This revised K24 application proposes a mentorship program in patient-oriented research in pediatric asthma, with a specific focus on health care disparities and disease management behaviors. The K24 Candidate is an Associate Professor (Research) in the Department of Psychiatry and Human Behavior of the Warren Alpert Medical School at Brown University, with a history of funding in behavioral interventions to improve disease management and address health disparities in pediatric asthma. Training Plan: The candidate will obtain additional training in longitudinal data analysis, behavioral genetics, evaluation and assessment in health education, and health care access for Latino immigrants to enrich her skills and mentoring capacity in future health care disparities research. Research Plan: A longitudinal study of medication adherence for Latinos and non-Latino white (NLW) youth with asthma is proposed to assess the differential course of medication adherence by culture across the transition to adolescence. Three waves of 50 youth with persistent asthma (150 total, 25 Latino, 25 NLW in each wave) will complete a multimethod assessment of asthma status, family factors, medication beliefs, and controller medication use. Assessments will occur in eighth grade, then again in tenth grade, with continuous monitoring of medication adherence throughout. Analyses will evaluate the role of medication beliefs and family connectedness in supporting asthma management in Latino and NLW youth with persistent asthma, and assess differential trajectories of medication use by ethnic group over time. Mentoring Plan: The proposed mentoring plan offers participation in an RCT to address asthma disparities in medication use, access to an ongoing educational program for asthma that serves over 700 families a year, and an archival dataset that includes a wealth of data on disease management behavior in over 800 Latino and NLW children in Rl and Puerto Rico. An additional ongoing seminar is planned for junior faculty on topics such as recruiting and retaining culturally diverse samples, and preparing research grant applications. This overall plan capitalizes on the rich resources and training opportunities available to postdoctoral fellows and junior faculty at Brown, including seven T32 fellowship programs, numerous junior faculty with K awards and small grants, seminars in research design, ethics, and statistics, and established infrastructure for evaluation.
Public Health Significance: Asthma is a common chronic illness in which minority children are disproportionately affected. Facilitating mentorship and execution of high quality patient-oriented research in this area is critical to address health care disparities. PROJECT/
