Rodríguez Erin M, Horner Sharon D, Bearman Sarah Kate, Gulbas Lauren, George-Jones Julia, Alvarado Cinthia, Esperanza Catherine
Department of Educational Psychology, University of Texas at Austin, 1912 Speedway, Stop D5000, Austin, TX 78712.
School of Nursing, University of Texas at Austin, 1710 Red River Street, Austin, TX 78712.
Clin Pract Pediatr Psychol. 2022 Jun;10(2):115-127. doi: 10.1037/cpp0000423. Epub 2021 Oct 28.
Psychosocial stress contributes to asthma disparities for low-SES Latinx children, but primary and secondary control coping by children and parents is associated with better psychosocial and asthma outcomes. Therefore, we developed and pilot tested (A2A), a family-based coping and asthma self-management intervention for low-SES Latinx families.
Children, parents, and primary care providers (N=16) participated in five focus groups to refine A2A's content and delivery. Subsequently, families of children ages 9-12 with asthma (N=24) were recruited from primary care clinics and randomly assigned to receive A2A or enhanced usual care (EUC).
Based on focus groups, A2A was refined to address feasibility, Latinx-specific cultural factors, and provider-family gaps. Results of the pilot RCT showed that 92% of families completed all sessions of A2A, and there were high levels of satisfaction with and fidelity to A2A. There were no statistically significant differences between the A2A and EUC groups at 3-month follow-up, although there were small, non-significant effects favoring A2A on parent-reported asthma control, parent secondary control coping, and emergency department visits.
We found evidence of acceptability, feasibility, and potential benefits of A2A for low-SES Latinx families. Findings provide guidance for future implementation in primary care.
心理社会压力导致低收入拉丁裔儿童哮喘差异，但儿童和家长的主要和次要控制应对方式与更好的心理社会和哮喘结果相关。因此，我们开发并进行了试点测试（A2A），这是一种针对低收入拉丁裔家庭的基于家庭的应对和哮喘自我管理干预措施。
儿童、家长和初级保健提供者（N = 16）参加了五个焦点小组，以完善A2A的内容和实施方式。随后，从初级保健诊所招募了患有哮喘的9至12岁儿童的家庭（N = 24），并随机分配接受A2A或强化常规护理（EUC）。
根据焦点小组的意见，对A2A进行了完善，以解决可行性、拉丁裔特定文化因素以及提供者与家庭之间的差距问题。试点随机对照试验的结果表明，92%的家庭完成了A2A的所有疗程，对A2A的满意度和忠诚度都很高。在3个月的随访中，A2A组和EUC组之间没有统计学上的显著差异，尽管在家长报告的哮喘控制、家长次要控制应对和急诊就诊方面，有一些有利于A2A的微小、不显著的效果。
我们发现了A2A对低收入拉丁裔家庭具有可接受性、可行性和潜在益处的证据。研究结果为未来在初级保健中的实施提供了指导。
