Project CURA: La Comunidad Unida Retando el Asma/The Community United to Challenge Asthma

Objective: Puerto Rican children suffer the highest asthma rates of any racial or ethnic group, yet intervention research directly targeting this population is limited. Project CURA aims to compare the ability of two interventions to improve asthma medication adherence and reduce home triggers for Puerto Rican youth.

Methods: Project CURA is a behavioral randomized controlled trial that incorporates a community-based participatory research approach. Participants in the study must be Puerto Rican, 5-18 years old, and have persistent uncontrolled asthma. They are randomly assigned to one of two interventions: community health worker home visits or written information in the mail. Recruitment is done by outreach in community schools, agencies, and health care facilities. Data are collected at baseline, after the intervention phase (5 months), and after the maintenance phase (12 months). Parents and children are asked about child asthma severity, control, and health care utilization. Objective data include skin testing for allergies, home inspections for triggers, dust analysis for allergens, medication administration technique, medication adherence, and salivary cotinine levels. Psychosocial measures include caregiver and child self-efficacy, health beliefs, social support, life stress, and depression. The study contains two cohorts for analysis: an elementary school cohort (n=50. K-8th grade) and a high school cohort (n=50, 9th-12th grade).

Results: Recruitment of the cohorts will be finished by June of 2010. Descriptive characteristics and asthma outcomes of the sample at baseline will be presented. Completed analyses of associations between demographic, social, clinical, and behavioral variables will be discussed.

Conclusions: Asthma morbidity in Puerto Rican children may be associated with high asthma triggers, poor mediation adherence, and psychosocial factors. Interventions that target these areas are needed.