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Tang J, Zhao Z, Guo R, Niu C, Zhang R, Wang L, Luo N. Preschool children's asthma medication: parental knowledge, attitudes, practices, and adherence. Front Pharmacol 2024; 15:1292308. [PMID: 38633619 PMCID: PMC11021651 DOI: 10.3389/fphar.2024.1292308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/16/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction: As parents or legal guardians primarily care for children with asthma, understanding their knowledge, attitudes, and practices (KAP) barriers to treatment and medication adherence is of essential importance. This study aimed to analyze the KAP toward asthma medication and adherence among preschool-aged asthmatic children's parents and explore the factors influencing adherence. Methods: This cross-sectional study was conducted between February 2023 and April 2023. Parents of preschool children with asthma were asked to complete the questionnaire containing knowledge, attitude, practice dimensions, and demographic characteristics. The Morisky Medication Adherence Scale (MMAS) was used to investigate adherence. Results: A total of 632 valid questionnaires (154 male and 478 female) were included. Parents showed moderate knowledge (9.49 ± 2.86, 63.27%, possible range: 0-15) and moderate attitudes (26.18 ± 2.51, 74.80%, possible range: 7-35) towards asthma medication, while their practices (27.46 ± 5.26, 91.53%, possible range: 6-30) were proactive; however, medication adherence was low (4.84 ± 1.78, total score: 8). The attitude scores (OR = 1.10, 95% CI: 1.01-1.19, P=0.020), practice scores (OR = 1.16, 95%CI: 1.12-1.21, p < 0.001), and smoking (OR = 1.64, 95%CI: 1.14-2.37, p = 0.008) were associated with medication adherence. Discussion: Preschool-aged asthmatic children's parents showed moderate knowledge, attitudes, and proactive practice toward asthma medication. Continuous training and education programs should be provided for parents to improve asthma medication management in preschool children.
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Affiliation(s)
| | | | - Rong Guo
- Department of Respiratory, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Engineering Research Center of Stem Cell Therapy, Chongqing, China
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Retinasekharan S, Md Shukri N, Ismail AF, Abdullah B. Knowledge, Attitude, and Practice of Intranasal Corticosteroid in Allergic Rhinitis Patients: Development of a New Questionnaire. Healthcare (Basel) 2021; 10:healthcare10010008. [PMID: 35052171 PMCID: PMC8775375 DOI: 10.3390/healthcare10010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/13/2021] [Accepted: 12/20/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives: The knowledge gap and attitude of allergic rhinitis (AR) patients using intranasal corticosteroid (INCS) led to the poor outcome of their disease. We aimed to develop and validate a new questionnaire to assess the knowledge, attitude, and practice (KAP) of AR patients that can be used to assess and understand the factors affecting compliance of INCS. Methods: The questionnaire comprised development and validation stages. A self-administered questionnaire was developed after a comprehensive literature review. It was subjected to content and face validity before a revised final version was drafted. Exploratory factor analysis was used to assess the validity of the questionnaire. Cronbach’s alpha was used to verify internal consistency. Results: The development phase resulted in a questionnaire consisting of 14 items. Explanatory factor analysis revealed four factors associated with KAP. The four factors were extracted, and 12 items were kept. The factors were attitude domain with four items (factor 1), practice domain with four items (factor 2), and knowledge domain with four items (factor 3 has two items, and factor 4 has two items). The Cronbach’s alpha of the four factors ranged from 0.614 to 0.809. The final questionnaire consists of 3 domains with 12 items (the knowledge domain with four questions; the attitude domain with four questions; the practice domain with four questions) and was valid and reliable. Conclusions: The newly developed questionnaire has adequate validity and reliability. It is a useful tool to improve the treatment of AR patients by understanding the factors affecting their compliance.
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Affiliation(s)
- Senthilraj Retinasekharan
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (S.R.); (N.M.S.)
| | - Norasnieda Md Shukri
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (S.R.); (N.M.S.)
| | - Ahmad Filza Ismail
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia;
| | - Baharudin Abdullah
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (S.R.); (N.M.S.)
