A Comprehensive Intervention in Asthma Management in a Population of Black and Hispanic Pregnant Women and its Effects on Asthma Control, and Maternal and Perinatal Morbidity
Principal Investigator: Dr. Darryl Jordan
Dr. Tina Hartert
Dr. Gwinett Ladson
Dr. Stephanie Sweet
Racial disparities in asthma care and outcomes have been widely reported, with minority populations (e.g. blacks and Hispanics) being unfavorably affected. Many factors, believed to be important contributors, include lower socioeconomic and educational status, cultural barriers, decreased access to medical care, environmental factors, and genetic differences. Women of childbearing age and, more specifically pregnant women, represent an important subgroup within minority populations, because of their biological role, their place in society, and their vulnerability to engage in high-risk behaviors (e.g. smoking). During pregnancy, both uncontrolled asthma and smoking can have deleterious effects in the newborn. Women during pregnancy may be more interested in their healthstate and that of their newborn, and this may be an ideal time in which to target intensive asthma care and smoking cessation programs. Additionally, pregnant women have a high frequency of health provider visits during pregnancy, allowing for opportunities to intervene in chronic health issues. Hence, the study of the relative effectiveness of interventions aimed at this patient population would be of great benefit for mothers. In addition, as genetic factors play a major role in the development of asthma, targeting pregnant women may have a positive indirect effect on asthma recognition and care in their offspring. We hypothesize that an intense, comprehensive, and culturally appropriate intervention in black and Hispanic pregnant women with asthma compared with a less intense intervention will improve asthma-specific outcome measures during pregnancy and the postpartum period for both the mother and potentially the newborn. To study this hypothesis, we have developed the TEACH (Total Education of Asthma and smoking Cessation to improve perinatal Health) program.