Despite significant advances in our understanding of the pathophysiology of asthma and marked improvements in the therapies available to treat asthma, disadvantaged and minority communities still carry a disproportionate burden from asthma. The exact reasons for this phenomenon are unknown, however, a number of factors have been proposed to account for this disparity, including genetic differences in vulnerability to asthma or asthma severity, differential rates of environmental exposure (e.g. cockroaches, dust), differences in the accessibility and quality of asthma medical care for patients of differing socioeconomic status, and inadequate asthma self-management practices, including poor adherence with therapy. It is widely believed that these factors interact to cause the observed excess burden of asthma within low-income, minority populations. Howard University and Johns Hopkins University have a long and successful history of collaborative studies designed to evaluate asthma morbidity in low-income, African-American children and adults with asthma. This application draws on this rich history to propose the formal collaboration of these institutions and investigators as a part of the Howard/Hopkins Center for Reducing Asthma Disparities. Specifically, this application presents four research projects designed to collaboratively investigate factors associated with the disproportionate burden of asthma experienced by inner-city, African-American children and adults. This application includes studies that will evaluate both the underlying genetic factors that may contribute to the observed excess risk in African-American communities, as well as studies of provider-patient communication designed to assess intervention strategies for remediating this risk. In addition, an essential goal of the Howard/Hopkins Center for Reducing Asthma Disparities will be to create a culturally sensitive training environment that is truly reciprocal, and designed to both enrich and enhance the research potential and asthma management capabilities of both participating institutions.
| Clerisme-Beaty, Emmanuelle M; Rand, Cynthia; Diette, Gregory B (2010) Reply to Farah. J Allergy Clin Immunol 125:770 |
| Gao, P; Grigoryev, D N; Rafaels, N M et al. (2010) CD14, a key candidate gene associated with a specific immune response to cockroach. Clin Exp Allergy 40:1353-64 |
| Clerisme-Beaty, Emmanuelle M; Karam, Sabine; Rand, Cynthia et al. (2009) Does higher body mass index contribute to worse asthma control in an urban population? J Allergy Clin Immunol 124:207-12 |
| Clerisme-Beaty, Emmanuelle; Rand, Cynthia S (2009) The effect of obesity on asthma incidence: moving past the epidemiologic evidence. J Allergy Clin Immunol 123:96-7 |
| Patino, Cecilia M; Okelo, Sande O; Rand, Cynthia S et al. (2008) The Asthma Control and Communication Instrument: a clinical tool developed for ethnically diverse populations. J Allergy Clin Immunol 122:936-943.e6 |
| Rand, Cynthia S; Apter, Andrea J (2008) Mind the widening gap: have improvements in asthma care increased asthma disparities? J Allergy Clin Immunol 122:319-21 |
| Reddy, Deepthi M; Fried, Linda P; Rand, Cynthia et al. (2007) Can older adult volunteers serve effectively to improve asthma management for children? Experience Corps Baltimore. J Asthma 44:177-81 |
| Gao, Li; Grant, Audrey V; Rafaels, Nicholas et al. (2007) Polymorphisms in the myosin light chain kinase gene that confer risk of severe sepsis are associated with a lower risk of asthma. J Allergy Clin Immunol 119:1111-8 |
| Barnes, Kathleen C; Grant, Audrey V; Hansel, Nadia N et al. (2007) African Americans with asthma: genetic insights. Proc Am Thorac Soc 4:58-68 |
| Gao, Li; Tsai, Yuhjung J; Grigoryev, Dmitry N et al. (2007) Host defense genes in asthma and sepsis and the role of the environment. Curr Opin Allergy Clin Immunol 7:459-67 |
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