- Correspondence: or
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Carrillo G, Roh T, Baek J, Chong-Menard B, Ory M. Evaluation of Healthy South Texas Asthma Program on improving health outcomes and reducing health disparities among the underserved Hispanic population: using the RE-AIM model. BMC Pediatr 2021; 21:510. [PMID: 34784927 PMCID: PMC8593094 DOI: 10.1186/s12887-021-02991-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 10/28/2021] [Indexed: 12/03/2022] Open
Abstract
Background In the United States, childhood asthma prevalence is higher among low-income communities and Hispanic populations. Previous studies found that asthma education could improve health and quality of life, especially in vulnerable populations lacking healthcare access. This study aims to describe Healthy South Texas Asthma Program (HSTAP), an evidence-based asthma education and environmental modification program in South Texas, and evaluate its associations with health-related outcomes among Hispanic children with asthma and their families. Methods The RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) planning and evaluation framework was used as an overarching tool to evaluate the impact of the HSTAP. This educational program included 451 children with asthma and their families living in South Texas, an impoverished area at the Texas-Mexico border. The program consisted of (a) the asthma education (2-h) for children with asthma provided by Respiratory Therapy students at the children’s schools and (b) the home visit Asthma and Healthy Homes education and walk-through sessions (at baseline and 3 months) for parents and two follow-up visits (6 and 9–12 months later) led by community health workers. The education was provided in either English or Spanish between September 2015 and August 2020 as part of the Healthy South Texas Initiative. A pre-and post-test design was implemented to assess the differences in health outcomes, knowledge, and behaviors using standardized self-reported surveys as reported by parents. Analyses included primary descriptive analyses, generalized estimating equation models, the Wilcoxon signed-rank test, and the McNemar test. Results The HSTAP was significantly associated with improved individual-level outcomes on the frequency of asthma-related respiratory symptoms, including shortness of breath, chest tightness, coughing, and sleep difficulty, among children with asthma, as well as an enhanced asthma knowledge in their family. This study also showed significant associations with children’s school attendance and participation in physical activities and family social events and decreased families’ worry about their asthma management. Conclusions The RE-AIM model was a helpful framework to assess the HSTAP on all its components. The results suggest that participation in an asthma education and environmental modification program was associated with improved individual-level health conditions and reduced health disparities among children with asthma in low-income communities. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02991-8.
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Affiliation(s)
- Genny Carrillo
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, 212 Adriance Lab Road, College Station, TX, 77843, USA.
| | - Taehyun Roh
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, 212 Adriance Lab Road, College Station, TX, 77843, USA
| | - Juha Baek
- Postdoctoral Fellow, Center for Outcomes Research, Houston Methodist, 7550 Greenbriar Dr, Houston, TX, 77030, USA
| | - Betty Chong-Menard
- Dr. Ramiro R. Casso NAH Campus, South Texas College, 1101 E. Vermont, McAllen, TX, 78503, USA
| | - Marcia Ory
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, 212 Adriance Lab Road, College Station, TX, 77843, USA
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Dawson RM, Heiney SP, Messias DH, Ownby D. A Patient-Centered Asthma Management Communication Intervention for Rural Latino Children: Protocol for a Waiting-List Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e18977. [PMID: 33258784 PMCID: PMC7738259 DOI: 10.2196/18977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/16/2020] [Accepted: 09/17/2020] [Indexed: 11/13/2022] Open
Abstract
Background Rural Latino children with asthma suffer high rates of uncontrolled asthma symptoms, emergency department visits, and repeat hospitalizations. This vulnerable population must negotiate micro- and macrolevel challenges that impact asthma management, including language barriers, primary care access, parental time off from work, insurance coverage, distance from specialty sites, and documentation status. There are few proven interventions that address asthma management embedded within this unique context. Objective Using a bio-ecological approach, we will determine the feasibility of a patient-centered collaborative program between rural Latino children with asthma and their families, school-based nursing programs, and primary care providers, facilitated by the use of a smartphone-based mobile app with a Spanish-language interface. We hypothesize that improving communication through a collaborative, patient-centered intervention will improve asthma management, empower the patient and family, decrease outcome disparities, and decrease direct and indirect costs. Methods The specific aims of this study include the following: (1) Aim 1: produce and validate a Spanish translation of an existing asthma management app and evaluate its usability with Latino parents of children with asthma, (2) Aim 2: develop and evaluate a triadic, patient-centered asthma intervention preliminary protocol, facilitated by the bilingual mobile app validated in Aim 1, and (3) Aim 3: investigate the feasibility of the patient-centered asthma intervention from Aim 2 using a waiting-list randomized controlled trial (RCT) to investigate the effects of the intervention on school days missed and medication adherence. Results Mobile app translation, initial usability testing, and app software refinement were completed in 2019. Analysis is in progress. Preliminary protocol testing is underway; we anticipate that the waiting-list RCT, using the refined protocol developed in Aim 2, will commence in fall 2020. Conclusions Tailored, technology-based solutions have the potential to successfully address issues affecting asthma management, including communication barriers, accessibility issues, medication adherence, and suboptimal technological interventions. Trial Registration ClinicalTrials.gov NCT04633018; https://www.clinicaltrials.gov/ct2/show/NCT04633018 International Registered Report Identifier (IRRID) DERR1-10.2196/18977
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Affiliation(s)
- Robin M Dawson
- College of Nursing, University of South Carolina, Columbia, SC, United States
| | - Sue P Heiney
- College of Nursing, University of South Carolina, Columbia, SC, United States
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Staffieri SE, Rees G, Sanfilippo PG, Cole S, Mackey DA, Hewitt AW. Improving parents' knowledge of early signs of paediatric eye disease: A double-blind randomized controlled trial. Clin Exp Ophthalmol 2020; 48:1250-1260. [PMID: 33058401 DOI: 10.1111/ceo.13866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/27/2020] [Accepted: 10/02/2020] [Indexed: 01/18/2023]
Abstract
IMPORTANCE Educating parents to recognize signs of eye disease and consult a healthcare professional is critical to timely diagnosis, intervention and outcomes. BACKGROUND We evaluate the effectiveness of an eye-health information pamphlet on parents' level of concern and help-seeking intention should they hypothetically observe leukocoria or strabismus in their child. DESIGN Double-blind, randomized controlled trial conducted at a metropolitan antenatal outpatient clinic. PARTICIPANTS In total, 518 pregnant women were enrolled in the study. METHODS After completing a study-specific, pre-test survey describing hypothetical clinical scenarios at baseline, participants were randomly assigned to receive a pamphlet on either paediatric eye health (intervention) or infant play (control). The post-test survey was sent by email 2 weeks after baseline. MAIN OUTCOME MEASURES A change in the parents' level of concern if they observed leukocoria or strabismus and a change in their help-seeking intention if they hypothetically observed leukocoria or strabismus in their child. RESULTS Of the 518 women, 382 (73.7%) completed the post-test survey. At follow-up, women who received the intervention were more likely to report a higher level of concern if they observed leukocoria (OR 1.711 [CI: 1.176-2.497] P = .005]) and were less likely to delay help-seeking (OR 0.560 [CI 0.382-0.817] P = .003). No change in the level of concern for strabismus was identified between the groups; however, at follow-up, women who received the intervention were less likely to delay help-seeking (OR 0.318 [CI 0.125-0.806] P = .016). CONCLUSION AND RELEVANCE Providing parents with relevant, evidence-based information can significantly improve their knowledge and positively influence help-seeking intentions if leukocoria or strabismus are observed.
