in advancing knowledge of multi-level factors affecting pediatric asthma disparities and reducing morbidity in children through evidence- based, sustainable interventions.

项目概要/摘要 波多黎各 (PR) 后裔儿童的哮喘患病率和发病率高于儿童 来自任何其他族裔群体。居住在 PR 岛上的儿童的哮喘患病率甚至高于 内地公关子女。我们建议实施和评估波多黎各哮喘综合计划 响应计划 (PR-AIR) 旨在解决波罗的桑胡安市儿童哮喘高发地区的儿童哮喘差异问题 哮喘负担。 PR-AIR 将基于证据的干预措施整合到家庭和学校环境中，并增强 家庭、学校和医疗保健提供者之间的沟通。在第一阶段，我们将召集 利益相关者的社区协作将在整个项目中提供投入，并深入使用 进行访谈，以确定社区的需求、障碍和促进因素，以实现 PR-AIR 的实施。我们将 确定我们现有的基于证据的虚拟和面对面的家庭干预措施的哪些特征 学校环境需要保真度一致的修改，并利用利益相关者的意见和障碍的匹配 选择实施策略，以确定增强 PR-AIR 吸收的方法。在第 2 阶段，我们将使用 混合 III 型有效性实施设计，评估低强度（虚拟）和高强度 （亲自）实施 PR-AIR 的方法。我们将依次向12个社区提供PR-AIR 通过使用集群随机、阶梯楔形的地理空间测绘确定患有高哮喘负担 试验设计，向 400 名 2-12 岁患有哮喘的儿童提供 PR-AIR。我们将使用混合方法 评估我们的实施策略对 PR-AIR 的影响、采用、实施和 维护，并评估 PR-AIR 在个人层面（哮喘控制、生活质量）的有效性，以及 社区层面（医疗保健利用、学校缺勤）结果。 PR-AIR 建立在 20 年的基础上 我们在 RI 和 PR 的研究团队之间进行合作，并投资于推进知识的发展 通过证据影响儿童哮喘差异和降低儿童发病率的多层次因素 基础的、可持续的干预措施。