Chronic conditions among children, adolescents, and young adults in acute care settings

Abstract Background Despite a growing prevalence of chronic disease risk factors, such as obesity, among young people in the United States and other countries, little is known about actual disease prevalence in this population. Almost nothing is known about this topic in many racial/ethnic groups that are rapidly growing in the United States, including Native Hawaiians, Other Pacific Islanders, and Filipinos. Yet these understudied groups are at high risk. The study goal was to determine the statewide prevalence of chronic disease in acute care for those aged 5-29 years, including Native Hawaiians, Filipinos, and Pacific Islanders. Methods Using Hawai'i statewide inpatient and emergency department (ED) data across all payers from 2015-2016, we considered the presence of at least one of five target chronic conditions (asthma, hypertension, chronic kidney disease, diabetes, stroke) from 13,514 inpatient stays by 9,467 unique individuals and 228,548 ED visits by 127,854 individuals. Results Twenty-eight percent of youth who were hospitalized and 12% with an ED visit had at least one chronic condition. In both inpatient and ED settings, race/ethnicity, age group, and payer varied significantly when comparing those with a chronic condition to those without a chronic condition. Notably, those with a chronic condition were disproportionately Native Hawaiian, Filipino, and Pacific Islander; 32.3% percent of those with an inpatient chronic condition and 34.9% of those with an ED chronic condition were Native Hawaiian. Conclusions Chronic diseases, including those more often seen in adulthood, are prevalent in young people in acute care settings in the state of Hawai'i with notable disparities. This data can help justify, guide, and support programs urgently needed to address these changing epidemiological trends, which may be of particular interest for Medicaid. Key messages We show that chronic conditions are prevalent in young people in acute care settings in the state of Hawai‘i with notable disparities. This can help justify, guide, and support programs to address these troubling epidemiological trends.

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Asian Americans and Pacific Islanders: Employment Issues in the United States

10.36650/nexus9.1-2_58-69_kim ◽

2011 ◽

Vol 9 (1-2) ◽

pp. 58-69

Author(s):

Marlene Kim

Keyword(s):

United States ◽

Asian Americans ◽

The United States ◽

Current Data ◽

Pacific Islanders ◽

Native Hawaiians ◽

Data Sets ◽

High Poverty ◽

Unemployment Rates

Asian Americans and Pacific Islanders (AAPIs) in the United States face problems of discrimination, the glass ceiling, and very high long-term unemployment rates. As a diverse population, although some Asian Americans are more successful than average, others, like those from Southeast Asia and Native Hawaiians and Pacific Islanders (NHPIs), work in low-paying jobs and suffer from high poverty rates, high unemployment rates, and low earnings. Collecting more detailed and additional data from employers, oversampling AAPIs in current data sets, making administrative data available to researchers, providing more resources for research on AAPIs, and enforcing nondiscrimination laws and affirmative action mandates would assist this population.

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Student Perceptions and Understanding of Client-Therapist Interactions Within the Inpatient Acute Care Environment: Qualitative Study

Physical Therapy ◽

10.2522/ptj.20140207 ◽

2015 ◽

Vol 95 (2) ◽

pp. 235-248 ◽

Cited By ~ 3

Author(s):

Lorna M. Hayward ◽

Kristin C. Greenwood ◽

Matthew Nippins ◽

Alicia Canali

Keyword(s):

