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Gu J, Li T, Ding Y, Chang C, Yin S, Wang Y. Effects of Pregnancy-Onset Asthma on Perinatal Outcomes: A Retrospective Cohort Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024:S2213-2198(24)00631-7. [PMID: 38880304 DOI: 10.1016/j.jaip.2024.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 06/03/2024] [Accepted: 06/04/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND It is unknown whether women with pregnancy-onset asthma are predisposed to worse pregnancy outcomes compared with women with pre-pregnancy asthma. OBJECTIVE To explore whether pregnancy-onset asthma leads to worse perinatal outcomes compared with pre-pregnancy asthma. METHODS Women who were discharged with a diagnosis of asthma and gave birth to a live singleton were included in this retrospective cohort analysis. Women were separated into groups based on whether the asthma was diagnosed during or before pregnancy. We compared clinical characteristics, perinatal outcomes, and asthma exacerbations (AEs) between groups. RESULTS A total of 335 women were included in this study, 39 of whom (11.6%) had pregnancy-onset asthma and 296 had pre-pregnancy asthma. All pregnant women in the pregnancy-onset group experienced AEs during pregnancy. The proportion of chronic hypertension, chronic hypertension with superimposed preeclampsia, and spontaneous preterm births in the pregnancy-onset group was significantly higher than that in the pre-pregnancy asthma group. After adjusting for age, body mass index, onset of asthma during pregnancy, and severity of AEs through multivariate analysis, pregnancy-onset asthma was an independent risk factor for spontaneous preterm birth (adjusted odds ratio = 7.71; 95% CI, 1.30-46.12) and severe AE was an independent risk factor for gestational hypertension and preeclampsia (adjusted odds ratio = 3.58; 95% CI, 1.30-9.87). CONCLUSIONS During pregnancy, pregnancy-onset asthma in women is associated with an exacerbation of the condition. Obstetricians should be vigilant for signs of asthma onset during pregnancy. Other health care providers should watch for symptoms of gestational hypertension and preeclampsia in pregnant women with preexisting or new-onset asthma.
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Affiliation(s)
- Jinyu Gu
- Center for Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China; National Clinical Research Center on Obstetrics and Gynecology Disease, Beijing, China; Department of Obstetrics and Gynecology, Shijiazhuang Maternal and Child Health Hospital, Shijiazhuang, China
| | - Tongxin Li
- Department of General Practice, Peking University Third Hospital, Beijing, China
| | - Yishan Ding
- Peking University School of Basic Medical Sciences, Beijing, China
| | - Chun Chang
- Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Siyuan Yin
- Peking University School of Basic Medical Sciences, Beijing, China
| | - Yan Wang
- Center for Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China; National Clinical Research Center on Obstetrics and Gynecology Disease, Beijing, China.
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Robert P, Lévesque B, Bourbeau J, Ahmad Khan F, Boulet LP, Dubé MA, Proulx JF, Ayotte P. Respiratory health and its determinants among Nunavimmiut: results from the Qanuilirpitaa? 2017 Nunavik Health Survey. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:136-151. [PMID: 36624337 PMCID: PMC10830964 DOI: 10.17269/s41997-022-00722-9] [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: 09/18/2021] [Accepted: 11/09/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Respiratory diseases are the leading cause of hospitalization in Nunavik (northern Québec, Canada) and contribute to disparities in life expectancy with the rest of Canada. As part of Qanuilirpitaa? 2017, a cross-sectional population-based health survey, we sought to describe the prevalence of respiratory health indicators, including the first estimate of airway obstruction based on spirometry in an Inuit population, and explore their associated characteristics. METHODS We analyzed data from 1296 participants aged 16 years and older, using multivariate logistic regression to assess characteristics associated with spirometry-determined airway obstruction and self-reported respiratory symptoms, i.e., wheezing in the last year and chronic cough during at least 3 months. RESULTS In this relatively young population (83% aged 16 to 54), the prevalences of wheezing, chronic cough, and airway obstruction were, respectively, 27% (95% CI 24-30), 21% (18-23), and 17% (14-20). These estimates are prone to biases due to the relatively low participation rate (about 37%). The most consistent associations were with smoking (≥ 15 pack-years; odds ratio [OR] 3.13, 3.39, and 2.86 for the three indicators, respectively) and food security (OR 0.55 with wheezing and OR 0.26 with chronic cough), as defined in the Household Food Security Survey Module. Wheezing was also associated with allergic sensitization to dogs (2.60) and obesity (2.18). Chronic cough was associated with respiratory infections during childhood (2.12), housing in need of major repairs (1.72), and housing crowding (1.50), and was negatively associated with participation to traditional activities (0.62) and going on the land (0.64). Airway obstruction was associated with being underweight (3.84) and post-secondary education (0.40). Among young adults and women, wheezing was also associated with any inhalation of solvents for recreational purposes during their lifetime (2.62 and 1.56, respectively), while airway obstruction was associated with regular marijuana use (2.22 and 1.84, respectively). CONCLUSION Smoking and food insecurity are both highly prevalent and strongly associated with respiratory symptoms in Nunavik. Together with essential smoking prevention and cessation programs, our findings suggest that solving food security and housing crises, improving socioeconomic conditions, and promoting traditional lifestyle may improve respiratory health in Nunavik.
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Affiliation(s)
- Philippe Robert
- Institut national de santé publique du Québec, Quebec City, QC, Canada
- Département de médecine sociale et préventive, Université Laval, Quebec City, QC, Canada
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Quebec City, QC, Canada
| | - Benoît Lévesque
- Institut national de santé publique du Québec, Quebec City, QC, Canada
- Département de médecine sociale et préventive, Université Laval, Quebec City, QC, Canada
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Quebec City, QC, Canada
| | - Jean Bourbeau
- Respiratory Epidemiology and Clinical Research Unit, Department of Medicine, McGill University, Montreal, QC, Canada
- Research Institute, McGill University Health Centre, Montreal Chest Institute, Montreal, QC, Canada
| | - Faiz Ahmad Khan
- Respiratory Epidemiology and Clinical Research Unit, Department of Medicine, McGill University, Montreal, QC, Canada
- Research Institute, McGill University Health Centre, Montreal Chest Institute, Montreal, QC, Canada
- McGill International TB Centre, Montreal, QC, Canada
| | - Louis-Philippe Boulet
- Institut universitaire de cardiologie et de pneumologie de Québec, Quebec City, QC, Canada
- Département de médecine, Université Laval, Quebec City, QC, Canada
| | - Marc-André Dubé
- Institut national de santé publique du Québec, Quebec City, QC, Canada
| | - Jean-François Proulx
- Department of Public Health, Nunavik Regional Board of Health and Social Services, Kuujjuaq, QC, Canada
| | - Pierre Ayotte
- Institut national de santé publique du Québec, Quebec City, QC, Canada.
