INTERVENTION FOR HISPANIC CHILDREN WITH ASTHMA

  • Wood, Pamela R (PI)

Project: Research project

Project Details

Description

Although asthma affects 6-10% of children aged 6-16 years, the prevalence
of asthma in Hispanic groups and the degree of resulting morbidity are
unknown. The purpose of this study is to design, implement, and evaluate
an intervention program for Hispanic children with asthma which includes
both a physician education and a patient/family education component. This
study seeks to answer the following questions: 1) Will a physician
education intervention result in improved medical management for Hispanic
children with asthma who are cared for within the context of an outpatient
clinic? 2) Will a focused educational intervention for Hispanic children
with asthma and their families result in decreased morbidity and improved
quality of life? Prior to enrollment of patients, all physicians will participate in an
intervention which includes the following elements: a brief seminar about
medical management for children with asthma, introduction of protocols in
low chart format (algorithms), use of a standardized progress note from for
children with asthma, a series of computer-based simulations and
individualized feedback to physicians. The effectiveness of the physician
education component in changing physician behavior will be measured by pre-
/post-test, chart audit, and performance on computer-based simulations. One hundred sixty (160) Hispanic children with asthma, aged 6-15 years who
are cared for in a pediatric residents' continuity clinic will be enrolled
for study. A research associate will interview parents and children
separately using standardized questionnaires to obtain information about 1)
health beliefs, 2) reported health behavior, 3) knowledge and attitudes
about asthma, 4) functional morbidity, 5) acculturation, and 6)
sociodemographic factors. A research nurse will perform spirometry on each
subject. Additional information will be obtained by review of medical
records and school attendance records. Patients will then be randomized
into treatment and control groups. Treatment group patients and their
families will participate in the patient education intervention. The
intervention will consist of a series of four videotapes and written
materials which focus on major aspects of self-management for children with
asthma. Patients and families will receive the four modules at one month
intervals. Selected modules will be reviewed with the research nurse at
appointed visits approximately 6, 9, and 12 months following enrollment.
Follow-up data will be obtained by interview, medical record review, and
spirometry at 6, 12, 18, and 24 months following enrollment. Intervention and control group children will be compared for morbidity (#
ER visits, # hospitalizations, # school days missed) and quality of life
(impact on family and functional status), after controlling for confounding
variables. Secondary data analysis will examine the effect of the
intervention on knowledge, reported health behaviors, and post-intervention
spirometry. If effective, the physician education and patient education
programs will serve as models for the implementation of similar programs in
outpatient clinic settings which serve Hispanic children with asthma.
StatusFinished
Effective start/end date8/1/907/31/96

Funding

  • National Institutes of Health
  • National Institutes of Health: $159,973.00
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $238,735.00

ASJC

  • Medicine(all)

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