Student Perceptions ◽

Acute Care ◽

Professional Competence ◽

Physical Therapists ◽

Sampling Technique ◽

The United States ◽

Doctor Of Physical Therapy ◽

Inpatient Settings ◽

Acute Care Settings ◽

The Impact

BackgroundPhysical therapists practicing in inpatient acute care settings in the United States work in a 21st century health care system that requires professional competence in clinical reasoning and decision making. For doctor of physical therapy (DPT) students, the development of confidence in the patient evaluation and the professional skills necessary for managing the inpatient environment can be challenging.ObjectiveThe study's purpose was to understand whether the early exposure of students to inpatient settings informed their understanding of the thought processes and actions of experienced clinicians during client interactions.DesignA qualitative design was used.MethodsThirty-three DPT students working in inpatient settings were recruited from 15 unique inpatient hospital (acute care and rehabilitation) facilities with a convenience sampling technique. Reflective data were collected for 1 month with clinician-facilitated discussion boards.ResultsFour themes emerged: environment, communication, evaluation, and client-therapist interaction. The themes informed a conceptual model depicting the observation by DPT students of factors that influenced interactions between clients and experienced clinicians in inpatient settings. Reflection on the what, the how, and the why that informed clinical decisions enabled students to recognize the situated nature of evaluation and treatment approaches.LimitationsThe use of a sample from 1 year of a DPT program at one university reduced the generalizability of the results.ConclusionsLimited research has examined student perceptions of the interactions of experienced clinicians with clients in inpatient acute care settings. More research is needed to understand the impact of exposing students to the thoughts and actions of therapists working in such settings earlier within DPT curricula.

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Prevalence of Selected Chronic Conditions Among Children, Adolescents, and Young Adults in Acute Care Settings in Hawai‘i

Preventing Chronic Disease ◽

10.5888/pcd17.190448 ◽

2020 ◽

Vol 17 ◽

Author(s):

Tetine Sentell ◽

So Yung Choi ◽

Lance Ching ◽

Michelle Quensell ◽

L. Brooke Keliikoa ◽

...

Keyword(s):

Young Adults ◽

Acute Care ◽

Chronic Conditions ◽

Adolescents And Young Adults ◽

Acute Care Settings

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What Contributes to Diagnostic Error or Delay? A Qualitative Exploration Across Diverse Acute Care Settings in the United States

Journal of Patient Safety ◽

10.1097/pts.0000000000000817 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Amelia Barwise ◽

Aaron Leppin ◽

Yue Dong ◽

Chanyan Huang ◽

Yuliya Pinevich ◽

...

Keyword(s):

United States ◽

Acute Care ◽

Diagnostic Error ◽

The United States ◽

Acute Care Settings ◽

Qualitative Exploration

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National Prevalence of Multidrug-Resistance Multidrug- Resistant in Enterobacteriaceae in the Ambulatory and Acute Care Settings in the United States in 2015

Open Forum Infectious Diseases ◽

10.1093/ofid/ofw172.242 ◽

2016 ◽

Vol 3 (suppl_1) ◽

Author(s):

Hina Patel ◽

Holly Hoffman-Roberts ◽

Ying P. Tabak ◽

John Mohr ◽

Richard S. Johannes ◽

...

Keyword(s):

United States ◽

Multidrug Resistance ◽

Acute Care ◽

The United States ◽

Multidrug Resistant ◽

Acute Care Settings ◽

National Prevalence

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Web-Based Peer Support Interventions for Adults Living With Chronic Conditions: Scoping Review (Preprint)

10.2196/preprints.14321 ◽

2019 ◽

Author(s):

Saima N Hossain ◽

Susan B Jaglal ◽

John Shepherd ◽

Laure Perrier ◽

Jennifer R Tomasone ◽

...

Keyword(s):