- Département de médecine sociale et préventive, Université Laval, Quebec City, QC, Canada.
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Quebec City, QC, Canada.
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Belaid L, Budgell R, Sauvé C, Andersson N. Shifting paradigm from biomedical to decolonised methods in Inuit public health research in Canada: a scoping review. BMJ Glob Health 2022; 7:bmjgh-2021-008311. [DOI: 10.1136/bmjgh-2021-008311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 09/25/2022] [Indexed: 11/06/2022] Open
Abstract
BackgroundThe National Inuit Strategy on Research focuses on advancing Inuit governance in research, increasing ownership over data and building capacity. Responding to this call for Inuit self-determination in research, academic researchers should consider cultural safety in research and ways to promote Inuit-led methods.MethodsThis scoping review collated academic literature on public health research in Inuit communities in Canada between 2010 and 2022. A critical assessment of methods used in public health research in Inuit communities examined cultural safety and the use of Inuit-attuned methods. Descriptive and analytical data were summarised in tables and figures. Knowledge user engagement in the research process was analysed with thematic analysis.Results356 articles met the inclusion criteria. Much of the published research was in nutrition and mental health, and few initiatives reported translation into promotion programmes. Almost all published research was disease or deficit focused and based on a biomedical paradigm, especially in toxicology, maternal health and chronic diseases. Recent years saw an increased number of participatory studies using a decolonial lens and focusing on resilience. While some qualitative research referred to Inuit methodologies and engaged communities in the research process, most quantitative research was not culturally safe. Overall, community engagement remained in early stages of co-designing research protocols and interventions. Discussion on governance and data ownership was limited. Recent years saw emerging discussions on these issues. Knowledge user capacity-building was limited to brief training on conventional data collection methods.ConclusionsThe last decade of published public health research has not responded to the National Inuit Strategy on Research. Participatory research is gaining ground, but has not reached its full potential. A shift from biomedical to decolonised methods is slowly taking place, and public health researchers who have not yet embraced this paradigm shift should do so.
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Kirychuk S, Russell E, Rennie D, Karunanayake C, Roberts C, Seeseequasis J, Thompson B, McMullin K, Ramsden VR, Fenton M, Abonyi S, Pahwa P, Dosman JA. Housing inadequacy in rural Saskatchewan First Nation communities. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000470. [PMID: 36962499 PMCID: PMC10021235 DOI: 10.1371/journal.pgph.0000470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/21/2022] [Indexed: 11/19/2022]
Abstract
Housing and house conditions on First Nation communities in Canada are important determinants of health for community members. Little is known about rural First Nation housing in the Canadian Prairies. The aim was to survey houses in two rural First Nation communities in Saskatchewan, Canada to understand housing conditions, prevalence of mold/mildew and dampness, and sources, locations and frequency of mold and dampness. Surveys were conducted with an adult member of each household in 144 houses. Surveys assessed: size, age, and number of rooms in the house; number of individuals residing in the house; presence of mold/mildew and dampness, and sources, locations and frequency of mold and dampness. Houses were mostly two-bedrooms (25.7%) or more (67.4%). Thirty-one percent of houses had six or more people living in the house with crowding present in 68.8% of houses. Almost half of the houses (44.5%) were in need of major repairs. More than half of the houses had water or dampness in the past 12 months in which dripping/puddles and standing water were most commonly identified and were from surface water and plumbing. More than half of the houses indicated that this dampness caused damage. A smell of mold or mildew was present in over half of the houses (52.1%) and 73.3% of these houses indicated that this smell was always present. Housing adequacy including crowding, dampness, and mold are significant issues for houses in these two rural Saskatchewan First Nation communities. Housing inadequacy is more common in these rural communities as compared to Canadian statistics. Housing inadequacy is modifiable and is important to address for multiple reasons, but notably, as a social determinant of health. Federal government strategy to address and redress housing in First Nation communities in Canada is a fiduciary responsibility and critical to reconciliation.
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Affiliation(s)
- Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
- Department of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Eric Russell
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
| | - Donna Rennie
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
| | - Chandima Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
| | - Clarice Roberts
- Community Member, Montreal Lake Cree Nation, Saskatchewan, Canada
| | | | - Brooke Thompson
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
| | - Kathleen McMullin
- Community Health and Epidemiology, University of Saskatchewan, Saskatchewan, Canada
| | - Vivian R Ramsden
- Department of Academic Family Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Mark Fenton
- Division of Respirology, Critical Care and Sleep Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Sylvia Abonyi
- Community Health and Epidemiology, University of Saskatchewan, Saskatchewan, Canada
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
- Community Health and Epidemiology, University of Saskatchewan, Saskatchewan, Canada
| | - James A Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatchewan, Canada
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A Systematic Review of Child Health and Developmental Outcomes Associated with Low Birthweight and/or Small for Gestational Age in Indigenous Children from Australia, Canada and New Zealand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312669. [PMID: 34886396 PMCID: PMC8657270 DOI: 10.3390/ijerph182312669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 11/16/2022]
Abstract
While much is known about the health implications of low birthweight for infants and adults, there is limited information about the health implications in childhood, particularly for Indigenous children. The aim of this systematic review was to assess associations between low birthweight (LBW) and/or small for gestational age (SGA) and the developmental, physical or mental health outcomes for Australian, Canadian and New Zealand Indigenous children (5-12 years), including the potential mediating role of cultural connections. The review was guided by an Aboriginal Advisory Group established to guide the Aboriginal Families Study. Four databases were investigated with pre-determined inclusion/exclusion criteria. The search identified 417 articles after independent screening by two authors. Eight studies assessing six child outcomes were included. The review identified limited evidence, although the review suggested possible links between LBW and/or SGA and childhood asthma, lower body mass index (BMI) and poorer academic performance. Links between LBW, SGA and disability, global health and developmental vulnerability were inconclusive. One study identified cultural-based resilience as protective against perinatal adversity. In summary, research on the relationship between adverse birth outcomes and Indigenous children's health and development is limited. Further investigation and collaboration with Indigenous communities is required to drive optimised health and social services responses and equitable system reform.
