Center for Managing Chronic Disease, University of Michigan, 1415 Washington Heights, Ann Arbor, Michigan, USA.
BMC Public Health. 2012 Jan 24;12:76. doi: 10.1186/1471-2458-12-76.
Among adults in the United States, asthma prevalence is disproportionately high among African American women; this group also experiences the highest levels of asthma-linked mortality and asthma-related health care utilization. Factors linked to biological sex (e.g., hormonal fluctuations), gender roles (e.g., exposure to certain triggers) and race (e.g., inadequate access to care) all contribute to the excess asthma burden in this group, and also shape the context within which African American women manage their condition. No prior interventions for improving asthma self-management have specifically targeted this vulnerable group of asthma patients. The current study aims to evaluate the efficacy of a culturally- and gender-relevant asthma-management intervention among African American women.
METHODS/DESIGN: A randomized controlled trial will be used to compare a five-session asthma-management intervention with usual care. This intervention is delivered over the telephone by a trained health educator. Intervention content is informed by the principles of self-regulation for disease management, and all program activities and materials are designed to be responsive to the specific needs of African American women. We will recruit 420 female participants who self-identify as African American, and who have seen a clinician for persistent asthma in the last year. Half of these will receive the intervention. The primary outcomes, upon which the target sample size is based, are number of asthma-related emergency department visits and overnight hospitalizations in the last 12 months. We will also assess the effect of the intervention on asthma symptoms and asthma-related quality of life. Data will be collected via telephone survey and medical record review at baseline, and 12 and 24 months from baseline.
We seek to decrease asthma-related health care utilization and improve asthma-related quality of life in African American women with asthma, by offering them a culturally- and gender-relevant program to enhance asthma management. The results of this study will provide important information about the feasibility and value of this program in helping to address persistent racial and gender disparities in asthma outcomes.
ClinicalTrials.gov: NCT01117805.
在美国成年人中，非裔美国女性的哮喘患病率不成比例地高；这一群体还经历着最高水平的与哮喘相关的死亡率和与哮喘相关的医疗保健利用。与生物性别相关的因素（例如，激素波动）、性别角色（例如，接触某些触发因素）和种族（例如，获得护理的机会不足）都导致了这一群体的哮喘负担过重，也塑造了非裔美国女性管理其病情的背景。以前没有专门针对这一脆弱的哮喘患者群体的改善哮喘自我管理的干预措施。目前的研究旨在评估一种针对非裔美国女性的文化和性别相关哮喘管理干预措施的疗效。
方法/设计：将使用随机对照试验比较五次哮喘管理干预与常规护理。该干预措施由经过培训的健康教育者通过电话提供。干预内容基于疾病管理的自我调节原则，所有项目活动和材料均旨在满足非裔美国女性的特定需求。我们将招募 420 名自认为是非裔美国女性的女性参与者，她们在过去一年中曾因持续性哮喘看过临床医生。其中一半将接受干预。主要结局是过去 12 个月内哮喘相关急诊就诊次数和夜间住院次数。我们还将评估干预对哮喘症状和哮喘相关生活质量的影响。数据将通过基线时的电话调查和病历回顾收集，并在基线后 12 个月和 24 个月进行评估。
我们旨在通过为非裔美国女性提供增强哮喘管理的文化和性别相关计划，减少哮喘相关的医疗保健利用并改善哮喘相关的生活质量。这项研究的结果将提供有关该计划在帮助解决哮喘结果中持续存在的种族和性别差异方面的可行性和价值的重要信息。
ClinicalTrials.gov：NCT01117805。
