Puerto Rican children in the United States experience the highest asthma prevalence and morbidity rates of all racial/ethnic groups and these rates are increasing. Factors such as biological differences in severity and sensitivity, environmental conditions, access to care, and socioeconomic status contribute to, but do not fully explain, these prevalence and morbidity rates. Inadequate self-management behaviors, which are potentially modifiable, also contribute to these asthma morbidity outcomes. This exploratory R21 application will develop and test an intervention to improve asthma self-management for this high-risk population. The intervention is unique in that the education and support provided to all participants from the standardized Core Curriculum can be modified using a Toolkit based on individual needs and strengths. The education incorporates specific skills training in environmental modification, problem solving, self-monitoring, and enlisting social support.
Specific Aim 1 is to explore influences of asthma self-management behaviors (including asthma belief models, the use of folk remedies, social support, stress, access to care, and socio-economic status) for Puerto Rican parents of children with asthma.
Specific Aim 2 will incorporate these influences into a community health worker asthma intervention and use a small behavioral randomized controlled trial to test the ability of this intervention to improve asthma self-management behaviors for parents of Puerto Rican children with asthma. The long-term goal is to apply these pilot data in the design and implementation of a larger behavioral randomized controlled trial that will test a similar asthma intervention aimed at improving asthma control. The investigators in this application have significant experience with community agencies serving the target population and have expanded these relationships to prepare for this application using the principles of community-based participatory research. A prominent community service agency and a local community college contributed to the design of this application and have committed their services in the study implementation and results dissemination. The data generated from this research will improve our understanding of the specific influences of asthma self-management for Puerto Rican parents of children with asthma and the study will provide important pilot data on an intervention that may ultimately improve asthma control for this high-risk population that suffers disproportionately from asthma. The participatory design serves to build community capacity for research and improve research quality and effectiveness.
The data generated from this research will improve our understanding of the specific influences of asthma self-management for Puerto Rican parents of children with asthma and the study will provide important pilot data on an intervention that may ultimately improve asthma control for this high-risk population that suffers disproportionately from asthma. The participatory design serves to build community capacity for research and improve research quality and effectiveness.
| Pappalardo, Andrea A; Karavolos, Kelly; Martin, Molly A (2017) What Really Happens in the Home: The Medication Environment of Urban, Minority Youth. J Allergy Clin Immunol Pract 5:764-770 |
| Martin, Molly A; Mosnaim, Giselle S; Olson, Daniel et al. (2015) Results from a community-based trial testing a community health worker asthma intervention in Puerto Rican youth in Chicago. J Asthma 52:59-70 |
| Martin, Molly A; Thomas, Ann Marie; Mosnaim, Giselle et al. (2013) Home asthma triggers: barriers to asthma control in Chicago Puerto Rican children. J Health Care Poor Underserved 24:813-27 |
| Martin, Molly A; Olson, Daniel; Mosnaim, Giselle et al. (2012) Recruitment, asthma characteristics, and medication behaviors in Midwestern Puerto Rican youth: data from Project CURA. Ann Allergy Asthma Immunol 109:121-7 |