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Brew B, Gibberd A, Marks GB, Strobel N, Allen CW, Jorm L, Chambers G, Eades S, McNamara B. Identifying preventable risk factors for hospitalised asthma in young Aboriginal children: a whole-population cohort study. Thorax 2021; 76:539-546. [PMID: 33419952 DOI: 10.1136/thoraxjnl-2020-216189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 12/14/2020] [Accepted: 12/17/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Australia has one of the highest rates of asthma worldwide. Indigenous children have a particularly high burden of risk determinants for asthma, yet little is known about the asthma risk profile in this population. AIM To identify and quantify potentially preventable risk factors for hospitalised asthma in Australian Aboriginal children (1-4 years of age). METHODS Birth, hospital and emergency data for all Aboriginal children born 2003-2012 in Western Australia were linked (n=32 333). Asthma was identified from hospitalisation codes. ORs and population attributable fractions were calculated for maternal age at birth, remoteness, area-level disadvantage, prematurity, low birth weight, maternal smoking in pregnancy, mode of delivery, maternal trauma and hospitalisations for acute respiratory tract infection (ARTI) in the first year of life. RESULTS There were 705 (2.7%) children hospitalised at least once for asthma. Risk factors associated with asthma included: being hospitalised for an ARTI (OR 4.06, 95% CI 3.44 to 4.78), area-level disadvantage (OR 1.58, 95% CI 1.28 to 1.94), being born at <33 weeks' gestation (OR 3.30, 95% CI 2.52 to 4.32) or birth weight <1500 g (OR 2.35, 95% CI 1.39 to 3.99). The proportion of asthma attributable to an ARTI was 31%, area-level disadvantage 18%, maternal smoking 5%, and low gestational age and birth weight were 3%-7%. We did not observe a higher risk of asthma in those children who were from remote areas. CONCLUSION Improving care for pregnant Aboriginal women as well as for Aboriginal infants with ARTI may help reduce the burden of asthma in the Indigenous population.
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Affiliation(s)
- Bronwyn Brew
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia .,School of Women's and Children's Health, University of New South Wales, Sydney, 2033, New South Wales, Australia
| | - Alison Gibberd
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Guy B Marks
- Woolcock Institute of Medical Research, Sydney, New South Wales, Australia.,South West Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Natalie Strobel
- Kurongkurl Katitjin, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Clare Wendy Allen
- Children's Hospital Westmead, University of Sydney, Westmead, New South Wales, Australia
| | - Louisa Jorm
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Georgina Chambers
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, 2033, New South Wales, Australia
| | - Sandra Eades
- Curtin Medical School, Curtin University, Perth, Western Australia, Australia
| | - Bridgette McNamara
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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Rennie DC, Karunanayake CP, Lawson JA, Kirychuk S, McMullin K, Abonyi S, Seeseequasis J, MacDonald J, Dosman JA, Pahwa P. Domestic Risk Factors for Atopic and non-Atopic Asthma in First Nations Children Living in Saskatchewan, Canada. CHILDREN-BASEL 2020; 7:children7050038. [PMID: 32349273 PMCID: PMC7278566 DOI: 10.3390/children7050038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/30/2020] [Accepted: 04/21/2020] [Indexed: 11/16/2022]
Abstract
Both allergic and non-allergic asthma phenotypes are thought to vary by specific housing and other indoor environmental conditions. This study evaluated risk factors for allergic asthma phenotypes in First Nation children, an understudied Canadian population with recognized increased respiratory morbidity. We conducted a cross-sectional survey with a clinical component to assess the respiratory health of 351 school-age children living on two rural reserve communities. Asthma was defined as parental report of physician diagnosed asthma or a report of wheeze in the past 12 months. Atopy was determined by a ≥ 3-mm wheal response to any of six respiratory allergens upon skin prick testing (SPT). Important domestic and personal characteristics evaluated included damp housing conditions, household heating, respiratory infections and passive smoking exposure. Asthma and atopy prevalence were 17.4% and 17.1%, respectively. Of those with asthma, 21.1% were atopic. We performed multivariate multinomial logistic regression modelling with three outcomes: non-atopic asthma, atopic asthma and no asthma for 280 children who underwent SPT. After adjusting for potential confounders, children with atopic asthma were more likely to be obese and to live in homes with either damage due to dampness (p < 0.05) or signs of mildew/mold (p = 0.06). Both natural gas home heating and a history of respiratory related infections were associated with non-atopic asthma (p < 0.01). Domestic risk factors for asthma appear to vary by atopic status in First Nations children. Determining asthma phenotypes could be useful in environmental management of asthma in this population.
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Affiliation(s)
- Donna C. Rennie
- College of Nursing, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 2Z4, Canada
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (J.A.D.); (P.P.)
- Correspondence: (D.C.R.); (C.P.K.); Tel.: +1-306-966-7886 (D.C.R.); +1-306-966-1647 (C.P.K.)
| | - Chandima P. Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (J.A.D.); (P.P.)