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Affiliation(s)
- Sandra E Staffieri
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.,Department of Surgery, Ophthalmology, University of Melbourne, Melbourne, Victoria, Australia.,Department of Ophthalmology, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Gwyneth Rees
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Paul G Sanfilippo
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Stephen Cole
- Royal Women's Hospital, Parkville, Victoria, Australia
| | - David A Mackey
- Lion's Eye Institute, Centre for Ophthalmology and Visual Sciences, University of Western Australia, Perth, Australia
| | - Alex W Hewitt
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.,Department of Surgery, Ophthalmology, University of Melbourne, Melbourne, Victoria, Australia.,Menzies Institute for Medical Research, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
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Adegbiji WA, Aremu SK, Aluko AAA, Adewoye RK. Knowledge and awareness of nasal allergy among patients in a developing country. J Family Med Prim Care 2020; 9:1477-1482. [PMID: 32509636 PMCID: PMC7266249 DOI: 10.4103/jfmpc.jfmpc_914_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 02/01/2020] [Accepted: 02/14/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Nasal allergy is a common public health disorder seen in clinical practice worldwide. This disorder affected activities such as sleep, education, trading, economy, and social life. This study aimed at determining the level of knowledge and awareness of nasal allergy among patients seen in the otorhinolaryngology clinical practice of a developing country. Methods and Materials: This was a descriptive cross-sectional study, which was carried out among patients seen in Ekiti state university teaching hospital, Nigeria. Each patient completed a pretested interviewer assisted questionnaire on socio-demographic features, awareness, and knowledge on nasal allergy. Data obtained were documented, collated, and analyzed by SPSS version 18.0. Results: There were 16.4% patient's awareness and knowledge on nasal allergy, and 10.6% had allergic rhinitis. The patients included 59.2% males and male to female ratio was 1.5:1.Most common sources of information on nasal allergy were from ear, nose, and throat specialist/other doctors in 62.6%. Other sources were friends/relatives and media/Internet in 28.5% and 9.0%, respectively. Knowledge and awareness on if the nasal allergy was common in Nigeria and worldwide among the patients were 26.6% and 24.9%, respectively. However, 56.7% patients were aware that nasal allergy were commonly seen and diagnosed in the hospital.On the basis of knowledge and awareness of etiology of nasal allergy, majority 55.2% believed micro-organisms caused nasal-allergy. Minority 40.4% agreed nasal allergy was caused by parents genetic transmission from parents to offspring.On the awareness and knowledge of nasal allergy and its manifestations, the most common symptoms was 63.4% itching ear, throat, and eyes others were 63.2% catarrh and 56.3% bout of sneezing. There were 64.6% patients awareness of nasal allergy causes impairing concentration. However, 68.2% believed nasal allergy were curable diseases. On the awareness and knowledge, treatment was 52.7% prayer/spiritual intervention, 34.3% herbs, and 57.1% over-the-counter medication. However, 45.4% were aware and knowledgeable on the significance of avoidance of allergens. Conclusion: The level of awareness and knowledge on nasal allergy low with high levels of prevalence. Patients awareness and knowledge on etiology, clinical manifestations, effects, and management of nasal allergy is low.
