Investigating the Relationships among Neighborhood Factors and Asthma Control in African American Children

调查邻里因素与非裔美国儿童哮喘控制之间的关系

• 批准号: 9394314
• 负责人: Kelli N DePriest
• 金额: $ 4.4万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-01 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9394314
• 关键词: Accident and Emergency department; Address; Affect; African American; Air Pollution; Area; Asthma; Baltimore; Child; Child health care; Childhood Asthma; Cities; Complex; Crime; Cross-Sectional Studies; Crowding; Data Analyses; Data Collection; Diagnosis; Economic Factors; Economically Deprived Population; Environment; Environmental Tobacco Smoke; Expenditure; Exposure to; Failure; Family; Foundations; Geographic Locations; Goals; Green space; Health; Health Benefit; Health Policy; Healthcare; Home environment; Housing; Impairment; Indoor pollutant; Link; Low income; Measures; Mission; National Institute of Nursing Research; Neighborhoods; Not Hispanic or Latino; Outcome; Parents; Perception; Pharmaceutical Preparations; Physical activity; Physical environment; Physiological; Play; Poaceae; Policies; Political Factor; Poverty; Prevalence; Public Health; Quality of life; Reporting; Research; Research Training; Resources; Role; Sampling; Seasons; Stress; Symptoms; Time; Trees; United States; Violence; base; contextual factors; cost; design; health disparity; high risk; improved; indexing; indoor allergen; informant; lower income families; neighborhood safety; programs; racial disparity; residence; segregation; skills; social; statistics; stressor; traffic-related air pollution; urban poverty; violent crime; willingness

PROJECT SUMMARY Over 2.3 million children in the US have uncontrolled asthma, defined by ≥2 symptom days per week, >1 symptom night per month, activity limitation, and use of rescue medications >2 days per week. African American children are disproportionately affected by uncontrolled asthma; they are 4.1 times more likely to be treated in emergency departments and 7.6 times more likely to die from asthma than are non-Hispanic White children. Racial disparities in childhood asthma have been partially attributed to differential exposures to growing up in poverty, living in unsafe and stressful neighborhoods, and unhealthy physical environments (air pollution, poor quality of housing, presence of pests in the home, and exposure to secondhand smoke). Although many of these neighborhood level factors are difficult to change, one potentially modifiable factor that may improve asthma control is the availability of greenspace. Defined as land with grass, trees, or other vegetation, greenspace has been linked to decreases in stress, heat, and air-pollution, variables associated with better asthma control in children. However, the few studies that have directly examined the relationship between the availability of neighborhood greenspace and asthma have yielded mixed results. One reason for the mixed results may be that none have accounted for critical contextual factors that could influence children’s use of the greenspace in urban cities such as neighborhood safety. Parents living in unsafe neighborhoods are likely to keep their children indoors, thereby increasing their children’s exposures to indoor asthma triggers and limiting the potential health benefits of neighborhood greenspace. Controlling for indoor asthma triggers in children’s homes, this study will examine the associations among neighborhood greenspace, neighborhood safety, and level of asthma control in an existing sample of 222 predominantly low-income, African American children in Baltimore City. The specific aims of this descriptive, cross-sectional study are to examine: 1) the association between neighborhood greenspace and level of asthma control; 2) the associations among two indicators of neighborhood safety (neighborhood violent crime rate and parent perceptions of neighborhood safety), and level of asthma control; and 3) the extent to which neighborhood safety may moderate the association between neighborhood greenspace and level of asthma control. I will use multiple measures and informants to capture study variables including geocoding, neighborhood crime statistics, parent reports, and physiologic measures. The proposed research training plan is foundational to a program of study focused on developing skills in neighborhood level research of health disparities affecting children living in urban poverty. This research aligns with the National Institute of Nursing Research’s mission to promote wellness by investigating the complex relationships between environment and the trajectory of non-communicable disease with an emphasis on health disparities.

项目摘要 美国超过230万儿童无法控制哮喘，每周≥2个症状天数，> 1 每月症状夜，活动限制以及救援药物的使用>每周2天。非裔美国人 儿童受到不受控制的哮喘影响不成比例的；它们的治疗可能性高4.1倍 紧急部门和非西班牙裔白人儿童死于哮喘的可能性高7.6倍。 儿童哮喘的种族分布部分归因于成长中的差异暴露 贫困，生活在不安全和压力很大的社区以及不健康的身体环境（空气污染，贫困 住房质量，房屋中存在害虫的存在以及二手烟的暴露）。 邻里水平因素难以改变，这可能改善哮喘的可能修改因素 控制是Greenspace的可用性。绿空间被定义为用草，树木或其他植被的土地 与压力，热量和空气污染的减轻有关，与更好的哮喘控制相关的变量 孩子们。但是，少数直接研究了可用性之间关系的研究 邻居绿空间和哮喘产生了不同的结果。结果混合的原因之一可能是 没有人考虑到可能影响儿童在城市中使用Greenspace的关键上下文因素 邻里安全等城市。居住在不安全社区的父母可能会留给孩子 在室内，从而增加了孩子对室内哮喘触发器的暴露并限制了潜在的健康状况 邻里绿地的好处。控制儿童之家中室内哮喘触发者，这项研究将 检查邻里绿色空间，邻里安全和哮喘控制水平之间的关联 在现有的222个主要低收入的非洲裔美国儿童的样本中。具体 这项描述性，横断面研究的目的是检查：1）邻居之间的关联 绿色空间和哮喘控制水平； 2）两个邻里安全指标之间的关联 （邻里暴力犯罪率和父母对邻里安全的看法）和哮喘控制水平； 3）邻里安全可以在多大程度上减轻邻里之间的关联 绿色空间和哮喘控制水平。我将使用多个措施和线人来捕获研究变量 包括地理编码，邻里犯罪统计，家长报告和生理措施。提议 研究培训计划是一项研究计划的基础，专注于在社区层面发展技能 对影响城市贫困儿童的健康差异的研究。这项研究与国家一致 护理研究所的使命是通过调查复杂关系来促进健康 环境和非通信疾病的轨迹，重点是卫生分配。