- Correspondence: (D.C.R.); (C.P.K.); Tel.: +1-306-966-7886 (D.C.R.); +1-306-966-1647 (C.P.K.)
| | - Josh A. Lawson
- Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0X8, Canada; (J.A.L.); (S.K.)
| | - Shelley Kirychuk
- Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0X8, Canada; (J.A.L.); (S.K.)
| | - Kathleen McMullin
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (K.M.); (S.A.)
| | - Sylvia Abonyi
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (K.M.); (S.A.)
| | - Jeremy Seeseequasis
- Willow Cree Health Centre, Beardy’s and Okemasis First Nation, P.O. Box 96, Duck Lake, SK S0K 1J0, Canada;
| | - Judith MacDonald
- William Charles Health Centre, Montreal Lake Cree Nation, P.O. Box 240, Montreal Lake, SK S0J 1Y0, Canada;
| | - James A. Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (J.A.D.); (P.P.)
- Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0X8, Canada; (J.A.L.); (S.K.)
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (J.A.D.); (P.P.)
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (K.M.); (S.A.)
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Kinghorn B, Fretts AM, O'Leary RA, Karr CJ, Rosenfeld M, Best LG. Socioeconomic and Environmental Risk Factors for Pediatric Asthma in an American Indian Community. Acad Pediatr 2019; 19:631-637. [PMID: 31103883 DOI: 10.1016/j.acap.2019.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 04/22/2019] [Accepted: 05/11/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND American Indian (AI)/Alaska Native children have increased asthma prevalence, morbidity, and mortality compared to non-Hispanic white children. Our study sought to examine environmental and socioeconomic factors of asthma among children in an AI community. METHODS This case-control study included children with physician-diagnosed asthma and age-matched controls, ages 6 through 17 years, in an AI community. Diagnosis and clinical characteristics were obtained from medical record review. Home visits included interviews regarding sociodemographic and household environmental exposures, physical exams, spirometry, and asthma control questionnaires (cases only). RESULTS Among the 108 asthma cases and 215 controls, 64% had an annual household income of <$25,000. Children with asthma had significantly higher odds of living in a multi-unit dwelling (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.2-4.4) or in residences with rodent or insect infestation (OR, 2.1; 95% CI, 1.1-3.8) and were less likely to live in homes with more than 8 occupants (OR, 0.5; 95% CI, 0.3-0.9). Also, there was a trend for lower caregiver education level, unmarried caregiver marital status, and annual household income level of <$25,000 in univariate analysis. However, after adjustment for socioeconomic status and household environmental factors, these estimates were not significant. Nearly half of cases had poorly controlled asthma and reported persistent cough, wheeze, and dyspnea, yet only 24% reported using a controller medication. CONCLUSIONS In this low-income AI community, we identified several social and environmental determinants of asthma, which were mediated by socioeconomic status and other household environmental factors, suggesting a complex interplay between socioeconomic status and environmental exposures. Furthermore, many children with asthma reported poor asthma control.
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Affiliation(s)
- BreAnna Kinghorn
- Seattle Children's Hospital (B Kinghorn, AM Fretts, CJ Karr, and M Rosenfeld), University of Washington, Seattle; Missouri Breaks Industries Research Inc. (RA O'Leary and LG Best), Eagle Butte, SD; Turtle Mountain Community College (LG Best), Belcourt, ND.
| | - Amanda M Fretts
- Seattle Children's Hospital (B Kinghorn, AM Fretts, CJ Karr, and M Rosenfeld), University of Washington, Seattle; Missouri Breaks Industries Research Inc. (RA O'Leary and LG Best), Eagle Butte, SD; Turtle Mountain Community College (LG Best), Belcourt, ND
| | - Rae A O'Leary
- Seattle Children's Hospital (B Kinghorn, AM Fretts, CJ Karr, and M Rosenfeld), University of Washington, Seattle; Missouri Breaks Industries Research Inc. (RA O'Leary and LG Best), Eagle Butte, SD; Turtle Mountain Community College (LG Best), Belcourt, ND
| | - Catherine J Karr
- Seattle Children's Hospital (B Kinghorn, AM Fretts, CJ Karr, and M Rosenfeld), University of Washington, Seattle; Missouri Breaks Industries Research Inc. (RA O'Leary and LG Best), Eagle Butte, SD; Turtle Mountain Community College (LG Best), Belcourt, ND
| | - Margaret Rosenfeld
- Seattle Children's Hospital (B Kinghorn, AM Fretts, CJ Karr, and M Rosenfeld), University of Washington, Seattle; Missouri Breaks Industries Research Inc. (RA O'Leary and LG Best), Eagle Butte, SD; Turtle Mountain Community College (LG Best), Belcourt, ND
| | - Lyle G Best
- Seattle Children's Hospital (B Kinghorn, AM Fretts, CJ Karr, and M Rosenfeld), University of Washington, Seattle; Missouri Breaks Industries Research Inc. (RA O'Leary and LG Best), Eagle Butte, SD; Turtle Mountain Community College (LG Best), Belcourt, ND
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Ahmed A, Becker A. Evaluation of eczema, asthma, allergic rhinitis and allergies among the grade-7 children of Iqaluit. Allergy Asthma Clin Immunol 2019; 15:26. [PMID: 31043967 PMCID: PMC6480605 DOI: 10.1186/s13223-019-0341-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 04/15/2019] [Indexed: 12/04/2022] Open
Abstract
Background Little is known about the prevalence of asthma, allergic rhinitis, eczema and allergies among Canadian Inuit children, especially those living in the arctic and subarctic areas. Methods A cross-sectional study among grade seven students attending schools in Iqaluit, the capital city of Nunavut, was conducted during the 2016/2017 school year. We used the International Study of Allergy and Asthma in Children (ISAAC) questionnaire with added questions relevant to the population. In addition, skin prick tests (SPT) were conducted to test for sensitization to common food and environmental allergens. Results The prevalence of current asthma is 5.2%, all of them were males and 2/3 of them were Inuit and all had a previous respiratory hospitalization. Past asthma prevalence is 8.6%, 60% males and 60% Inuit. There was an inverse relationship to crowdedness possibly as a confounding factor because of getting a higher prevalence among the non-Inuit who usually live in less crowded houses. Current allergic rhinitis prevalence is 8.6%, 60% of the cases were among the mixed Inuit/Caucasian ethnicity while no cases among the non-Inuit, there was a female predominance 3:2. Past history of allergic rhinitis prevalence is 10.3%, half of the cases were among the mixed ethnicity (5.2% of that ethnicity) followed by Inuit (3.4%) and non-Inuit (1.7%), female: Male ratio 1:1. Current eczema prevalence was 27.6%, with half of the cases among the mixed ethnicity (13.8% of that group), followed by Inuit (8.6%). There was a female predominance with protective effect of exclusive breastfeeding. Past eczema prevalence 34.5%, with half of the cases were among the mixed ethnicity (17.2% of that group), followed by Inuit (10.3%). There was a female predominance. We noted a high rate of sensitization to Cat at 29.2%, most of the cases were among the mixed ethnicity, while absent sensitization to other common inhalant allergens. Conclusion While being cautious about firm conclusions due to the small sample size and power, the noticed variations in the prevalence and risk factors of asthma, allergic rhinitis and eczema among different ethnicities living at the same subarctic environment might be related to several possible explanations like genetic, gene-environment interaction and/or lifestyle factors, it was out of the scope of this study to determine the causality of such variation in prevalence, which emphasizes the need for further investigation.