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Affiliation(s)
| | - Shuaib Kayode Aremu
- ENT Department, Federal Teaching Hospital Ido-Ekiti, Ekiti State/Afe-Babalola University Ado-Ekiti, Ekiti State, Nigeria
| | - Abdul Akeem A Aluko
- ENT Department, Bayero University/Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria
| | - Rasaq Kayode Adewoye
- Department of Community Medicine Federal Teaching Hospital, IdoEkiti/AfeBabalola University, Ado- Ekiti, Nigeria
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Baek J, Huang K, Conner L, Tapangan N, Xu X, Carrillo G. Effects of the home-based educational intervention on health outcomes among primarily Hispanic children with asthma: a quasi-experimental study. BMC Public Health 2019; 19:912. [PMID: 31288792 PMCID: PMC6617892 DOI: 10.1186/s12889-019-7272-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 07/02/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Childhood asthma is a significant health issue with 8.3% prevalence in the U.S. Its prevalence is particularly higher among low-income communities in the Texas-Mexico border region, as they often lack access to clinical care and health insurance. This study examines the impact of a home-based education led by Community Health Workers (CHWs) on health outcomes for asthmatic, predominantly Hispanic children in these communities. METHODS The study was a quasi-experimental design to learn the effectiveness of the asthma home-based education by comparing changes of health outcomes between baseline and follow-up of intervention and control groups. This study enrolled 290 participants, consisting of 130 in the intervention group and 160 in the control group. The educational intervention led by the CHWs referenced the Asthma and Healthy Homes curriculum and contents of the Seven Principles of Healthy Homes. The multiple linear regression analysis was conducted to estimate the associations between the intervention and each health outcome. RESULTS When comparing the intervention group with the control group, the intervention group showed a significantly greater decrease in asthma attacks than the control group (p = 0.049). Although all of the five Children's Health Survey for Asthma (CHSA) scores showed significant improvements between baseline and follow-up in both groups, we found that increases of CHSA scores in the intervention group were higher than the control group except for emotional health of children (EC) score. The multiple linear regression models demonstrated that the mean changes in asthma attacks (p = 0.036) and emotional health of families (EF) score (p = 0.038) were significantly better in the intervention group than the control group, adjusting for children's age of diagnosis, household income, use of steroids, family history of allergy, and type of insurance. CONCLUSIONS This study concluded that the home-based education by CHWs effectively improve health outcomes among children in communities lacking access to medical resources. The findings suggest the importance of the home-based education program in promoting emotional and medical care for children and their families in low-income communities like those in the Texas-Mexico border region.
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Affiliation(s)
- Juha Baek
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, 212 Adriance Lab Road, College Station, TX, 77843, USA
| | - Ke Huang
- Department of Statistics, Texas A&M University, Blocker Building, 3143, 155 Ireland St, College Station, TX, 77843, USA
| | - Lucia Conner
- Program on Asthma Research and Education, Healthy South Texas, Texas A&M School of Public Health, McAllen Campus, 2101 S. McColl Road, McAllen, TX, 78503, USA
| | - Niko Tapangan
- Hidalgo County Health and Human Services Department, 1304 S 25th Ave, Edinburg, TX, 78542, USA
| | - Xiaohui Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, 212 Adriance Lab Road, College Station, TX, 77843, USA
| | - Genny Carrillo
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, 212 Adriance Lab Road, College Station, TX, 77843, USA.
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Tuyen LTT, Gunawan J. Behavior management in the field of nursing: A concept analysis. Nurs Forum 2018; 53:481-488. [PMID: 29943834 DOI: 10.1111/nuf.12275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM This concept analysis is to clarify what behavior management in the field of nursing means, what attributes signify it, and what its antecedents and consequences are. BACKGROUND A variety of definitions of behavior management were identified in literature. This has resulted in a degree of confusion in the way behavior management is described. METHODS The Walker and Avant concept analysis approach was applied. Literature searches were conducted using CINAHL, Academic Search Complete, Business Source Complete, Communication and Mass Media Complete, Education Research Complete, PubMed Medline, Google Scholar and many online dictionaries, with timeline from January 2000 to November 2017. FINDINGS The analysis demonstrates that the concept of behavior management in nursing field has two core attributes: (a) conscious actions to maintain and promote positive activities, and (b) training and assisting from the person who has knowledge and experience. Antecedents include poor general knowledge, lack of ability to control, and personality. Consequences include an improvement of quality and productivity and quality of life, reduction of mortality rate of diseases, and development of pro-social skills for the youth. CONCLUSION The analysis helps nurses to understand the concept and its application into clinical practice as well as to develop appropriate intervention plans for patients.
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Affiliation(s)
- Le Thi Thanh Tuyen
- Faculty of Nursing, Da Nang University of Medical Technology and Pharmacy, Da Nang, Viet Nam
| | - Joko Gunawan
- Academy of Nursing of Belitung, Akademi Keperawatan Pemerintah Kabupaten Belitung, Indonesia
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Giese JK. Evidence-based pediatric asthma interventions and outcome measures in a healthy homes program: An integrative review. J Asthma 2018; 56:662-673. [PMID: 29722589 DOI: 10.1080/02770903.2018.1472279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Asthma disproportionately impacts and has poorer outcomes in low-income, minority, and inner-city children. The home environment has a profound impact on a child's asthma. Home-based asthma visits have the potential to positively impact a child's asthma, especially in targeted populations. The purpose of this integrative review is 1.) to explore the effectiveness of home-based education and environmental measures and 2.) to explore specific indicators and tools to measure pediatric asthma control and program effectiveness. DATA SOURCES Medline, CINHAL, and Ovid databases were searched from 2010 to 2017 utilizing the keywords healthy homes AND asthma and home based interventions AND asthma. STUDY SELECTIONS A total of 71 articles were retrieved of which 27 articles met the inclusion criteria of English language, human subjects, and the inclusion of pediatric populations. Three additional articles were hand-searched from previous references. In total, 30 articles were reviewed. A quality appraisal was conducted utilizing standardized appraisal tools. RESULTS Home-based asthma education and environmental interventions have proven to be effective. The programs reviewed varied in types of interventions, intensity and duration, the type of provider, length of follow-up, and outcome measures. Successful programs were patient-centered, included a home assessment and individualized education and interventions, and were collaborative. Multiple outcome indicators such as health care utilization, asthma control, missed days of school or productivity, asthma symptoms, and verification of environmental remediation have been utilized. CONCLUSION Home-based asthma programs can be beneficial to children with poorly controlled asthma and have the potential to be cost-effective.
