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Harris D, Borish L. How we treat type 2 low asthma. Ann Allergy Asthma Immunol 2024; 133:43-46. [PMID: 38960564 PMCID: PMC11225797 DOI: 10.1016/j.anai.2024.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/11/2024] [Accepted: 04/12/2024] [Indexed: 07/05/2024]
Affiliation(s)
- Drew Harris
- Division of Pulmonary Medicine, Department of Medicine, University of Virginia Health Systems, Charlottesville, Virginia
| | - Larry Borish
- Division of Allergy, Asthma and Immunology, Department of Medicine, University of Virginia Health Systems, Charlottesville, Virginia.
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2
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Gabbay JM, Abrams EM, Nyenhuis SM, Wu AC. Housing Insecurity and Asthma Outcomes. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:327-333. [PMID: 37871647 DOI: 10.1016/j.jaip.2023.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/03/2023] [Accepted: 10/14/2023] [Indexed: 10/25/2023]
Abstract
Asthma is a chronic respiratory disease with widespread prevalence that affects children, adolescents, and adults. Asthma morbidity and mortality can be exacerbated in the setting of housing insecurity. In this Grand Rounds Review article, we present a case and discuss the implications that housing insecurity has on asthma outcomes in the United States. We then highlight ways in which providers can advocate for patients with asthma and housing insecurity.
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Affiliation(s)
| | - Elissa M Abrams
- Department of Pediatrics, Section of Allergy and Clinical Immunology, University of Manitoba, Winnipeg, MB, Canada
| | - Sharmilee M Nyenhuis
- Department of Pediatrics, Section of Allergy and Immunology, University of Chicago, Chicago, Ill
| | - Ann Chen Wu
- Department of Medicine, Boston Children's Hospital, Boston, Mass; Division of Child Health Research and Policy, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Mass
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3
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Gandhi SA, Heinzerling A, Flattery J, Cummings KJ. Occupational Contributions to Respiratory Health Disparities. Clin Chest Med 2023; 44:635-649. [PMID: 37517841 PMCID: PMC10861114 DOI: 10.1016/j.ccm.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Occupation is an important contributor to disparities in respiratory disease, affecting financial status, health-care access, and exposure to hazardous substances. Although occupation and associated exposures are included in the socioecological models, work exposures remain persistently absent from research on health inequities and their contribution to health. This article focuses on the occupational contribution to disparities in asthma, chronic obstructive pulmonary disease, silicosis, coronavirus disease 2019, and lung cancer. Because occupational exposures are largely preventable through proper workplace controls, the recognition of occupational causes of disease can provide an opportunity for interventions to bring about health equity.
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Affiliation(s)
- Sheiphali A Gandhi
- Division of Occupational and Environmental Medicine, Department of Medicine, University of California San Francisco, 2330 Post St Ste 460, San Francisco, CA 94115, USA
| | - Amy Heinzerling
- Occupational Health Branch, California Department of Public Health, 850 Marina Bay Parkway P-3, Richmond, CA 94804, USA
| | - Jennifer Flattery
- Occupational Health Branch, California Department of Public Health, 850 Marina Bay Parkway P-3, Richmond, CA 94804, USA
| | - Kristin J Cummings
- Occupational Health Branch, California Department of Public Health, 850 Marina Bay Parkway P-3, Richmond, CA 94804, USA.
