Daphne Koinis-Mitchell, Christina D'Angelo, Maria Teresa Coutinho, Sheryl J Kopel, Rebecca Noga, Heather Yoho, Luis Guzman, Sumera S Subzwari, Elizabeth L McQuaid, Ligia Chavez, Jean-Marie Bruzzese, Anna J Yeo, Glorisa Canino
{"title":"城市拉丁裔中学儿童哮喘管理干预同伴管理的发展和调整。","authors":"Daphne Koinis-Mitchell, Christina D'Angelo, Maria Teresa Coutinho, Sheryl J Kopel, Rebecca Noga, Heather Yoho, Luis Guzman, Sumera S Subzwari, Elizabeth L McQuaid, Ligia Chavez, Jean-Marie Bruzzese, Anna J Yeo, Glorisa Canino","doi":"10.1080/02770903.2025.2539807","DOIUrl":null,"url":null,"abstract":"<p><p><b>Objective</b>: Children from Latino backgrounds face unique challenges in managing asthma. Barriers are compounded when children live in urban settings and are exposed to urban stressors (e.g., barriers to medication use, neighborhood stress). Asthma management in schools is often directly implicated. This study aims to address these gaps in care by developing a 4-session, peer-facilitated, culturally tailored asthma self-management group intervention in urban public-school settings. <b>Methods</b>: We developed and tested the ASMAS (<u>A</u>sthma <u>S</u>elf-<u>Ma</u>nagement in <u>S</u>chools) intervention, utilizing an iterative process guided by previous work and theoretical models. Feedback from focus groups was used to further tailor ASMAS. We enrolled 81 middle school students in a cross-site pilot randomized controlled trial (RCT) to evaluate the efficacy of ASMAS compared both to Attention Control and No-Treatment Control conditions. Outcomes included asthma control, asthma-related sleep disruption, school absences, asthma self-efficacy, and availability of rescue inhaler and asthma action plan (AAP) at school. <b>Results</b>: Compared to Attention Control participants, youth who received ASMAS had improved asthma outcomes over time (baseline to end-of-treatment) including asthma control (t = 2.1, <i>p</i><.05, d=.4, M<sub>diff</sub>=1.5), asthma-related sleep disruptions (t=-.24, <i>p</i> <.05, d=-.4, M<sub>diff</sub>=-3.6), school absences (d=-.2), asthma management self-efficacy (t = 2.3, <i>p</i> <.05, d=.4, M<sub>diff</sub>=0.3) and rates of AAP (t = 1.8, <i>p</i> =.06; d=.3, M<sub>diff</sub>=20%) and rescue inhalers availability (t = 2.0, <i>p</i> <.01, d=.7, M<sub>diff</sub>=23%). Similar patterns were maintained at 4-month follow-up. <b>Conclusions</b>: Results demonstrate ASMAS' feasibility and highlight the potential benefits of the tailored asthma intervention. A full-scale RCT to evaluate ASMAS' effectiveness, implementation, and sustainability is warranted.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-16"},"PeriodicalIF":1.3000,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Development and Tailoring of a Peer-Administered Asthma Management Intervention for Urban Latino Middle School Children.\",\"authors\":\"Daphne Koinis-Mitchell, Christina D'Angelo, Maria Teresa Coutinho, Sheryl J Kopel, Rebecca Noga, Heather Yoho, Luis Guzman, Sumera S Subzwari, Elizabeth L McQuaid, Ligia Chavez, Jean-Marie Bruzzese, Anna J Yeo, Glorisa Canino\",\"doi\":\"10.1080/02770903.2025.2539807\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Objective</b>: Children from Latino backgrounds face unique challenges in managing asthma. Barriers are compounded when children live in urban settings and are exposed to urban stressors (e.g., barriers to medication use, neighborhood stress). Asthma management in schools is often directly implicated. This study aims to address these gaps in care by developing a 4-session, peer-facilitated, culturally tailored asthma self-management group intervention in urban public-school settings. <b>Methods</b>: We developed and tested the ASMAS (<u>A</u>sthma <u>S</u>elf-<u>Ma</u>nagement in <u>S</u>chools) intervention, utilizing an iterative process guided by previous work and theoretical models. Feedback from focus groups was used to further tailor ASMAS. We enrolled 81 middle school students in a cross-site pilot randomized controlled