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Affiliation(s)
- Jeannie K Giese
- a Belmont University School of Nursing , Nashville , Tennessee , United States
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AlOtaibi E, AlAteeq M. Knowledge and practice of parents and guardians about childhood asthma at King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia. Risk Manag Healthc Policy 2018; 11:67-75. [PMID: 29713207 PMCID: PMC5907886 DOI: 10.2147/rmhp.s143829] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Family management of asthmatic children is affected by several factors, primarily the parent’s knowledge and attitude toward asthma. Objective The aim of this study was to explore the knowledge and practice of parents and guardians about asthma in their children. Methods Two hundred and thirty-one self-administered questionnaires were distributed to parents and guardians attending, with their children, general pediatric and pediatric pulmonology outpatient clinics at King Abdullah Specialist Children’s Hospital, King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia, during the period from August 2016 to March 2017. Results Most of the participants (79.6%) have moderate knowledge. The mean of total knowledge was found to be higher among mothers compared with other groups (p=0.019). Most participants (88.3%) reported providing asthma treatment regularly and 61.9% visited the clinic regularly. Almost half of the participants have misconceptions about asthma medications. During acute asthma attacks, more than half of the participants (54.5%) massaged their child’s chest or back, and 52.4% provided the child homemade or herbal remedies. Conclusion This study revealed a moderate level of knowledge about asthma among the parents and guardians of asthmatic children, but poor knowledge about asthma medications. For better control of asthma, more effort is needed to educate caregivers and to enhance their awareness about asthma and highlight the misconceptions about asthma medications at both hospital level and community level.
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Affiliation(s)
- Eman AlOtaibi
- King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of the National Guard, Health Affairs, Department of Family Medicine and Primary Health Care, Riyadh, Saudi Arabia
| | - Mohammed AlAteeq
- King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of the National Guard, Health Affairs, Department of Family Medicine and Primary Health Care, Riyadh, Saudi Arabia
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Luckie K, Pang TC, Kritikos V, Saini B, Moles RJ. Systematic review and content analysis of asthma knowledge questionnaires: A focus on the knowledge surrounding acute exacerbation management. J Asthma 2017; 55:615-628. [PMID: 28759285 DOI: 10.1080/02770903.2017.1355380] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Asthma education is a key component of asthma management. Asthma education around the management of a person who is having an acute exacerbation of asthma (often referred to as asthma first aid (AFA) training) is important, particularly in a school setting. There is no gold standard assessment of asthma knowledge and also there is no specific tool to measure the knowledge of AFA. Our aim was to identify asthma knowledge questionnaires and perform a content analysis. We were interested in evaluating the number, the type and the format of AFA questions. METHOD A literature search was performed to identify the instruments which were able to assess asthma knowledge of people with asthma and/or caregivers of people with asthma. An electronic database search was performed in EMBASE, IPA, MEDLINE and PUBMED. Articles which described the development or psychometric testing of an asthma knowledge questionnaire were included. The content of questions in each instrument was analysed and categorised using the NVivo software, and a secondary analysis was performed to identify knowledge questions relevant to the management of an acute asthma exacerbation. RESULTS Forty-four papers with 37 different instruments met the inclusion criteria. The majority of the instruments contained a relatively low proportion of questions related to the management of acute asthma, i.e., only 162 of the 780 questions (21%). No questionnaire had sufficient specific emphasis on acute asthma management knowledge to test the impact of AFA training. CONCLUSION There is a scope to develop an up-to-date validated acute asthma management knowledge questionnaire for use in research and clinical settings.