Peer Support ◽

Social Participation ◽

Scoping Review ◽

Chronic Conditions ◽

Chronic Condition ◽

Support Programs ◽

Web Based ◽

Randomized Controlled ◽

Appraisal Support ◽

Key Characteristics

BACKGROUND Globally, 1 in 3 adults live with multiple chronic conditions. Thus, effective interventions are needed to prevent and manage these chronic conditions and to reduce the associated health care costs. Teaching effective self-management practices to people with chronic diseases is one strategy to address the burden of chronic conditions. With the increasing availability of and access to the internet, the implementation of web-based peer support programs has become increasingly common. OBJECTIVE The purpose of this scoping review is to synthesize existing literature and key characteristics of web-based peer support programs for persons with chronic conditions. METHODS This scoping review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping reviews guidelines. Studies were identified by searching MEDLINE, CINAHL, Embase, PsycINFO, and the Physiotherapy Evidence Database. Chronic diseases identified by the Public Health Agency of Canada were included. Our review was limited to peer support interventions delivered on the web. Peers providing support had to have the chronic condition that they were providing support for. The information abstracted included the year of publication, country of study, purpose of the study, participant population, key characteristics of the intervention, outcome measures, and results. RESULTS After duplicates were removed, 12,641 articles were screened. Data abstraction was completed for 41 articles. There was a lack of participant diversity in the included studies, specifically with respect to the conditions studied. There was a lack of studies with older participants aged ≥70 years. There was inconsistency in how the interventions were described in terms of the duration and frequency of the interventions. Informational, emotional, and appraisal support were implemented in the studied interventions. Few studies used a randomized controlled trial design. A total of 4 of the 6 randomized controlled trials reported positive and significant results, including decreased emotional distress and increased health service navigation, self-efficacy, social participation, and constructive attitudes and approaches. Among the qualitative studies included in this review, there were several positive experiences related to participating in a web-based peer support intervention, including increased compassion and improved attitudes toward the individual’s chronic condition, access to information, and empowerment. CONCLUSIONS There is limited recent, high-level evidence on web-based peer support interventions. Where evidence exists, significant improvements in social participation, self-efficacy, and health-directed activity were demonstrated. Some studies incorporated a theoretical framework, and all forms of peer support—emotional, informational, and appraisal support—were identified in the studies included in this review. We recommend further research on web-based peer support in more diverse patient groups (eg, for older adults and chronic conditions outside of cancer, cardiovascular disease, and HIV or AIDS). Key gaps in the area of web-based peer support will serve to inform the development and implementation of future programs. CLINICALTRIAL

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Web-Based Peer Support Interventions for Adults Living With Chronic Conditions: Scoping Review

JMIR Rehabilitation and Assistive Technologies ◽

10.2196/14321 ◽

2021 ◽

Vol 8 (2) ◽

pp. e14321

Author(s):

Saima N Hossain ◽

Susan B Jaglal ◽

John Shepherd ◽

Laure Perrier ◽

Jennifer R Tomasone ◽

...

Keyword(s):

Peer Support ◽

Social Participation ◽

Scoping Review ◽

Chronic Conditions ◽

Chronic Condition ◽

Support Programs ◽

Web Based ◽

Randomized Controlled ◽

Appraisal Support ◽

Key Characteristics

Background Globally, 1 in 3 adults live with multiple chronic conditions. Thus, effective interventions are needed to prevent and manage these chronic conditions and to reduce the associated health care costs. Teaching effective self-management practices to people with chronic diseases is one strategy to address the burden of chronic conditions. With the increasing availability of and access to the internet, the implementation of web-based peer support programs has become increasingly common. Objective The purpose of this scoping review is to synthesize existing literature and key characteristics of web-based peer support programs for persons with chronic conditions. Methods This scoping review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping reviews guidelines. Studies were identified by searching MEDLINE, CINAHL, Embase, PsycINFO, and the Physiotherapy Evidence Database. Chronic diseases identified by the Public Health Agency of Canada were included. Our review was limited to peer support interventions delivered on the web. Peers providing support had to have the chronic condition that they were providing support for. The information abstracted included the year of publication, country of study, purpose of the study, participant population, key characteristics of the intervention, outcome measures, and results. Results After duplicates were removed, 12,641 articles were screened. Data abstraction was completed for 41 articles. There was a lack of participant diversity in the included studies, specifically with respect to the conditions studied. There was a lack of studies with older participants aged ≥70 years. There was inconsistency in how the interventions were described in terms of the duration and frequency of the interventions. Informational, emotional, and appraisal support were implemented in the studied interventions. Few studies used a randomized controlled trial design. A total of 4 of the 6 randomized controlled trials reported positive and significant results, including decreased emotional distress and increased health service navigation, self-efficacy, social participation, and constructive attitudes and approaches. Among the qualitative studies included in this review, there were several positive experiences related to participating in a web-based peer support intervention, including increased compassion and improved attitudes toward the individual’s chronic condition, access to information, and empowerment. Conclusions There is limited recent, high-level evidence on web-based peer support interventions. Where evidence exists, significant improvements in social participation, self-efficacy, and health-directed activity were demonstrated. Some studies incorporated a theoretical framework, and all forms of peer support—emotional, informational, and appraisal support—were identified in the studies included in this review. We recommend further research on web-based peer support in more diverse patient groups (eg, for older adults and chronic conditions outside of cancer, cardiovascular disease, and HIV or AIDS). Key gaps in the area of web-based peer support will serve to inform the development and implementation of future programs.

