Improving Appropriate Use of Antibiotics for URI in Children of Recently Immigrated Latinos

Dr. Stockwell

Dr. Catallozzi

Elaine Larson, RN, PhD, FAAN, CIC
Dr. Larson

Columbia University Irving Institute for Clinical and Translational Research
Planning Grants for Collaborative and Multidisciplinary Pilot Research (CaMPR)

Title: IMPROVING APPROPRIATE USE OF ANTIBIOTICS FOR URI IN CHILDREN OF RECENTLY IMMIGRATED LATINOS

Co-PIs:

Elaine Larson, RN, PhD, Professor of Therapeutic and Pharmaceutical Research, Columbia University School of Nursing and Professor of Epidemiology, Mailman School of Public Health, Columbia University
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
Marina Catallozzi, MD, 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: Columbia University's NCRR-funded CTSA: Irving Institute for Clinical and Translational Research
Dates: 11/5/08 - 3/4/09
Funding: $25,000

| Project Summary | Research Team |

PROJECT SUMMARY

Antimicrobial resistance is one of the most pressing public health issues facing the world today, and there is consistent evidence for a link between antibiotic use and increasing antimicrobial resistance in the community. Nevertheless, inappropriate use of antimicrobials, particularly for viral upper respiratory infections (URI), continues to be a global problem. Reasons for this include public expectations and demand for medication, lack of understanding about the ineffectiveness of antibiotics against viral illness, and the ease of access to antibiotics without prescription in many parts of the world. In addition, improper use of prescribed antibiotics compounds this problem. Antibiotic misuse and resistance are more common in countries in which antibiotics are available over the counter and in which cultural patterns regarding medication use and beliefs about medication effectiveness differ. Latinos represent the fastest growing ‘minority’ population in the U.S. and have generally immigrated from countries in which antibiotics are available without prescription. Antibiotics are readily available without prescription in local bodegas (small independent grocery stores), botanical stores, and small independent pharmacies in New York City, as is the case in other urban areas with large immigrant populations from countries in which antibiotics are readily obtained over-the-counter, including South and Central America, Africa, and most of Asia. Although this problem has been recognized for years by enforcement agencies, the magnitude of the problem (there are >7,000 bodegas in Manhattan alone) and the cultural norms of many recent immigrants have been stumbling blocks to effective intervention. Furthermore, even when antibiotics are properly prescribed, families may not take them correctly due to problems with health literacy. There is an especially high risk of problems with health literacy leading to medication errors in non-English speaking, immigrant populations.

Children have an extraordinary number of URIs yearly. Parents commonly seek antibiotics for their child’s URI since many do not know that a virus is the usual cause of the common cold; many also believe that antibiotics kill viruses. They seek antibiotics not only from their child’s health care provider, but also from local bodegas. Therefore, parents of young children are prime targets for interventions to decrease antimicrobial resistance.

The long term goal of this project is to develop and test an intervention to decrease inappropriate antibiotic use for URI in children among recently immigrated Latino community members, based on the CDC action plan to combat antimicrobial resistance. The specific aim of this planning grant is to bring together a new collaborative team to develop a tailored, culturally appropriate intervention using the Precede-Proceed Health Education Model, to address predisposing, enabling, and reinforcing factors which result in judicious and appropriate antibiotic use among families of recently immigrated Latinos. The tools developed with this planning grant will then be incorporated into a protocol for a future large randomized clinical trial.

CORE RESEARCH TEAM
Click on name to view faculty profile or send e-mail

Name	Role	Institution / Department
Elaine L. Larson, RN, PhD Professor of Pharmaceutical and Therapeutic Research and Professor of Epidemiology	Co-Principal Investigator	Columbia University School of Nursing and Department of Epidemiology, Mailman School of Public Health, Columbia University
Melissa Stockwell, MD, MPH Assistant Professor of Clinical Pediatrics and Assistant Professor of Population and Family Health	Co-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
Marina Catallozzi, MD Assistant Professor of Clinical Pediatrics and Assistant Professor of Population and Family Health	Co-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
Cassie Landers, EdD, MPH Assistant Professor of Population and Family Health	Co-Investigator	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
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
Angela Barrett	Research Assistant	Columbia University School of Nursing