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Affiliation(s)
- Ahmed Ahmed
- 1Department of Pediatrics, University of Ottawa, Ottawa, ON Canada
| | - Allan Becker
- 2Section of Allergy and Clinical Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB Canada
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Karunanayake CP, Amin K, Abonyi S, Dosman JA, Pahwa P. Prevalence and determinants of asthma among aboriginal adolescents in Canada. J Asthma 2019; 57:40-46. [PMID: 30628527 DOI: 10.1080/02770903.2018.1541354] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective: The objective of the study was to determine the prevalence and associated risk factors of asthma in Aboriginal adolescents in Canada based on the Canadian Aboriginal Peoples Survey (APS) 2012. Few studies have investigated the prevalence and risk factors of asthma in Aboriginal adolescents in Canada. Methods: Data from the cross-sectional APS 2012 were analyzed to accomplish the objective. Logistic regression analysis was utilized to determine significant risk factors of lifetime diagnosis of asthma among Aboriginal adolescents. The outcome of interest for adolescents was based on the question: "Do you have asthma that have been diagnosed by a health professional?" Individual, environmental, and contextual factors were tested for an association with lifetime diagnosis of asthma among adolescents. Results: The overall prevalence of lifetime diagnosis of asthma was 16.0%. The prevalence of lifetime diagnosis of asthma was 16.8% for adolescent boys and 15.3% for adolescent girls. Based on multivariable logistic regression analysis, the risk factors of lifetime diagnosis of asthma were: age, income, being overweight, smoking inside the home, having one to two children under 18 years in the household, history of bronchitis, living in an urban residence, education, and geographical location. Female sex was reported to have a protective effect on or reduce risk of the prevalence of lifetime diagnosis of asthma compared to the male sex. Conclusions: Lifetime diagnosis of asthma prevalence appears to be lower in Aboriginal adolescent girls than in adolescent boys. Lifetime diagnosis of asthma prevalence in these adolescents is associated with age, income, education, being overweight, smoking inside the home, history of bronchitis, and location of residence, both geographical region and urban residence. The prevalence of lifetime diagnosis of asthma among Aboriginal adolescent is higher compared to the general adolescent population in Canada.
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Affiliation(s)
- Chandima P Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Khalid Amin
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Sylvia Abonyi
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - James A Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Punam Pahwa
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Swartz A, Collier T, Young CA, Cruz E, Bekmezian A, Coffman J, Celedon J, Alkon A, Cabana MD. The effect of early child care attendance on childhood asthma and wheezing: A meta-analysis. J Asthma 2018; 56:252-262. [PMID: 29630417 DOI: 10.1080/02770903.2018.1445268] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Research evidence offers mixed results regarding the relationship between early child care attendance and childhood asthma and wheezing. A meta-analysis was conducted to synthesize the current research evidence of the association between early child care attendance and the risk of childhood asthma and wheezing. METHOD Peer reviewed studies published from 1964-January 2017 were identified in MEDLINE, CINAL, and EMBASE using MeSH headings relevant to child care and asthma. Two investigators independently reviewed the selected articles from this search. All relevant articles that met our inclusion criteria were selected for further analysis. Data were extracted from studies that had sufficient data to analyze the odds of asthma or wheezing among children who attended child care. RESULTS The meta-analysis of 32 studies found that (1) early child care attendance is protective against asthma in children 3-5 years of age but not for children with asthma 6 years of age or older. (2) Early child care attendance increases the risk of wheezing among children 2 years of age or younger, but not the risk of wheezing for children over 2 years of age. CONCLUSIONS This meta-analysis shows that early child care attendance is not significantly associated with the risk of asthma or wheeze in children 6 years of age or older.
