Despite higher levels of morbidity and mortality, African American children receive asthma care that is less consistent with national asthma guideline recommendations compared to white children. Access to care, insurance status and socioeconomic status have not fully explained these disparities. Poor assessments of asthma morbidity and suboptimal communication between physicians and parents of inner-city children with asthma may contribute racial disparities in quality of asthma care. We propose to examine the effects of an asthma-focused communication intervention on parent-physician communication and quality of asthma care among inner-city African American children. The objective of this project is to design, validate and implement an effective Pediatric Asthma Control and Communication Instrument (P-ACCI) within an innercity- based, university pediatric clinic. We therefore propose the following Specific Aims: 1) To develop and validate a simple, paper-and-pencil pediatric asthma control and communication instrument (P-ACCI) to serve as a both a prompt and a communication aide for the physician and the parent to discuss issues of asthma health;2) To conduct a pilot randomized clinical trial in a primary care pediatric setting of inner-city African American children with asthma in order to assess the effects of the P-ACCI on the quality of patientphysician communication and quality of asthma care. We hypothesize that: 1) the P-ACCI is a valid measure of asthma morbidity;2) regular use of the P-ACCI will improve the quality of parent-physician communication and the quality of asthma care for children. Relevance: There is a pressing need for simple, low-cost clinical strategies applicable in diverse settings to improve communication about variables important to asthma management. Such strategies would enhance clinical judgment, decision-making, and quality of asthma care. The current study will evaluate a novel, lowcost tool with the potential to reduce asthma care disparities related to poor parent-physician communication My career goals involve becoming a successful investigator of racial disparities in quality of asthma care, and to become a Professor of Pediatrics who develops remedies to improve asthma care through a multidisciplinary research center, and to reduce racial disparities in asthma care and asthma outcomes.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23HL089410-02
Application #
7688118
Study Section
Special Emphasis Panel (ZHL1-CSR-R (F1))
Program Officer
Rothgeb, Ann E
Project Start
2008-09-16
Project End
2013-07-31
Budget Start
2009-08-01
Budget End
2010-07-31
Support Year
2
Fiscal Year
2009
Total Cost
$137,379
Indirect Cost
Name
Johns Hopkins University
Department
Pediatrics
Type
Schools of Medicine
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Mitchell, Stephanie J; Bilderback, Andrew L; Okelo, Sande O (2016) Racial Disparities in Asthma Morbidity Among Pediatric Patients Seeking Asthma Specialist Care. Acad Pediatr 16:64-7
Wu, Dominic J; Hipolito, Evelyn; Bilderback, Andrew et al. (2016) Predicting future emergency department visits and hospitalizations for asthma using the Pediatric Asthma Control and Communication Instrument - Emergency Department version (PACCI-ED). J Asthma 53:387-91
Okelo, Sande O; Eakin, Michelle N; Riekert, Kristin A et al. (2014) Validation of parental reports of asthma trajectory, burden, and risk by using the pediatric asthma control and communication instrument. J Allergy Clin Immunol Pract 2:186-92
Lefton-Greif, Maureen A; Okelo, Sande O; Wright, Jennifer M et al. (2014) Impact of children's feeding/swallowing problems: validation of a new caregiver instrument. Dysphagia 29:671-7
Goldberg, Elizabeth M; Laskowski-Kos, Ursula; Wu, Dominic et al. (2014) The Pediatric Asthma Control and Communication Instrument for the Emergency Department (PACCI-ED) improves physician assessment of asthma morbidity in pediatric emergency department patients. J Asthma 51:200-8
Okelo, Sande O; Siberry, George K; Solomon, Barry S et al. (2014) Asthma treatment decisions by pediatric residents do not consistently conform to guidelines or improve with level of training. Acad Pediatr 14:287-93
Okelo, Sande O; Eakin, Michelle N; Patino, Cecilia M et al. (2013) The Pediatric Asthma Control and Communication Instrument asthma questionnaire: for use in diverse children of all ages. J Allergy Clin Immunol 132:55-62
McGrath-Morrow, Sharon A; Ryan, Timothy; McGinley, Brian M et al. (2012) Polysomnography in preterm infants and children with chronic lung disease. Pediatr Pulmonol 47:172-9
Collaco, J Michael; Kole, Amanda J; Riekert, Kristin A et al. (2012) Respiratory medication adherence in chronic lung disease of prematurity. Pediatr Pulmonol 47:283-91
Collaco, J Michael; Choi, SeEun Jennifer; Riekert, Kristin A et al. (2011) Socio-economic factors and outcomes in chronic lung disease of prematurity. Pediatr Pulmonol 46:709-16