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4
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Ayuningrum DP, Fajariyah RN, Novirsa R, Astutik E. Relationship between Body Mass Index and Gender with Asthma. JURNAL BERKALA EPIDEMIOLOGI 2021. [DOI: 10.20473/jbe.v9i22021.115-122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Asthma is ranked 16th among the leading causes of years lived with disability (YLD) and ranks 28th among the causes of global burden of disease (GBD). Various potential factors can cause asthma, which include body mass index (BMI) and gender. Purpose: This research aimed to determine the relationship between BMI and gender in people living with asthma in Indonesia. Methods: This research employed secondary data obtained from the Indonesian family life support (IFLS) 5th edition. This research used an observational analysis technique with a cross-sectional approach. The number of respondents in this research were 30,713. In this study, the BMI category was based on WHO’s classification for Asians. Data was analyzed using logistic regression tests and chi square. Statistical significance was set at a value of p<0.05. Results: As many as 17,175 respondents had a normal BMI range (56.92%), out of which the majority were women—16,001 respondents (52.10%). After controlling the other variables, statistical test results with logistic regression indicated that male respondents had 1.23 times the odds of experiencing asthma compared to females (adjusted odds ratio (AOR)=1.23; 95% confidence interval (CI), 1.04–1.44; p=0.02). Again, after controlling the other variables, underweight respondents had 1.31 times the odds of experiencing asthma compared to respondents who had a normal BMI (AOR=1.31; 95%CI=1.07–1.59; p=0.01). Conclusion: A relationship between gender and the category of people who were underweight after determining their BMI could be established. Health counseling can be provided to help improve the respiratory conditions of these individuals.
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Paggiaro P, Barbaglia S, Centanni S, Croce D, Desideri E, Giustini S, Micheletto C, Musarra A, Scichilone N, Trama U, Zedda MT, Canonica GW. Overcoming Barriers to the Effective Management of Severe Asthma in Italy. J Asthma Allergy 2021; 14:481-491. [PMID: 34007186 PMCID: PMC8121981 DOI: 10.2147/jaa.s293380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 04/21/2021] [Indexed: 11/27/2022] Open
Abstract
Introduction People with severe asthma (SA) often have poor disease control and quality of life, and are at high risk of exacerbations, lung function decline and asthma-related death. The present expert opinion article aimed to identify unmet needs in the management of SA in Italy, and propose possible solutions to address these needs. Methods At five multidisciplinary events in Italy, attendees identified factors that interfered with the effective management of SA and suggested how these barriers could be overcome. A core group of 12 Italian experts (pulmonologists, general practitioners, allergists, payers and patients) identified the main issues and proposed possible solutions based on the results from the meetings and relevant articles from the literature. Results and Conclusions We reviewed the gap between real-world practice and guidelines, oral corticosteroid overuse, SA-related mortality, and barriers to effective SA treatment. Common themes were lack of awareness about SA among both patients and clinicians, and lack of networking/information exchange between those involved in the treatment of SA. Participants agreed on the need to implement patient education and create multidisciplinary groups of specialists to improve SA management through multidisciplinary educational initiatives, meetings with local experts, development of a flow chart for referral/connection with local experts and specialized centers. Clinical instruments that might help specialists improve SA management included referral networks, integrated care pathways, phenotyping and treatment algorithms, exacerbation tracking, and examination of electronic medical records for patients with uncontrolled asthma. The following actions need to be implemented in Italy: i) maximize the use of advanced therapies, eg, biologics; ii) increase/improve education for physicians and patients; iii) improve multidisciplinary communication and care coordination; iv) introduce regional and local protocols for SA diagnosis and treatment; and v) change the structure of healthcare services to reduce specialist waiting times and facilitate access to biologic therapies.