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Affiliation(s)
- Alicia Swartz
- a Family Health Care Nursing , University of California San Francisco School of Nursing , San Francisco , CA , USA
| | - Tina Collier
- b Department of Testing Services , American Dental Association , Chicago , IL , USA
| | - Chelsea Anne Young
- c Psychiatry, University of California San Francisco , San Francisco , CA , USA
| | - Eddie Cruz
- d Pediatrics, University of California San Francisco , San Francisco , CA , USA
| | - Arpi Bekmezian
- d Pediatrics, University of California San Francisco , San Francisco , CA , USA
| | - Janet Coffman
- e Institute for Health Policy Studies , University of California San Francisco , San Francisco , CA , USA
| | - Juan Celedon
- f Pediatrics , University of Pittsburgh , Pittsburgh , PA , USA
| | - Abbey Alkon
- a Family Health Care Nursing , University of California San Francisco School of Nursing , San Francisco , CA , USA
| | - Michael D Cabana
- d Pediatrics, University of California San Francisco , San Francisco , CA , USA
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Ahmed A, Hakim A, Becker A. Evaluation of eczema, asthma, allergic rhinitis and allergies among the Grade-1 children of Iqaluit. Allergy Asthma Clin Immunol 2018; 14:9. [PMID: 29492095 PMCID: PMC5827980 DOI: 10.1186/s13223-018-0232-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 01/25/2018] [Indexed: 01/08/2023] Open
Abstract
Background Little is known about the prevalence of asthma, allergic rhinitis, eczema and allergies among Canadian Inuit children, especially those living in the arctic and subarctic areas. Methods A cross-sectional study among Grade 1 students attending schools in Iqaluit, the capital of Nunavut, was conducted during the 2015/2016 school year. We used the International Study of Allergy and Asthma in Children questionnaire with added questions relevant to the population. In addition, skin prick tests were conducted to test for sensitization to common food and environmental allergens. Results The prevalence of current asthma was 15.9% (> 2:1 males) with the highest prevalence among those with any non-Inuit heritage at 38.5%. The prevalence of current and past allergic rhinitis was 6.8%, also predominant among males, with the lowest prevalence among the mixed ethnicity. Home crowdedness was inversely related to past asthma. Being ever outside Nunavut was associated with higher prevalence of current and past asthma. No statistically significant relationship was found with passive smoking or exclusive breast feeding during the first 4 months of life. The current eczema prevalence was 20.5%, with the highest prevalence recorded among the Inuit at 25% compared to 15.4% among the mixed ethnicity and 14.3% among the non-Inuit. We noted a high rate of sensitization to cat at 26.7% while absent sensitization to other common inhalant allergens. Conclusion Variations in the prevalence and risk factors of asthma, allergic rhinitis and eczema among different ethnicities living at the same subarctic environment may be related to genetic, gene-environment interaction and/or lifestyle factors that require further investigation.
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Affiliation(s)
- Ahmed Ahmed
- 1Department of Pediatrics, University of Ottawa, Ottawa, ON Canada
| | - Amir Hakim
- 2National Heart and Lung Institute, Imperial College, London, UK
| | - Allan Becker
- 3Section of Allergy and Clinical Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB Canada
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Fu QL, Du Y, Xu G, Zhang H, Cheng L, Wang YJ, Zhu DD, Lv W, Liu SX, Li PZ, Shi JB, Ou CQ. Prevalence and Occupational and Environmental Risk Factors of Self-Reported Asthma: Evidence from a Cross-Sectional Survey in Seven Chinese Cities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13111084. [PMID: 27827944 PMCID: PMC5129294 DOI: 10.3390/ijerph13111084] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 10/16/2016] [Accepted: 10/27/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Asthma is one of the most common chronic diseases and associated with significant morbidity and mortality. However, few data on occupational and environmental risk factors of asthma are available, particularly in Asian adults. Based on a national cross-sectional survey, we assessed the prevalence and risk factors of asthma in Chinese adults. METHODS A total of 9974 participants aged 15 years and over in seven Chinese cities were selected using a stratified four-stage random sampling. All participants were interviewed face-to-face in their homes using a standardized self-administered questionnaire. Multivariate logistic regression analyses were adopted to determine various risk factors for asthma. RESULTS The prevalence of self-reported lifetime asthma was 2.46% among the entire adult population, 3.02% among males and 1.93% among females. The prevalence varied by age group, ethnicity, marital status, education, and floor space per person (p < 0.05). After adjusting for socio-demographic variables and smoking, we found independent occupational and environmental determinants of asthma, including a clearance-related job (OR = 2.28, 95%CI: 1.07-4.89), occupational exposure to industrial or occupational poisonous gas (OR = 4.21, 95%CI: 2.43-7.30), having large amounts of carpet in the workplace (OR = 2.61, 95%CI: 1.20-5.69) and using coal for cooking (OR = 2.65, 95%CI: 1.26-5.57). CONCLUSIONS Asthma is a serious public health problem in China. Our study provides important updated information on the prevalence of asthma and its associated risk factors, which may help us better understand the epidemiology of asthma and prevent this disorder.
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Affiliation(s)
- Qing-Ling Fu
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
| | - Yue Du
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China.
| | - Geng Xu
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
| | - Hua Zhang
- Department of Otorhinolaryngology, The First Affiliated Hospital, Xinjiang Medical University, Urumchi 830054, China.
| | - Lei Cheng
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China.
| | - Yan-Jun Wang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
| | - Dong-Dong Zhu
- Department of Otolaryngology Head and Neck Surgery, China-Japan Union Hospital, Jilin University, Changchun 130033, China.
| | - Wei Lv
- Department of Otolaryngology, Peking Union Medical College Hospital, Beijing 100032, China.
| | - Shi-Xi Liu
- Department of Otorhinolaryngology, West China Hospital of Medicine, Sichuan University, Chengdu 610041, China.
| | - Pei-Zhong Li
- Department of Otorhinolaryngology, Affiliated Huai'an First People's Hospital, Nanjing Medical University, Huai'an 223300, China.
| | - Jian-Bo Shi
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China.
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Stewart M, Evans J, Letourneau N, Masuda J, Almond A, Edey J. Low-Income Children, Adolescents, and Caregivers Facing Respiratory Problems: Support Needs and Preferences. J Pediatr Nurs 2016; 31:319-29. [PMID: 26968529 DOI: 10.1016/j.pedn.2015.11.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 11/15/2015] [Accepted: 11/16/2015] [Indexed: 10/22/2022]
Abstract
UNLABELLED Burdens of poverty are often compounded by respiratory problems. This study aimed to identify the support needs and intervention preferences for low-income families facing this challenge. DESIGN AND METHODS Interviews were conducted in two Canadian provinces with low-income children/adolescents (n=32) diagnosed with respiratory health problems and their parents or family caregiver (n=37). RESULTS These vulnerable children and parents described non-supportive interactions with some health service providers and inadequate information. They reported isolation and support deficits, exacerbated by limited resources and health restrictions. Children/adolescents felt isolated and excluded and wanted to connect with peers. Group or dyadic level support, delivered by peers and health professionals, was desired. The importance of logistics to enhance accessibility and appeal of group or dyadic support interventions was clearly identified. CONCLUSIONS The findings of this study reveal that low-income children and their families encounter challenges to accessing support and to utilizing support resources. PRACTICE IMPLICATIONS Partnerships with low-income children/adolescents and family caregivers in provision of education and social support can combat isolation and ignorance. Reducing inequities for this high risk population could be achieved by providing support from experienced peers, in combination with health professional guidance, and knowledge about pulmonary health.
