Our proposed Center for Reducing Asthma Disparities involves partnership between researchers at Harvard University (Charming Laboratory, BWH and HSPH) and a network of Boston-area Community Health Centers (CHCs) affiliated with the non-profit community-based organization CCHERS (Center for Community Health Education, Research and Service).
Broad specific aims are (see Section D for more detailed aims): 1. Conduct a community needs assessment to assess differences in perceptions about asthma etiology, disparities, and effective treatment between community representatives, CHC patients, and CHC providers. 2. Determine the role of socio/environmental exposures (psychosocial stress, indoor allergens, cigarette smoking and diesel-related air pollutants) on asthma onset through study of a prenatally enrolled birth cohort. 3. Determine the role of genetics in modifying the risk of the social/physical environment by concurrent assessment of the following genetic factors thought to influence immune development and airway inflammation in early life: stress (corticosteroid regulatory genes, adrenergic system regulatory genes), diesel exhaust and smoking (biotransformation genes), indoor allergens (cytokine pathway genes). 4. Use a quasi-experimental design to evaluate the effectiveness of the research, training, and outreach components of our project in leading to significant changes in the ability of particular stakeholders to design and implement sound asthma intervention strategies. 5. Development of training programs at Harvard that provide masters and predoctoral students as well as postdoctoral fellows with experience and expertise in Community-Based Participatory Research (CBPR) focused on reducing asthma disparities. 6. Develop training and information dissemination materials for health center staff and community members (especially caregivers of children with asthma). CCHERS will take the lead in implementing Specific Aims 1, 4 and 6, while the Harvard group will take the lead on Aims 2, 3 and 5. In addition to building needed infrastructure to support partnership-based research and interventions aimed at reducing health disparities, this proposal has the potential to make significant contributions to the scientific literature with respect to health disparities and asthma.
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