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Affiliation(s)
- Pierluigi Paggiaro
- Department of Surgery, Medicine, Molecular Biology, and Critical Care, University of Pisa, Pisa, Italy
| | - Simona Barbaglia
- Associazione Nazionale Pazienti "Respiriamo Insieme", Padova, Italy
| | - Stefano Centanni
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.,Respiratory Unit, ASST Santi Paolo e Carlo, Milan, Italy
| | - Davide Croce
- Center for Health Economics, Social and Health Care Management, LIUC-Università Cattaneo, Castellanza, Italy
| | | | - Saffi Giustini
- Italian General Practitioners' Association "SIMG", Florence, Italy.,Local Health Unit of Montale, Pistoia, Italy
| | - Claudio Micheletto
- Cardio-Thoracic Department, Respiratory Unit, Integrated University Hospital, Verona, Italy
| | - Antonino Musarra
- Allergy Unit, National Healthcare System, Reggio Calabria, Italy
| | - Nicola Scichilone
- Biomedical Department of Internal and Specialist Medicine, University of Palermo, Palermo, Italy
| | - Ugo Trama
- Dirigente UOD 06 Politica del Farmaco e Dispositivi, Naples, Italy
| | - Maria Teresa Zedda
- Italian General Practitioners' Association "SIMG", Florence, Italy.,General Practice, Cagliari, Italy
| | - Giorgio Walter Canonica
- Personalized Medicine Asthma & Allergy Clinic, Humanitas University and Research Hospital-IRCCS, Milan, Italy
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Samuels-Kalow ME, Boggs KM, Cash RE, Herrington R, Mick NW, Rutman MS, Venkatesh AK, Zabbo CP, Sullivan AF, Hasegawa K, Zachrison KS, Camargo CA. Screening for Health-Related Social Needs of Emergency Department Patients. Ann Emerg Med 2020; 77:62-68. [PMID: 33160720 DOI: 10.1016/j.annemergmed.2020.08.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/03/2020] [Accepted: 08/06/2020] [Indexed: 01/20/2023]
Abstract
STUDY OBJECTIVE There has been increasing attention to screening for health-related social needs. However, little is known about the screening practices of emergency departments (EDs). Within New England, we seek to identify the prevalence of ED screening for health-related social needs, understand the factors associated with screening, and understand how screening patterns for health-related social needs differ from those for violence, substance use, and mental health needs. METHODS We analyzed data from the 2018 National Emergency Department Inventory-New England survey, which was administered to all 194 New England EDs during 2019. We used descriptive statistics to compare ED characteristics by screening practices, and multivariable logistic regression models to identify factors associated with screening. RESULTS Among the 166 (86%) responding EDs, 64 (39%) reported screening for at least one health-related social need, 160 (96%) for violence (including intimate partner violence or other violent exposures), 148 (89%) for substance use disorder, and 159 (96%) for mental health needs. EDs reported a wide range of social work resources to address identified needs, with 155 (93%) reporting any social worker availability and 41 (27%) reporting continuous availability. CONCLUSION New England EDs are screening for health-related social needs at a markedly lower rate than for violence, substance use, and mental health needs. EDs have relatively limited resources available to address health-related social needs. We encourage research on the development of scalable solutions for identifying and addressing health-related social needs in the ED.
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Affiliation(s)
- Margaret E Samuels-Kalow
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
| | - Krislyn M Boggs
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Rebecca E Cash
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Ramsey Herrington
- Division of Emergency Medicine, University of Vermont, Burlington, VT
| | - Nathan W Mick
- Department of Emergency Medicine, Maine Medical Center, Portland, ME
| | - Maia S Rutman
- Departments of Pediatrics and Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Arjun K Venkatesh
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT
| | | | - Ashley F Sullivan
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Kohei Hasegawa
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Kori S Zachrison
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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7
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Ash JS, Chase D, Baron S, Filios MS, Shiffman RN, Marovich S, Wiesen J, Luensman GB. Clinical Decision Support for Worker Health: A Five-Site Qualitative Needs Assessment in Primary Care Settings. Appl Clin Inform 2020; 11:635-643. [PMID: 32998170 DOI: 10.1055/s-0040-1715895] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Although patients who work and have related health issues are usually first seen in primary care, providers in these settings do not routinely ask questions about work. Guidelines to help manage such patients are rarely used in primary care. Electronic health record (EHR) systems with worker health clinical decision support (CDS) tools have potential for assisting these practices. OBJECTIVE This study aimed to identify the need for, and barriers and facilitators related to, implementation of CDS tools for the clinical management of working patients in a variety of primary care settings. METHODS We used a qualitative design that included analysis of interview transcripts and observational field notes from 10 clinics in five organizations. RESULTS We interviewed 83 providers, staff members, managers, informatics and information technology experts, and leaders and spent 35 hours observing. We identified eight themes in four categories related to CDS for worker health (operational issues, usefulness of proposed CDS, effort and time-related issues, and topic-specific issues). These categories were classified as facilitators or barriers to the use of the CDS tools. Facilitators related to operational issues include current technical feasibility and new work patterns associated with the coordinated care model. Facilitators concerning usefulness include users' need for awareness and evidence-based tools, appropriateness of the proposed CDS for their patients, and the benefits of population health data. Barriers that are effort-related include additional time this proposed CDS might take, and other pressing organizational priorities. Barriers that are topic-specific include sensitive issues related to health and work and the complexities of information about work. CONCLUSION We discovered several themes not previously described that can guide future CDS development: technical feasibility of the proposed CDS within commercial EHRs, the sensitive nature of some CDS content, and the need to assist the entire health care team in managing worker health.
