A COMMUNITY UNITED TO REDUCE DISPARITIES IN COMORBID PEDIATRIC ASTHMA AND OBESITY

社区团结起来，减少小儿哮喘和肥胖共病的差异

• 批准号: 7881320
• 负责人: MOLLY A MARTIN
• 金额: $ 34.89万
• 依托单位: RUSH UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7881320
• 关键词: Absenteeism; Address; Affect; Age; Applications Grants; Area; Asthma; Behavior Therapy; Behavioral; Biological Markers; Body mass index; Caregivers; Chicago; Child; Childhood; Childhood Asthma; Communities; Community Actions; Complex; Data; Development; Diet; Disease; Disease Management; Distress; Education; Effectiveness; Elements; Ensure; Environment; Epidemic; Epidemiologic Studies; Ethnic Origin; Evaluation; Family; Fatty acid glycerol esters; Focus Groups; Future; Genetic; Goals; Health; Health behavior; Healthy People 2010; Home environment; Individual; Intervention; Intervention Studies; Lead; Literature; Low income; Measures; Minority; Morbidity - disease rate; Nature; Obesity; Outcome; Outcome Measure; Overweight; Parents; Participant; Perception; Pharmaceutical Preparations; Phase; Physical activity; Pilot Projects; Population; Population Study; Prevalence; Race; Randomized Controlled Trials; Reporting; Research; Research Design; Research Personnel; Schools; Self Management; Sexual abuse; Stress; Students; Surveys; Symptoms; Target Populations; Testing; United States National Institutes of Health; Urban Health; Violence; Work; cohort; community burden; community organizations; design; diet and exercise; experience; group intervention; health equity; high risk; improved; informant; inner city; innovation; intervention effect; mortality; obesity in children; prevent; psychological distress; response; sex; skills; skills training; stressor; success; teacher; therapy design; trend

The associations in prevalence and morbidity between asthma and obesity suggest that interventions targeting comorbid asthma and obesity may lead to greater success in controlling both conditions. The team of investigators for this proposal has developed strong partnerships with local organizations in a low-income minority community in Chicago where asthma and obesity rates are significantly higher than the national rates. Community prevalence of asthma and obesity has been determined, qualitative pilot work has been conducted, and the community is now prepared for action on these diseases. This proposal aims to develop an intervention for comorbid asthma and obesity. The first phase of this study is to define the intervention. Specific Aim 1 is to conduct a qualitative exploration of comorbid asthma and obesity. The results will inform the design of the subsequent interventions. Phase 2 is to conduct several pilot studies to determine the feasibility and efficacy of an individual-level intervention and a community-level intervention to improve asthma control and obesity in overweight/obese minority children with asthma ages 5-12. Specific Aim 2 will begin with a pilot behavioral randomized controlled trial to test the feasibility and efficacy of a home intervention that provides self-management skills education to families. Outcomes measured in the one-year trial of 100 participants include asthma control, body mass index, physical activity, and stress/distress. The following year, a school-wide intervention that targets teachers, parents, and children in the school environment will be pilot tested. Outcomes for this pilot include schoollevel measures of absenteeism from asthma, physical activity, and school meal content. A 50 participant cohort of overweight/obese children with asthma in the target school will also be followed to assess individual changes in asthma control and body mass index. Because of the epidemic levels of community violence in Chicago and the high levels of sexual abuse and violence for inner-city children in general, an Exploratory Aim is to assess the relationships between reported caregiver major and traumatic stressors, biomarkers of stress in caregivers, child reported major and traumatic stressors, and biomarkers of stress in children with comorbid asthma and obesity. After completion of these interventions. Phase 3 will evaluate the outcomes and possibly conduct further small qualitative studies to determine which elements should be included in future intervention efforts. The intervention design that results will be the focus of future NIH grant proposals emanating from the Rush Centerfor Urban Health Equity.

哮喘和肥胖之间的患病率和发病率之间的关联表明，干预措施 针对哮喘和肥胖的共病可能会在控制这两种疾病方面取得更大的成功。团队 该提案的调查人员与低收入地区的当地组织建立了牢固的伙伴关系 芝加哥少数族裔社区的哮喘和肥胖率明显高于全国 费率。社区哮喘和肥胖患病率已确定，定性试点工作已开展 已开展，社区现在已准备好针对这些疾病采取行动。 该提案旨在制定针对哮喘和肥胖共病的干预措施。本次第一阶段 研究的目的是定义干预措施。具体目标 1 是对合并哮喘进行定性探索 和肥胖。结果将为后续干预措施的设计提供信息。第 2 阶段是进行 多项试点研究，以确定个人层面干预措施的可行性和有效性，以及 社区一级的干预措施，以改善超重/肥胖少数民族儿童的哮喘控制和肥胖 5-12 岁患有哮喘。具体目标 2 将从试点行为随机对照试验开始进行测试 向家庭提供自我管理技能教育的家庭干预的可行性和有效性。 在 100 名参与者参与的为期一年的试验中测量的结果包括哮喘控制、体重指数、 体力活动和压力/苦恼。第二年，针对教师的全校干预措施， 学校环境中的家长和儿童将接受试点测试。该试点的成果包括学校层面 因哮喘、体力活动和学校膳食内容而缺勤的衡量标准。 50 名参与者 还将跟踪目标学校中患有哮喘的超重/肥胖儿童队列，以评估 哮喘控制和体重指数的个体变化。由于社区的疫情程度 芝加哥的暴力事件以及内城区儿童普遍存在的性虐待和暴力事件， 探索性目标是评估报告的护理人员专业与创伤性压力源之间的关系， 照顾者压力的生物标志物、儿童报告的主要压力源和创伤性压力源以及家庭压力的生物标志物 患有哮喘和肥胖症的儿童。完成这些干预措施后。第三阶段将评估 的结果，并可能进行进一步的小型定性研究，以确定哪些要素应该被纳入 纳入未来的干预工作。由此产生的干预设计将是未来 NIH 的重点 拉什城市健康公平中心提出的拨款提案。