Koinis-Mitchell Daphne, McQuaid Elizabeth L, Kopel Sheryl J, Esteban Cynthia A, Ortega Alexander N, Seifer Ronald, Garcia-Coll Cynthia, Klein Robert, Cespedes Elizabeth, Canino Glorisa, Fritz Gregory K
Child and Family Psychiatry, Bradley/Hasbro Research Center, Brown Medical School, Providence, RI 02903, USA.
J Clin Psychol Med Settings. 2010 Mar;17(1):38-48. doi: 10.1007/s10880-009-9178-3.
The objective of this study was to examine associations between specific dimensions of the multi-dimensional cumulative risk index (CRI) and asthma morbidity in urban, school-aged children from African American, Latino and Non-Latino White backgrounds. An additional goal of the study was to identify the proportion of families that qualify for high-risk status on each dimension of the CRI by ethnic group. A total of 264 children with asthma, ages 7-15 (40% female; 76% ethnic minority) and their primary caregivers completed interview-based questionnaires assessing cultural, contextual, and asthma-specific risks that can impact asthma morbidity. Higher levels of asthma-related risks were associated with more functional morbidity for all groups of children, despite ethnic group background. Contextual and cultural risk dimensions contributed to more morbidity for African-American and Latino children. Analyses by Latino ethnic subgroup revealed that contextual and cultural risks are significantly related to more functional morbidity for Puerto Rican children compared to Dominican children. Findings suggest which type of risks may more meaningfully contribute to variations in asthma morbidity for children from specific ethnic groups. These results can inform culturally sensitive clinical interventions for urban children with asthma whose health outcomes lag far behind their non-Latino White counterparts.
本研究的目的是调查多维累积风险指数（CRI）的特定维度与来自非裔美国人、拉丁裔和非拉丁裔白人背景的城市学龄儿童哮喘发病率之间的关联。该研究的另一个目标是确定按种族划分的、在CRI各维度上符合高风险状态的家庭比例。共有264名患有哮喘的儿童，年龄在7至15岁之间（40%为女性；76%为少数族裔）及其主要照料者完成了基于访谈的问卷，评估了可能影响哮喘发病率的文化、环境和哮喘特定风险。尽管有族裔背景，但所有儿童组中，与哮喘相关的风险水平越高，功能性发病率越高。环境和文化风险维度对非裔美国人和拉丁裔儿童的发病率影响更大。按拉丁裔族裔亚组分析显示，与多米尼加儿童相比，环境和文化风险与波多黎各儿童更高的功能性发病率显著相关。研究结果表明哪种类型的风险可能对特定族裔儿童哮喘发病率的差异更有意义。这些结果可为健康状况远远落后于非拉丁裔白人同龄人的城市哮喘儿童提供具有文化敏感性的临床干预措施提供参考。