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Affiliation(s)
- Miriam Stewart
- Faculty of Nursing and School of Medicine, University of Alberta, Edmonton, AB, Canada.
| | - Joshua Evans
- Faculty of Humanities & Social Sciences, Athabasca University, Athabasca, AB, Canada
| | - Nicole Letourneau
- Faculties of Nursing & Medicine, University of Calgary, Calgary, AB, Canada
| | - Jeffrey Masuda
- Department of Environment and Geography, University of Manitoba, Winnipeg, MB, Canada
| | - Amanda Almond
- Social Support Research Program, Faculty of Nursing, University of Alberta, Level 3, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Jocelyn Edey
- Faculty of Nursing and School of Public Health, University of Alberta, Level 3, Edmonton Clinic Health Academy, Edmonton, AB, Canada
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Senthilselvan A, Niruban SJ, King M, Majaesic C, Veugelers P, Laing L, Rowe BH. Prevalence and risk factors of asthma in First Nations children living on reserves in Canada. Canadian Journal of Public Health 2016; 106:e483-8. [PMID: 26986908 DOI: 10.17269/cjph.106.5147] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 09/08/2015] [Accepted: 09/10/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To explore the prevalence and determine the risk factors of asthma in First Nations children aged 0 to 11 years living on reserves in Canada. METHODS In this cross-sectional study, we considered the data collected as part of the First Nations Regional Health Survey involving 6,657 children living in 238 First Nations communities in the 10 Canadian provinces, the Northwest Territories and the Yukon. RESULTS The overall prevalence of asthma that has lasted or is expected to last at least six months (ever-asthma) among children living on reserves was 14.6%: a prevalence of 12.9% among 0 to 4 year olds and 15.6% among 5 to 11 year olds. The prevalence of ever-asthma was greater among boys (16.1%) than girls (13.2%). Children from homes with two or more children aged less than 11 years and those who were engaged in daily physical activities were less likely to have a report of ever-asthma. Children from high-income families and smoke-free homes were more likely to have a report of ever-asthma. The association between allergy and ever-asthma was stronger in children with low birth weight. The association between chronic ear infections and ever-asthma was stronger in girls than boys. CONCLUSIONS The overall prevalence of ever-asthma and factors associated with ever-asthma in First Nations children living on reserves were similar to those reported for off-reserve Aboriginal children and non-Aboriginal Canadian children.
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Valery PC, Whop LJ, Morseu-Diop N, Garvey G, Masters IB, Chang AB. Carers' perspectives on an effective Indigenous health model for childhood asthma in the Torres Strait. Aust J Rural Health 2015; 24:170-5. [PMID: 26692037 DOI: 10.1111/ajr.12257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2015] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To describe parents'/carers' views of the characteristics of a clinical service model shown to improve asthma outcomes. DESIGN A randomised controlled study on education intervention for childhood asthma by Indigenous health care workers. SETTING Thursday Island, Horn Island and Bamaga. PARTICIPANTS Thirty-five children received the intervention and 53 were in the control group. At the last study visit 12 months after enrolment, carers were asked to give feedback about the clinical service delivered by paediatric respiratory physicians and the asthma education intervention. INTERVENTION Additional asthma education. MAIN OUTCOME MEASURES Carers' responses to the open-ended questions were analysed separately by three Indigenous investigators who assigned codes and developed the themes. These were then cross-checked and combined to develop an overall interpretation of the data. RESULTS The carers (n = 81) of 88 children in the Torres Strait region of North Queensland reported positively to the clinical service delivery. Service was rated as excellent = 26.8%, very good = 51.2%, good = 19.5% and poor = 2.4%. Parents'/carers' views about the clinical service model were grouped into seven themes: clear communication by health professionals, service delivery, professional approach, clear transfer of knowledge and education/clinical knowledge of asthma, established rapport/caregiver satisfaction, importance of coming into the local community, and areas of concern for the carers/parents. CONCLUSION Community-based perspectives of an effective health service model include empowered Indigenous health care workers currently attached to the medical specialist service with elements of high expertise and appropriate cultural awareness that enabled clear communication and transfer of knowledge.
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Affiliation(s)
- Patricia C Valery
- Menzies School of Health Research, Northern Territory, Australia.,QIMR Berghofer Medical Research Institute, Population Health, Brisbane, Queensland, Australia
| | - Lisa J Whop
- Menzies School of Health Research, Northern Territory, Australia
| | | | - Gail Garvey
- Menzies School of Health Research, Northern Territory, Australia
| | - Ian B Masters
- Lady Cilento Children's Hospital, Queensland Children's Medical Research Institute, Queensland University of Technology, Brisbane, Australia
| | - Anne B Chang
- Menzies School of Health Research, Northern Territory, Australia.,Lady Cilento Children's Hospital, Queensland Children's Medical Research Institute, Queensland University of Technology, Brisbane, Australia
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Doggett N, Dogra S. Physical inactivity and television-viewing time among Aboriginal adults with asthma: a cross-sectional analysis of the Aboriginal Peoples Survey. Health Promot Chronic Dis Prev Can 2015; 35:54-61. [PMID: 25970805 PMCID: PMC4910434 DOI: 10.24095/hpcdp.35.3.02] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The purpose of this analysis was to (1) determine the association between asthma and physical activity levels or sedentary time among Aboriginal adults, and (2) understand the influence of physical inactivity and sedentary time on health care use among Aboriginal adults with asthma. METHODS We analyzed 20 953 adults from the 2006 Aboriginal Peoples Survey. Those with self-reported physician-diagnosed asthma and a current prescription for asthma medication were considered to have current asthma. Insufficient physical activity was defined as < 3 hours/week of moderate to vigorous physical activity; high television screen time was defined as > 10 hours/week. Health care use was assessed using the number of health professional visits and overnight hospital stays. RESULTS Aboriginal adults with asthma were more likely to report high television-viewing time (OR = 1.16; CI: 1.11-1.22) and insufficient physical activity (OR = 1.15; CI: 1.10-1.20) than those without asthma. Those with asthma who reported high television-viewing time reported more health professional consults in the past 12 months (OR = 2.59; CI: 2.34-2.87), more overnight stays in hospital in the past year (OR = 1.95; CI: 1.82-2.08) and more overnight stays in the hospital in the past 5 years (OR = 1.13; CI: 1.07-1.18); results were less consistent for physical activity and health care use. CONCLUSION These findings suggest that Aboriginal adults with asthma are less active than their peers without asthma and that such a lifestyle may be associated with higher health care use. These findings have implications for physical activity promotion and sedentary behaviour strategies targeting Aboriginal adults with asthma.
