K23 Abstract A Patient-Centered Asthma Management Communication Intervention for Rural Latino Children DESCRIPTION: Rural Latino children with asthma suffer high rates of uncontrolled asthma symptoms, emergency department visits, and repeat hospitalizations. This vulnerable population must negotiate micro and macro level challenges that impact asthma management, including language barriers, primary care access, parental time off from work, insurance coverage, distance from specialty sites, and documentation status. There are few proven interventions that address asthma management embedded within this unique context. Using a bio-ecological approach, we will determine the feasibility of a patient-centered collaborative program between rural Latino children with asthma and their families, school based nursing, and primary care providers, facilitated by the use of a smart phone based mobile application (mobile app) with a Spanish-language interface. We hypothesize that improving communication through a collaborative, patient-centered intervention will improve asthma management, empower the patient and family, decrease outcome disparities, and decrease direct and indirect costs.
The specific aims of this study include: 1) Produce and validate a Spanish translation of an existing asthma management app and evaluate its usability with Latino parents of children with asthma; 2) Develop and evaluate a triadic, patient-centered asthma intervention preliminary protocol, facilitated by the bilingual mobile app validated in aim 1; and 3) Investigate the feasibility of the patient-centered asthma intervention from aim 2 using a wait list randomized control trial (RCT) to investigate the effects of the intervention on school days missed and medication adherence. The results of this study will be used to support a full scale randomized control trial R01 grant application in Year 4 of this award. The career development award will provide Dr. Estrada the mentoring and training needed to develop knowledge and skills in rural asthma disparities research, intervention development and program evaluation, and integration of technology- based interventions. At the close of the award, she will be positioned to design, implement, and evaluate research that will significantly impact rural asthma disparities.
There is growing evidence that rural asthma rates are similar to urban asthma rates, yet prior research has focused on urban population groups and interventions. Additionally, rural Latino children with asthma have unique challenges and barriers that contribute to health outcomes disparities. The findings from the proposed research will support the development of a targeted and cost-effective intervention that may improve asthma outcomes in this vulnerable population group.
| Estrada, Robin Dawson; Messias, DeAnne K Hilfinger (2018) Language Co-Construction and Collaboration in Interpreter-Mediated Primary Care Encounters With Hispanic Adults. J Transcult Nurs 29:498-505 |
| Nitsos, Alexandra; Estrada, Robin Dawson; Messias, DeAnne K Hilfinger (2017) Tummy Time for Latinos With Limited English Proficiency: Evaluating the Feasibility of a Cultural and Linguistically Adapted Parent Education Intervention. J Pediatr Nurs 36:31-36 |
| Carpenter, Delesha M; Estrada, Robin Dawson; Roberts, Courtney A et al. (2017) Urban-Rural Differences in School Nurses' Asthma Training Needs and Access to Asthma Resources. J Pediatr Nurs 36:157-162 |
