Vogt Rainbow, Bersamin Andrea, Ellemberg Cheryl, Winkleby Marilyn A
School of Policy, Planning, and Development, University of Southern California, Tomas Rivera Policy Institute, Los Angeles, California, USA.
J Asthma. 2008 Sep;45(7):568-74. doi: 10.1080/02770900802005269.
To better understand risk factors associated with current asthma in a low-income, ethnically diverse population, we analyzed pooled data from the 2004-2006 Behavioral Risk Factor Surveillance System survey conducted in Salinas, CA. We were particularly interested in modifiable risk factors, as the survey was conducted as part of a large community-based intervention that addresses asthma, obesity, and diabetes. We also conducted semi-structured interviews with key informants involved with the clinical, school, and community aspects of the intervention to inform the intervention's progress, and adapt practices and programs to reach those most in need. Of the 4925 adults in this analysis, 51% were Mexican-American and 32% lacked a high-school diploma; 227 women and 84 men had current asthma, and 194 were parents of children with current asthma; prevalences of 7.7%, 4.3%, and 7.0% respectively. Over 20% of women and men with asthma were current smokers and/or exposed to passive smoking, more than 50% reported less than the recommended 60 minutes or more of physical activity per day, and approximately 40% were obese or morbidly obese (42% of women and 36% of men compared to 26% of adults without asthma). Two of the strongest modifiable risk factors associated with current asthma and identified by the stepwise multiple regression models were: could not afford prescription medication(s) in the past 12 months (OR 2.5, p < 0.001 for adults with asthma, OR 1.8, p < 0.01 for parents of children with asthma) and morbid obesity (OR 3.4, p < 0.001 for adults with asthma). Among adults who reported one or more episodes of asthma in the past 30 days, 28% of women and 30% of men had not used a preventive medication, and 48% of women and 57% of men had not used a prescription asthma inhaler (20% had not used either). This study adds to the scarce body of literature on the prevalence of asthma and related risk factors in a predominately Mexican-American, semi-rural community, and illustrates how survey and key informant data can enhance knowledge of local study populations and guide interventions to improve asthma control and treatment.
为了更好地了解低收入、种族多样化人群中与当前哮喘相关的风险因素，我们分析了2004 - 2006年在加利福尼亚州萨利纳斯进行的行为风险因素监测系统调查的汇总数据。我们特别关注可改变的风险因素，因为该调查是一项针对哮喘、肥胖和糖尿病的大型社区干预措施的一部分。我们还对参与干预措施临床、学校和社区方面的关键信息提供者进行了半结构化访谈，以了解干预措施的进展情况，并调整实践和项目，以惠及最有需要的人群。在本次分析的4925名成年人中，51%是墨西哥裔美国人，32%没有高中文凭；227名女性和84名男性患有当前哮喘，194名是患有当前哮喘儿童的父母；患病率分别为7.7%、4.3%和7.0%。超过20%的哮喘患者男女当前吸烟和/或接触过被动吸烟，超过50%的人报告每天进行的体育活动少于建议的60分钟或更多，约40%的人肥胖或病态肥胖（哮喘女性患者中有42%，男性患者中有36%，而无哮喘成年人中这一比例为26%）。逐步多元回归模型确定的与当前哮喘相关的两个最强可改变风险因素是：在过去12个月中无力支付处方药费用（哮喘成年人的比值比为2.5，p < 0.001；哮喘儿童父母的比值比为1.8，p < 0.01）和病态肥胖（哮喘成年人的比值比为3.4，p < 0.001）。在过去30天内报告有一次或多次哮喘发作的成年人中，28%的女性和30%的男性未使用预防性药物，48%的女性和57%的男性未使用处方哮喘吸入器（20%的人两种药物都未使用）。本研究补充了关于以墨西哥裔美国人为主的半农村社区哮喘患病率及相关风险因素的稀少文献，并说明了调查和关键信息提供者数据如何能够增进对当地研究人群的了解，并指导干预措施以改善哮喘控制和治疗。