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Dramatic Increases in Obesity and Overweight Prevalence among Asian Subgroups in the United States, 1992–2011

ISRN Preventive Medicine ◽

10.5402/2013/898691 ◽

2013 ◽

Vol 2013 ◽

pp. 1-12 ◽

Cited By ~ 15

Author(s):

Gopal K. Singh ◽

Sue C. Lin

Keyword(s):

Asian Indians ◽

Chinese Immigrants ◽

The United States ◽

Pacific Islanders ◽

Native Hawaiians ◽

Obesity Prevalence ◽

Foreign Born ◽

Obesity And Overweight ◽

The Us ◽

Overweight Prevalence

We examined trends in adult obesity and overweight prevalence among major Asian/Pacific Islander (API) subgroups and the non-Hispanic whites from 1992 to 2011. Using 1992–2011 National Health Interview Surveys, obesity, overweight, and BMI differentials were analyzed by logistic, linear, and log-linear regression. Between 1992 and 2011, obesity prevalence doubled for the Chinese, the Asian Indians, the Japanese, and the Hawaiians/Pacific Islanders; and tripled for the Filipinos. Obesity prevalence among API adults tripled from 3.7% in 1992 to 13.3% in 2010, and overweight prevalence doubled from 23.2% to 43.1%. Immigrants in each API subgroup had lower prevalence than their US-born counterparts, with immigrants’ obesity and overweight risks increasing with increasing duration of residence. During 2006–2011, obesity prevalence ranged from 3.3% for Chinese immigrants to 22.3% for the US-born Filipinos and 41.1% for the Native Hawaiians/Pacific Islanders. The Asian Indians, the Filipinos, and the Hawaiians/Pacific Islanders had, respectively, 3.1, 3.8, and 10.9 times higher odds of obesity than those of the Chinese adults. Compared with Chinese immigrants, the adjusted odds of obesity were 3.5–4.6 times higher for the US-born Chinese and the foreign-born Filipinos, 9 times higher for the US-born Filipinos and whites, 3.8–5.5 times higher for the US-born and foreign-born Asian Indians, and 21.9 times higher for the Native Hawaiians. Substantial ethnic heterogeneity and rising prevalence underscore the need for increased monitoring of obesity and obesity-related risk factors among API subgroups.

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Health-Related Quality of Life of Young People With and Without Chronic Conditions

Journal of Pediatric Psychology ◽

10.1093/jpepsy/jsaa052 ◽

2020 ◽

Vol 45 (7) ◽

pp. 780-792

Author(s):

Martin Pinquart

Keyword(s):

Quality Of Life ◽

Young People ◽

Chronic Conditions ◽

Chronic Condition ◽

Psychosocial Health ◽

Health Related Quality ◽

Child Gender ◽

Related Quality ◽

Health Related

Abstract Objective The aim of this meta-analysis was to compare levels of health-related quality of life (HRQOL) among children with and without chronic physical and/or sensory conditions, based on PedsQL 4.0 General Core Scales. Methods Studies were identified with electronic databases (CINAHL, PSYCINFO, MEDLINE, Google Scholar, PSYNDEX) and from the PedsQL website. We included controlled studies that compared PedsQL scores of children (mean age < 18 years) with and without chronic physical and/or sensory conditions and uncontrolled studies on children with chronic physical and/or sensory conditions from countries where data from peers without chronic conditions have been published. Random-effects meta-analyses were computed. Results In total, 1,231 studies fulfilled the inclusion criteria. There were large declines of the total and physical score as well as medium-sized declines of psychosocial health and its subscales, based on criteria of interpreting effect sizes by Cohen [Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159]. Children with cerebral palsy and spina bifida showed the largest declines across all scales, but significant declines emerged in all compared 29 chronic conditions. We identified moderating effects of duration of the chronic condition, rater, child gender, country, sociodemographic equivalence of the compared groups, type of control condition, and publication status. Conclusions Young people with chronic health conditions should be screened for HRQOL, and the profile across different domains should be preferred over the use of a sum score. Child self-reports are particularly relevant for assessing emotional and social functioning. Effective measures aimed at improving HRQOL are needed, especially if the chronic condition leads to severe declines of physical functioning.

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