trial (RCT) to evaluate the efficacy of ASMAS compared both to Attention Control and No-Treatment Control conditions. Outcomes included asthma control, asthma-related sleep disruption, school absences, asthma self-efficacy, and availability of rescue inhaler and asthma action plan (AAP) at school. <b>Results</b>: Compared to Attention Control participants, youth who received ASMAS had improved asthma outcomes over time (baseline to end-of-treatment) including asthma control (t = 2.1, <i>p</i><.05, d=.4, M<sub>diff</sub>=1.5), asthma-related sleep disruptions (t=-.24, <i>p</i> <.05, d=-.4, M<sub>diff</sub>=-3.6), school absences (d=-.2), asthma management self-efficacy (t = 2.3, <i>p</i> <.05, d=.4, M<sub>diff</sub>=0.3) and rates of AAP (t = 1.8, <i>p</i> =.06; d=.3, M<sub>diff</sub>=20%) and rescue inhalers availability (t = 2.0, <i>p</i> <.01, d=.7, M<sub>diff</sub>=23%). Similar patterns were maintained at 4-month follow-up. <b>Conclusions</b>: Results demonstrate ASMAS' feasibility and highlight the potential benefits of the tailored asthma intervention. 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引用次数: 0
摘要
目的:拉丁裔儿童在管理哮喘方面面临独特的挑战。当儿童生活在城市环境中并暴露于城市压力因素(例如,药物使用障碍、邻里压力)时,障碍会更加复杂。学校的哮喘管理经常直接牵涉其中。本研究旨在通过在城市公立学校环境中开发一种4期、同伴促进、文化定制的哮喘自我管理小组干预来解决这些护理差距。方法:我们开发并测试了ASMAS(学校哮喘自我管理)干预措施,利用先前工作和理论模型指导的迭代过程。来自焦点小组的反馈用于进一步定制ASMAS。我们招募了81名中学生进行了一项跨站点的随机对照试验(RCT),以评估ASMAS与注意控制和无治疗控制条件的疗效。结果包括哮喘控制、哮喘相关睡眠中断、缺课、哮喘自我效能、救援吸入器和哮喘行动计划(AAP)在学校的可用性。结果:与注意力控制参与者相比,接受ASMAS治疗的青少年哮喘结局随着时间的推移(基线至治疗结束)得到改善,包括哮喘控制(t= 2.1, pdiff=1.5),哮喘相关睡眠中断(t=-)。24, p diff=-3.6),缺勤(d=- 0.2),哮喘管理自我效能(t = 2.3, p diff=0.3)和AAP率(t = 1.8, p = 0.06;d =。3, Mdiff=20%)和抢救吸入器可用性(t = 2.0, p diff=23%)。在4个月的随访中保持类似的模式。结论:结果证明了ASMAS的可行性,并强调了量身定制哮喘干预的潜在益处。有必要进行全面的随机对照试验来评估ASMAS的有效性、实施和可持续性。
Development and Tailoring of a Peer-Administered Asthma Management Intervention for Urban Latino Middle School Children.
Objective: Children from Latino backgrounds face unique challenges in managing asthma. Barriers are compounded when children live in urban settings and are exposed to urban stressors (e.g., barriers to medication use, neighborhood stress). Asthma management in schools is often directly implicated. This study aims to address these gaps in care by developing a 4-session, peer-facilitated, culturally tailored asthma self-management group intervention in urban public-school settings. Methods: We developed and tested the ASMAS (Asthma Self-Management in Schools) intervention, utilizing an iterative process guided by previous work and theoretical models. Feedback from focus groups was used to further tailor ASMAS. We enrolled 81 middle school students in a cross-site pilot randomized controlled trial (RCT) to evaluate the efficacy of ASMAS compared both to Attention Control and No-Treatment Control conditions. Outcomes included asthma control, asthma-related sleep disruption, school absences, asthma self-efficacy, and availability of rescue inhaler and asthma action plan (AAP) at school. Results: Compared to Attention Control participants, youth who received ASMAS had improved asthma outcomes over time (baseline to end-of-treatment) including asthma control (t = 2.1, p<.05, d=.4, Mdiff=1.5), asthma-related sleep disruptions (t=-.24, p <.05, d=-.4, Mdiff=-3.6), school absences (d=-.2), asthma management self-efficacy (t = 2.3, p <.05, d=.4, Mdiff=0.3) and rates of AAP (t = 1.8, p =.06; d=.3, Mdiff=20%) and rescue inhalers availability (t = 2.0, p <.01, d=.7, Mdiff=23%). Similar patterns were maintained at 4-month follow-up. Conclusions: Results demonstrate ASMAS' feasibility and highlight the potential benefits of the tailored asthma intervention. A full-scale RCT to evaluate ASMAS' effectiveness, implementation, and sustainability is warranted.
期刊介绍:
Providing an authoritative open forum on asthma and related conditions, Journal of Asthma publishes clinical research around such topics as asthma management, critical and long-term care, preventative measures, environmental counselling, and patient education.