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Affiliation(s)
- Kate Luckie
- a Faculty of Pharmacy , University of Sydney , Sydney , NSW , Australia
| | - Tsz Chun Pang
- a Faculty of Pharmacy , University of Sydney , Sydney , NSW , Australia.,b Faculty of Pharmacy , University of Nottingham , Nottingham , UK
| | - Vicky Kritikos
- a Faculty of Pharmacy , University of Sydney , Sydney , NSW , Australia.,c Woolcock Institute of Medical Research , Sydney , NSW , Australia
| | - Bandana Saini
- a Faculty of Pharmacy , University of Sydney , Sydney , NSW , Australia
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Carrillo G, Han D, Lucio RL, Seol YH, Chong-Menard B, Smith K. Impacting Environmental and Public Health through the Use of Dual Targeted and Tailored Asthma Educational Interventions. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2015; 2015:476173. [PMID: 26240576 PMCID: PMC4512578 DOI: 10.1155/2015/476173] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 06/22/2015] [Indexed: 12/03/2022]
Abstract
Home-based asthma environmental education for parents of asthmatic children is needed since many health professionals lack the time to offer it. However, developing targeted and tailored education is important in order to address the individual needs of participants. This nonrandomized longitudinal study examined knowledge on asthma with an Asthma and Healthy Homes educational intervention training offered to parents of children from low income families who reside in the Rio Grande Valley of Texas. Eighty-nine parents received the training and pre- and posttest surveys were used to measure knowledge outcomes. A standardized assessment on asthma triggers was used to identify the different triggers each child was exposed to, and a follow-up survey was conducted 6 months after the educational intervention to identify how many parents reported household and behavior changes as a result of the training. Results showed significant changes in behavior by participants as a result of the training received. This study suggests that these behavioral changes are attributed to the dual "targeted" and "tailored" educational interventions delivered to parents which resulted in a greater understanding of how to manage asthma by eliminating asthma triggers in their respective homes.
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Affiliation(s)
- Genny Carrillo
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M Health Science Center, College Station, TX 77843, USA
| | - Daikwon Han
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M Health Science Center, 1266 TAMU, College Station, TX 77843, USA
| | - Rose L. Lucio
- Texas A&M Health Science Center, McAllen Campus, 2101 South McColl Road, McAllen, TX 78503, USA
| | - Yoon-Ho Seol
- Department of Health Informatics, Georgia Regents University, Augusta, GA 30912-0400, USA
| | - Betty Chong-Menard
- Clinical Education, Respiratory Therapy Program, South Texas College, Dr. Ramiro R. Casso Nursing & Allied Health Campus, 1101 E. Vermont, McAllen, TX 78503, USA
| | - Kenneth Smith
- Respiratory Therapy Services, Rio Grande Regional Hospital, 101 E. Ridge Road, McAllen, TX 78503, USA
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Trueblood AB, Rincon R, Perales R, Hollingsworth R, Miller C, McDonald TJ, Cizmas L. A Pilot Study of Changes in Environmental Knowledge and Behaviors among Head Start Employees and Parents Following Environmental Health Training in Webb County, TX. J Immigr Minor Health 2014; 18:135-42. [PMID: 25538003 DOI: 10.1007/s10903-014-0150-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Head Start centers in Webb County, Texas primarily serve low-income Hispanic families disproportionately affected by environmental exposures. A total of 560 parents and employees attended environmental trainings. Pre- and post-assessments measured whether the trainings were effective at improving related knowledge and behaviors. A total of 152 parents and 94 employees signed consent forms. Only the 64 parents and 50 employees who completed all questionnaires were included in the data analysis. Paired t tests and McNemar tests found significant improvements in knowledge and behaviors related to multiple environmental topics (p < 0.05). Mean scores out of eleven for knowledge before and immediately after were 9.69 (95 % CI 9.44, 9.94) and 10.58 (95 % CI 10.42, 10.74), respectively. Mean scores out of ten for behavior before and 1 month after training were 8.00 (95 % CI 7.71, 8.29) and 9.29 (95 % CI 9.10, 9.48), respectively. This pilot study found improved knowledge and behaviors following environmental health training.
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Affiliation(s)
- Amber B Trueblood
- Department of Environmental and Occupational Health, Texas A&M Health Science Center School of Public Health, 102 SPH Administration Building, 1266 TAMU, College Station, TX, 77840, USA
| | - Rudy Rincon
- South Texas Environmental Education and Research Program, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Roger Perales
- South Texas Environmental Education and Research Program, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Ryan Hollingsworth
- Department of Environmental and Occupational Health, Texas A&M Health Science Center School of Public Health, 102 SPH Administration Building, 1266 TAMU, College Station, TX, 77840, USA
| | - Claudia Miller
- South Texas Environmental Education and Research Program, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Thomas J McDonald
- Department of Environmental and Occupational Health, Texas A&M Health Science Center School of Public Health, 102 SPH Administration Building, 1266 TAMU, College Station, TX, 77840, USA
| | - Leslie Cizmas
- Department of Environmental and Occupational Health, Texas A&M Health Science Center School of Public Health, 102 SPH Administration Building, 1266 TAMU, College Station, TX, 77840, USA.
