Patel Minal R, Song Peter X K, Sanders Georgiana, Nelson Belinda, Kaltsas Elena, Thomas Lara J, Janevic Mary R, Hafeez Kausar, Wang Wen, Wilkin Margaret, Johnson Timothy R, Brown Randall W
Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, Michigan.
Department of Biostatistics, University of Michigan, Ann Arbor, Michigan.
Ann Allergy Asthma Immunol. 2017 Feb;118(2):212-219. doi: 10.1016/j.anai.2016.11.016. Epub 2016 Dec 27.
Few interventions have focused on the difficulties that African American women face when managing asthma.
To evaluate a telephone-based self-regulation intervention that emphasized African American women's management of asthma in a series of 6 sessions.
A total of 422 African American women with persistent asthma were randomly assigned to either an intervention or control group receiving usual care. Behavioral factors, symptoms and asthma control, asthma-related quality of life, and health care use at baseline and 2 years after baseline were assessed. Generalized estimating equations were used to assess the long-term effect of the intervention on outcomes.
Compared with the control group, those who completed the full intervention (6 sessions) had significant gains in self-regulation of their asthma (B estimate, 0.73; 95% CI, 0.17-1.30; P < .01), noticing changes to their asthma during their menstrual cycle (B estimate, 1.42; 95% CI, 0.69-2.15; P < .001), and when having premenstrual syndrome (B estimate, 1.70; 95% CI, 0.67-2.72; P < .001). They also had significant reductions in daytime symptoms (B estimate, -0.15; 95% CI, -0.27 to -0.03; P < .01), asthma-related hospitalization (B estimate, 0.51; 95% CI, 0.00-1.02; P < .05), and improved asthma control (B estimate, 1.34; 95% CI, 0.57-2.12; P < .001). However, neither grouped changed over time in outcomes.
Despite high comorbidity, African American women who completed a culturally responsive self-management program had improvements in asthma outcomes compared with the control group. Future work should address significant comorbidities and psychosocial issues alongside asthma management to improve asthma outcomes in the long term.
clinicaltrials.gov Identifier NCT01117805.
很少有干预措施关注非裔美国女性在管理哮喘时所面临的困难。
评估一种基于电话的自我调节干预措施，该措施在一系列6次疗程中强调非裔美国女性对哮喘的管理。
总共422名患有持续性哮喘的非裔美国女性被随机分配到干预组或接受常规护理的对照组。对行为因素、症状和哮喘控制情况、与哮喘相关的生活质量以及基线时和基线后2年的医疗保健使用情况进行评估。使用广义估计方程来评估干预对结果的长期影响。
与对照组相比，完成全部干预（6次疗程）的患者在哮喘自我调节方面有显著改善（B估计值，0.73；95%置信区间，0.17 - 1.30；P <.01），在月经周期中注意到哮喘变化（B估计值，1.42；95%置信区间，0.69 - 2.15；P <.001），以及在经前综合征期间（B估计值，1.70；95%置信区间，0.67 - 2.72；P <.001）。她们在白天症状（B估计值， - 0.15；95%置信区间， - 0.27至 - 0.03；P <.01）、与哮喘相关的住院率（B估计值，0.51；95%置信区间，0.00 - 1.02；P <.05）方面也有显著降低，并且哮喘控制得到改善（B估计值，1.34；95%置信区间，0.57 - 2.12；P <.001）。然而，两组在结果方面均未随时间发生变化。
尽管合并症发生率高，但与对照组相比，完成了具有文化适应性的自我管理项目的非裔美国女性在哮喘结果方面有改善。未来的工作应在管理哮喘的同时解决严重的合并症和心理社会问题，以长期改善哮喘结果。
clinicaltrials.gov标识符NCT01117805。