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Affiliation(s)
- Joan S Ash
- Department of Medical Informatics and Clinical Epidemiology, School of Medicine, Oregon Health & Science University, Portland, Oregon, United States
| | - Dian Chase
- Department of Medical Informatics and Clinical Epidemiology, School of Medicine, Oregon Health & Science University, Portland, Oregon, United States
| | - Sherry Baron
- Department of Urban Studies, Barry Commoner Center for Health and the Environment, Queens College, City University of New York, New York, New York, United States
| | - Margaret S Filios
- National Institute for Occupational Safety and Health/Centers for Disease Control and Prevention, Cincinnati, Ohio and Morgantown, West Virginia, United States
| | - Richard N Shiffman
- Yale Center for Medical Informatics, Yale University School of Medicine, New Haven, Connecticut, United States
| | - Stacey Marovich
- National Institute for Occupational Safety and Health/Centers for Disease Control and Prevention, Cincinnati, Ohio and Morgantown, West Virginia, United States
| | - Jane Wiesen
- Department of Medical Informatics and Clinical Epidemiology, School of Medicine, Oregon Health & Science University, Portland, Oregon, United States
| | - Genevieve B Luensman
- National Institute for Occupational Safety and Health/Centers for Disease Control and Prevention, Cincinnati, Ohio and Morgantown, West Virginia, United States
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8
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Teague WG. Pediatric Severe Asthma in the Era of Biologic Treatments. PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY 2020; 33:118-120. [PMID: 32953228 DOI: 10.1089/ped.2020.1249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- W Gerald Teague
- Division of Respiratory Medicine, Allergy, Immunology, and Sleep, Charlottesville, Virginia, USA.,Department of Pediatrics, Child Health Research Center, University of Virginia School of Medicine, Charlottesville, Virginia, USA
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9
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VanDerGeest K, Ko LK, Karr C, Torres E, Drury D, Austin E. Private well stewardship within a rural, agricultural Latino community: a qualitative study. BMC Public Health 2020; 20:863. [PMID: 32503551 PMCID: PMC7275588 DOI: 10.1186/s12889-020-08963-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 05/20/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Nitrate contamination in groundwater disproportionately impacts agricultural Latino communities, creating a significant hazard for Latinos that rely on private wells. Private well users must conduct water testing and other well stewardship behaviors to ensure that their well water is safe to drink. This study sought to identify the key factors impacting private well water testing behavior in rural, agricultural Latino communities. METHODS We conducted 4 focus groups with private well users, 2 in Spanish and 2 in English. We recruited 37 participants from the Lower Yakima Valley, Washington State, a rural, agricultural community with a large Latino population and elevated nitrate concentrations in groundwater. A semi-structured interview guide was developed to capture factors impacting testing as guided by the Risk, Attitudes, Norms, Ability, and Self-Regulation (RANAS) model. Inductive thematic analysis was conducted by two coders to identify common themes. RESULTS Themes emerged around the factors impacting well stewardship, including well water testing, treatment, and maintenance, and were not specific to nitrate contamination. Private well users reported many of the same factors reported in other communities, with the exception of home repair experience and challenges around landlords and neighbors on shared wells, which have not been reported previously. In addition to landlords and neighbors, lack of actionable information, economic limitations, and lack of technical support emerged as factors that made well stewardship burdensome for individuals. The majority of participants reported using bottled water, including many who used point-of-use or point-of-entry water treatment systems. CONCLUSIONS The burden of well stewardship in rural, agricultural Latino communities may suggest the need for interventions at the community, county, or state levels and not at the individual level alone. Additionally, the role of landlords, neighbors on shared wells, and home repair experience in well stewardship represent important areas of exploration for researchers and public health practitioners.