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Rashid S, Carcel C, Morphew T, Amaro S, Galant S. Effectiveness of a promotora home visitation program for underserved Hispanic children with asthma. J Asthma 2014; 52:478-84. [PMID: 25405362 DOI: 10.3109/02770903.2014.986738] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Retention in a mobile asthma clinic, the Breathmobile™, of ≥3 visits has previously been shown to be essential for attaining asthma control in underserved children. The objective of this study in primarily Hispanic-American children was to determine the difference in retention between those seen in the Breathmobile™ compared to those receiving an additional promotora-based home visit (HV). METHODS Children with asthma in the Breathmobile™ program were evaluated for asthma status and aeroallergen sensitivity. Indication for HV included poor asthma control, educational and environmental control needs. An initial visit consisted of environmental assessment as well as a 3-h interactive educational session covering asthma basics. A follow-up visit 1 month later assessed implementation. The primary outcome measure of retention was ≥6 months in the Breathmobile™ program. RESULTS Of the 1007 asthmatic children seen between April 2002 and June of 2005, 136 received HV. These children showed significantly greater retention compared to those without HV with a median number of visits (5 visits versus 2 visits), ≥3 Breathmobile™ visits (86.0% versus 38.8%), median number of days in the program (299 versus 63 days) and percentage of patients in the program ≥6 months (67.8% versus 31.3%) p < 0.001. HV and asthma severity were each independent predictors of retention. CONCLUSIONS The addition of a promotora HV program proved effective in providing greater retention in the Breathmobile™ program essential for asthma control. Randomized clinical trials will be needed to show the impact on health care utilization and asthma control.
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Affiliation(s)
- Shumyla Rashid
- Children's Hospital of Orange County , Breathmobile, Orange, CA , USA and
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Radic S, Milenkovic B, Gvozdenovic B, Zivkovic Z, Pesic I, Babic D. The correlation between parental education and their knowledge of asthma. Allergol Immunopathol (Madr) 2014; 42:518-26. [PMID: 24948185 DOI: 10.1016/j.aller.2013.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 12/19/2013] [Accepted: 12/23/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the impact of parental education on the success of Asthma Educational Intervention (AEI). METHODS AEI took place after the children's hospitalisation. Parental asthma knowledge was assessed at three time points: before AEI, immediately after, and 12 months later. The Intervention (I) group of parents (N=231) received complete AEI. The Control (C) group of parents (N=71) received instructions for proper use of asthma medications and the handbook. RESULTS Asthma knowledge in I group increased immediately after the AEI (p<0.01), and had not changed (p>0.05) 12 months later. There were four subgroups in group I divided based on education level: elementary school, high school, college, and university degrees. Taking into account the parental education level, there were no differences in the baseline and final knowledge of asthma between subgroups (p>0.05). The number of asthma exacerbations decreased after AEI (5.96:2.50, p<0.01), regardless of the parental degree. Knowledge of asthma in group C did not improve during the study (p=0.17). Final asthma knowledge was higher in group I compared to group C (p<0.01). CONCLUSION The parental education level did not influence the level of asthma knowledge after the AEI. The motivation and the type of asthma education had the greatest input on the final results. PRACTICE IMPLICATIONS All parents should be educated about asthma regardless of their general education.
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Wilson KE, Miller AL, Bonuck K, Lumeng JC, Chervin RD. Evaluation of a sleep education program for low-income preschool children and their families. Sleep 2014; 37:1117-25. [PMID: 24882907 DOI: 10.5665/sleep.3774] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES To evaluate a novel sleep education program for low-income preschool children and their families. DESIGN Randomized trial of an educational intervention. SETTING Community-based. PARTICIPANTS Head Start preschool families (n = 152) in greater Lansing and Detroit, Michigan. INTERVENTIONS Classrooms or Head Start sites were randomized to an intervention group (prompt intervention) versus a control group (delayed intervention). Parents attended a one-time, 45-min sleep education program and preschoolers received 2 w (320 total min) of classroom sleep curriculum. MEASUREMENTS Parent knowledge, attitudes, self-efficacy, and beliefs were assessed as the primary outcomes just before the 45-min sleep intervention, immediately postintervention, and approximately 1 mo postintervention. Parents reported their child's bedtimes and wake times on 7-day sleep diaries at baseline and at 1-mo follow-up. Average weeknight sleep durations and bedtimes served as secondary outcomes. RESULTS Linear mixed models showed a time × treatment effect for parents' knowledge, attitudes, and self-efficacy (each P < 0.05) but not beliefs. These improvements were found immediately postintervention but were not retained at 1-mo follow-up. Children in the intervention group improved their weeknight sleep duration at 1-mo follow-up by 30 min (11.0 ± 0.9 h vs. 10.5 ± 1.0 hours at baseline) compared to controls (10.4 ± 0.9 h versus 10.5 ± 0.9 h at baseline) (P = 0.04 for difference between groups). Children did not show statistically significant improvements in bedtime. CONCLUSIONS Educational interventions in early childhood can have an effect on parents' sleep knowledge, attitudes, and self-efficacy, and on children's sleep behavior. However, repeated exposure to the new information may be important for parents as well as their children.