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Affiliation(s)
- N Doggett
- School of Recreational Management and Kinesiology, Acadia University, Wolfville, Nova Scotia, Canada
| | - S Dogra
- Faculty of Health Sciences, Kinesiology, University of Ontario Institute of Technology, Oshawa, Ontario, Canada
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Chang AB, Brown N, Toombs M, Marsh RL, Redding GJ. Lung disease in indigenous children. Paediatr Respir Rev 2014; 15:325-32. [PMID: 24958089 DOI: 10.1016/j.prrv.2014.04.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 04/29/2014] [Indexed: 12/20/2022]
Abstract
Children in indigenous populations have substantially higher respiratory morbidity than non-indigenous children. Indigenous children have more frequent respiratory infections that are, more severe and, associated with long-term sequelae. Post-infectious sequelae such as chronic suppurative lung disease and bronchiectasis are especially prevalent among indigenous groups and have lifelong impact on lung function. Also, although estimates of asthma prevalence among indigenous children are similar to non-indigenous groups the morbidity of asthma is higher in indigenous children. To reduce the morbidity of respiratory illness, best-practice medicine is essential in addition to improving socio-economic factors, (eg household crowding), tobacco smoke exposure, and access to health care and illness prevention programs that likely contribute to these issues. Although each indigenous group may have unique health beliefs and interfaces with modern health care, a culturally sensitive and community-based comprehensive care system of preventive and long term care can improve outcomes for all these conditions. This article focuses on common respiratory conditions encountered by indigenous children living in affluent countries where data is available.
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Affiliation(s)
- A B Chang
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Brisbane, Australia; Queensland Respiratory Centre, Royal Children's Hospital, Brisbane, Queensland Medical Research Institute, Queensland University of Technology, Brisbane, Australia.
| | - N Brown
- National Aboriginal Community Controlled Health Organisation and University of Wollongong, Wollongong, New South Wales, Australia
| | - M Toombs
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Brisbane, Australia; Indigenous Health, Toowoomba Rural Clinical School, University of Queensland
| | - R L Marsh
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Brisbane, Australia
| | - G J Redding
- University of Washington School of Medicine, Pediatric Pulmonary Division, Children's Hospital and Regional Medical Center, Seattle, Washington, USA
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Risk factors for nonwork-related adult-onset asthma and occupational asthma: a comparative review. Curr Opin Allergy Clin Immunol 2014; 14:84-94. [PMID: 24535141 DOI: 10.1097/aci.0000000000000042] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW To identify the similarities and differences between nonwork-related adult-onset and occupational asthma from various literature sources published between 2010 and 2013, with respect to the epidemiology, phenotypic manifestations, and risk factors for the disease. RECENT FINDINGS The incidence of adult-onset asthma from pooled population studies is estimated to be 3.6 per 1000 person-years in men and 4.6 cases per 1000 person-years in women. In adults with new-onset asthma, occupational asthma is a common asthma phenotype. Work-related factors are estimated to account for up to 25% of adult cases of asthma and occupational asthma comprising about 16% of adult-onset asthma cases. The review finds that nonwork-related adult-onset asthma is a heterogenous entity and that environmental exposure factors (aside from occupational exposures) appear to have a lesser role than host factors when compared with occupational asthma. SUMMARY Large-scale general population studies are needed to identify the similarities and differences between nonwork-related adult-onset and occupational asthma, which may enable a better understanding of these entities and promote efforts towards holistic management approaches for these asthma phenotypes.
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Asthma education program for First Nations children: an exemplar of the knowledge-to-action framework. Can Respir J 2014; 20:295-300. [PMID: 23936889 DOI: 10.1155/2013/260489] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The prevalence of asthma in Aboriginal children is 6% to 14%. Gaps in knowledge regarding asthma and its management exist in First Nations (FN) communities, and culturally relevant education and resources are required. Studies have recommended that the children's asthma education program, the 'Roaring Adventures of Puff', be modified through partnership with FN communities to be culturally appropriate. OBJECTIVE To adapt this knowledge tool and design an effective implementation process for FN knowledge users (children with asthma and care providers), guided by the Canadian Institutes of Health Research knowledge translation framework. METHODS The problem was identified, knowledge was identified⁄reviewed⁄selected (literature review); knowledge was adapted to the local context (FN working and advisory groups); barriers to knowledge use were assessed (by knowledge users); and interventions were selected, tailored and implemented (modified curricula and the creation of a new activity book and web-based resources, and regional coordinators, asthma educator mentors and community teams were recruited). RESULTS Major outcomes were the adapted tools and blueprints for tailoring implementation. Additional outcomes were preliminary observations and outputs from the iterative processes, including information about local context and barriers. Specific additions were roles for community members supported by asthma educators (applying FN teaching models and addressing health care demands); relevant triggers (addressing knowledge gaps); and FN images and stories, themes of circle, sacred teachings, nature and family⁄elders (culture and addressing low reading levels). CONCLUSION The framework model provides a logical, valuable tool for adapting a knowledge tool and implementation process to new knowledge users. Future research should measure uptake, effect on health outcomes of FN asthma sufferers and sustainability.
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Chronic airways disease in First Nations, Inuit and Métis in Canada. Can Respir J 2013; 19:353-4. [PMID: 23248797 DOI: 10.1155/2012/590658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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