Appropriate Care of URI in Children of Latino Immigrants: The ACURI Project

Dr. Stockwell

Grant # RC1 MD004109
Title: APPROPRIATE CARE OF URI IN CHILDREN OF LATINO IMMIGRANTS: THE ACURI PROJECT
PI: Melissa Stockwell, MD, MPH, Assistant Professor of Clinical Pediatrics, College of Physicians & Surgeons of Columbia University and Assistant Professor of Population and Family Health, Mailman School of Public Health, Columbia University
Funder: National Center on Minority Health and Health Disparities of the National Institutes of Health (NIH/NCHMD)
Dates: 9/20/09 - 6/30/11
Funding: $499,815

The major goals of this project are to evaluate the impact of a tailored intervention, the ACURI project, on A) health literacy levels regarding upper respiratory infections (URI) specifically focusing on predisposing, enabling, and reinforcing factors and B) pediatric emergency department visits for viral URI, among Latino households in Early Head Start/Head Start as well as to perform a cost effective analysis of the URI health literacy intervention.

| Project Summary | Research Team |

PROJECT SUMMARY

Limited health literacy affects over 90 million Americans, and is strongly associated with poor health. While limited health literacy affects people of all social, cultural and economic backgrounds, it is especially prevalent in low income households, and among minorities and people with limited English proficiency.

Young children have multiple viral URIs a year, especially those in group activities like daycare. Latino parents have been shown to be at high risk for poor health literacy regarding URIs. Limited health literacy, as related to knowledge, attitudes and care practices, among Latino parents can directly affect their ability to care for and treat themselves and their families. This can result in increased costly emergency department visit, and inappropriate antibiotic seeking leading to increase individual and community-wide antibiotic resistance.

The CDC recommends community based culturally appropriate interventions to educate families about viral URIs. While previous studies have found a positive impact of educational efforts to increase parental knowledge regarding URIs and antibiotic resistance, they were not developed for minority populations with poor health literacy, and did not include cost-effective analyses. Early Head Start/Head Start (EHS/HS) educational programs for low-income families have been shown to be promising sites for community based health education interventions, but need further evaluation.

The purpose of this study is to conduct a randomized controlled trial to comparatively assess the effectiveness of our tailored educational intervention, The Appropriate Care of URI (ACURI) Project, to improve health literacy levels regarding upper respiratory infections (URIs) and to decrease pediatric emergency department (PED) visits, among Latino households in Early Head Start/Head Start. Our intervention builds capacity in the participating EHS/HS nationally. Funding for this project will allow hiring of three community members, including two community health workers, thereby building community capacity. It will also contribute to the local economy through parental incentives and purchase of supplies from local businesses.

CORE RESEARCH TEAM
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Name	Role	Institution / Department
Melissa Stockwell, MD, MPH Assistant Professor of Clinical Pediatrics and Assistant Professor of Population and Family Health	Principal Investigator	Department of Pediatrics, College of Physicians & Surgeons of Columbia University and the Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University
Elaine L. Larson, RN, PhD Professor of Pharmaceutical and Therapeutic Research and Professor of Epidemiology	Co-Investigator	Columbia University School of Nursing and Department of Epidemiology, Mailman School of Public Health, Columbia University
Marina Catallozzi, MD Assistant Professor of Clinical Pediatrics and Assistant Professor of Population and Family Health	Co-Investigator	Department of Pediatrics, College of Physicians & Surgeons of Columbia University and the Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University
Dodi Meyer, MD Assistant Clinical Professor in Pediatrics	Co-Investigator	Department of Pediatrics, College of Physicians & Surgeons of Columbia University
Bernadette Boden-Albala, DrPH Assistant Professor of Sociomedical Science in Neurology	Other Significant Contributor	Department of Neurology, College of Physicians & Surgeons of Columbia University
Carmen Rodriguez, PhD Director, Columbia University Head Start and Assistant Clinical Professor in Public Health	Co-Investigator	The Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University
Emelin Martinez	Health Educator	Department of Pediatrics, College of Physicians & Surgeons of Columbia University