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Affiliation(s)
| | - Alison L Miller
- Center for Human Growth and Development ; Department of Health Education and Health Behavior, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Karen Bonuck
- Department of Family and Social Medicine and Department of Obstetrics, Gynecology and Women's Health, Albert Einstein College of Medicine
| | - Julie C Lumeng
- Center for Human Growth and Development ; Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI
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Zhao J, Shen K, Xiang L, Zhang G, Xie M, Bai J, Chen Q. The knowledge, attitudes and practices of parents of children with asthma in 29 cities of China: a multi-center study. BMC Pediatr 2013; 13:20. [PMID: 23379859 PMCID: PMC3577449 DOI: 10.1186/1471-2431-13-20] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 01/31/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Asthma is becoming increasingly prevalent among children in China. Poor parent knowledge and attitudes often contribute to inappropriate management practices, leading to deficiencies in the care process. We aimed to document the knowledge, attitudes and practices (KAP) of parents of children with asthma and analyze how knowledge and attitudes relate to practices. Our secondary objective was to identify the factors associated with parent KAP scores. METHODS A KAP questionnaire was distributed to parents caring for 2960 children (0-14 years) diagnosed with asthma for at least 3 months from China's 29 provinces. A 50-item questionnaire was devised for this cross-sectional survey based on a comprehensive review of the subject. Questionnaires were scored on 30 items regarding parent asthma-related KAP, with one point for every correct response and a possible range of 0-13 for knowledge, 0-7 for attitudes and 0-10 for practices. Higher scores indicated better KAP. Chi-squared tests and logistic regression were used to identify factors associated with practices and combined KAP scores. RESULTS The response rate was 83.95% (2485/2960). Only 18.31% (455/2485) of parents correctly answered ≥ 60% of the knowledge questions (mean = 5.69). Most (89.85%; 2226/2485) gave positive responses to ≥ 60% of the attitude questions (mean = 5.23) while 67.89% (1687/2485) correctly answered ≥ 60% of the practices questions (mean = 6.19). Knowledge and attitudes were positively associated with pulmonary function testing, regular physician visits, monitoring with a peak flow meter and the Children's Asthma Control Test questionnaire, avoidance of asthma triggers, using an inhaled β2 receptor agonist and adherence to medication regimen (p ≤ 0.05). Attitudes were also associated with allergen testing. In logistic regression analysis, high KAP scores (dichotomized by a cut-off score of 18) were positively associated with food allergy, rhinitis, physician visits, frequency of visits and parent education (p < 0.05, OR > 1). CONCLUSIONS Generally, the parents' KAP were poor. A gap between recommended and actual practice was observed, which may be related to inadequate knowledge about and poor attitudes toward childhood asthma. Improving knowledge and attitudes may encourage better practices among parents of children with asthma.
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Affiliation(s)
- Jing Zhao
- Capital Institute of Pediatrics, Beijing, China
| | | | - Li Xiang
- Beijing Children’s Hospital, Beijing, China
| | | | - Meng Xie
- Capital Institute of Pediatrics, Beijing, China
| | - Juan Bai
- Capital Institute of Pediatrics, Beijing, China
| | - Qiyi Chen
- Capital Institute of Pediatrics, Beijing, China
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Arnold RJ, Stingone JA, Claudio L. Computer-assisted school-based asthma management: a pilot study. JMIR Res Protoc 2012; 1:e15. [PMID: 23612058 PMCID: PMC3626150 DOI: 10.2196/resprot.1958] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2011] [Revised: 07/24/2012] [Accepted: 10/05/2012] [Indexed: 12/05/2022] Open
Abstract
Background The high prevalence of asthma among children continues to be a major public health issue. In particular, low-income African-American and Hispanic children often receive asthma care in the emergency department and lack access to continuity of care. Objective The aim of the current study was to test the feasibility of implementing a computerized program for empowering low-income children with asthma to manage their own disease. This pilot program consisted of a guided, personalized, Web-based computer program as the main component of a school-based asthma intervention. Methods The Automated Live E-Health Response Tracking System (ALERTS), a computer-assisted, Web-based tracking program, was tested for implementation in a school in East Harlem, New York. The program required children with asthma, assisted by trained researchers, to routinely measure their peak flow meter readings and answer a symptom questionnaire. The program provided individualized feedback on their disease status based on peak flow meter input. The computer program sent reports to the child’s physician and the nurse practitioner at the on-site school health center. The children were also encouraged to bring the reports home to their parents. A pre/post study design was employed such that each participant acted as his/her own control. Comparisons of preintervention and postintervention outcomes were calculated using the paired t-test and the McNemar test for dichotomous data. Results Twenty-four children (6 to 12 years) participated in the program over 2 to 15 months. Improvements in health outcomes showed the greatest significance among the group of participants who were enrolled for 8 months or longer. Statistically significant improvements were seen in the average physical health score of the children (from 65.64 preintervention to 76.28 postintervention, P = .045). There was a significant decrease in the number of participants experiencing wheezing episodes (n = 9 to n = 2, P = .03), and in the average number of wheezing episodes per child (1.86 to 0.43, P = .02). Although not statistically significant, decreases were also seen in the number of children experiencing an asthma attack and in the average number of asthma attacks among participants. There was also a significant decrease in the average number of visits to doctors’ offices or clinics (1.23 to 0.38, P = .04). There were no overnight hospitalizations in the two-week period following the end of the pilot program, a nonsignificant reduction from an average of 0.21 per child. Conclusion This individualized, computer-assisted intervention resulted in improvements in some health outcomes among low-income children in an urban, public school-based setting. Consistent peak flow meter self-measurements, management of medication usage, and a computerized approach to symptom tracking resulted in fewer asthma exacerbations and improved overall physical health among this pediatric population with asthma.
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Affiliation(s)
- Renée Jg Arnold
- Mount Sinai School of Medicine, Preventive Medicine, New York, NY, United States.
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