Over the past decade there has been a heightened awareness of the disproportionate impact of asthma morbidity and mortality among African Americans and persons of lower social economic status. The causes underlying this disparity have not been fully elucidated. However, there is strong evidence that the level of social stress imposed by this condition and the degree of coping and self-management skills present are factors that may be particularly important in explaining these disparities. The purpose of this project is to develop a collaborative research program between Northwestern University Feinberg School of Medicine and Cook County Hospital to fully characterize the relationship of social stress, coping, and self-regulatory health behaviors in the context of asthma disparities among African American and low income populations. Once characterized, the project will then develop and test an intervention strategy to reduce asthma disparities in high-risk populations based on evidence-based models that have demonstrated success in social work, nursing, and community interventions. There are four research aims for this proposed Center of Excellence. (1) To develop and validate culturally appropriate psychosocial instruments related to the underlying causes of disparity in asthma morbidity (2) To identify the structural relationships of psychosocial factors to other known influential factors related to disparities in asthma outcomes. (3) To study the changes in structural relationship among influential factors in asthma disparity over time as related to changes in health status. (4) To develop, pilot test, and field test a community-based asthma team (peer coach, asthma nurse, and social worker) intervention to enhance individuals ability to cope with chronic illness and improve asthma-related behaviors. A second major goal of this Center will be to train and mentor new clinical investigators and social scientists to be able to conduct research in this field of interest.
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