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Affiliation(s)
- Kori VanDerGeest
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA.
| | - Linda K Ko
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA
| | - Catherine Karr
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
- Pacific Northwest Agricultural Safety and Health Center, University of Washington School of Public Health, Seattle, WA, USA
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Elizabeth Torres
- Northwest Communities Education Center/Radio KDNA, Granger, WA, USA
| | - Dennise Drury
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
- Pacific Northwest Agricultural Safety and Health Center, University of Washington School of Public Health, Seattle, WA, USA
| | - Elena Austin
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
- Pacific Northwest Agricultural Safety and Health Center, University of Washington School of Public Health, Seattle, WA, USA
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10
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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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11
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Penzias RE, Sanabia V, Bhaumik U, Sommer SJ, Shreeve KM, Woods ER. Parent experiences with a nurse-supervised community health worker asthma home-visiting program. J Asthma 2018; 56:1314-1324. [PMID: 30395749 DOI: 10.1080/02770903.2018.1536144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective: This study seeks to identify helpful components of a nurse-supervised Community Health Worker (CHW) asthma home-visiting program, obtain feedback from parents and families about their experiences, and receive suggestions for new services that the program could provide. Methods: Likert scale ratings and semi-structured qualitative interviews were conducted with parents who were selected from a representative sample and previously participated in the program. Five-point Likert scale ratings from 1 (not helpful) to 5 (very helpful) were obtained for 11 program components. Interviews were analyzed using a grounded theory participatory approach. Data were analyzed and themes were identified by two different coders using Dedoose software. Results: A total of 22 participants were enrolled and 20 participants completed Likert scale ratings and qualitative interviews. Likert scale ratings (mean standard deviation [SD]) show that program strengths include asthma education (4.75 [0.55]), supplies (4.65 [0.99]), help with housing conditions (3.94 [1.56], pest management (3.79 [1.69]) and greater access to community resources (3.70 [1.30]). The ratings suggest that families need more help with other social determinants of health, such as school, lack of enough money or food, and mental health and behavioral concerns (3.05 [1.78]). Interviews echoed these ratings and revealed several themes about family and parental stress, children's activity limitations, desire for outreach after the 12-month intervention, a need for help with other social determinants and more emotional support. Conclusions: This study shows that the program was well received and reveals the importance of addressing social determinants of health and behavioral health concerns.
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Affiliation(s)
- Rebecca E Penzias
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital , Boston , MA , USA
| | - Virginia Sanabia
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital , Boston , MA , USA
| | - Urmi Bhaumik
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital , Boston , MA , USA.,Office of Community Health, Boston Children's Hospital , Boston , MA , USA
| | - Susan J Sommer
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital , Boston , MA , USA
| | - Kyra M Shreeve
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital , Boston , MA , USA
| | - Elizabeth R Woods
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital , Boston , MA , USA
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12
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Affiliation(s)
- Gioia Mosler
- Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, London E1 2AT, UK.
| | - Tunde Euba
- c/o Greenwich & Lewisham Young People's Theatre, London, UK
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