Schools’ Capacity to Help Low-Income, Minority Children to Manage Asthma

2005 ◽  
Vol 21 (4) ◽  
pp. 236-242 ◽  
Author(s):  
Elizabeth W. Anderson ◽  
Melissa Valerio ◽  
Manlan Liu ◽  
Dana Jones Benet ◽  
Christine Joseph ◽  
...  
Keyword(s):  
Low Income ◽  
Asthma Management ◽  
School Personnel ◽  
Asthma Prevalence ◽  
Health Providers ◽  
Minority Children ◽  
Parents And Children ◽  
Nursing Services ◽  
Children With Asthma ◽  
The Impact

This article describes the challenges and strengths of asthma management in 14 low-income, predominantly African American urban elementary schools serving more than 5,000 students. Asthma prevalence was 24.5%. Teachers, school principals, parents, and children described how asthma was managed at school. Data from classmates of students with asthma showed that they had moderate to high levels of information about the disease. Data from teachers indicated the great need for practical instruction on how they might effectively support a child with asthma in the classroom and on the playground. Principals raised concerns about expectations for the functioning of school staff and implementation of school policies especially related to asthma emergencies. Parents reported a range of problems their children face at school. Data from children with asthma showed that 75% believed asthma affected their schoolwork. Findings from this study should be useful to school personnel, health providers, and others who assist children and their families to manage asthma at school. Data suggest that making school nursing services available is warranted, given the impact of asthma on the school community.

The impact of caregiver health literacy on healthcare outcomes for low income minority children with asthma

2019 ◽  
Vol 57 (12) ◽  
pp. 1316-1322 ◽  
Author(s):  
Paula Jo Belice ◽  
Giselle Mosnaim ◽  
Stanley Galant ◽  
Yoonsang Kim ◽  
Hye-Won Shin ◽  
...  
Keyword(s):  
Health Literacy ◽  
Low Income ◽  
Healthcare Outcomes ◽  
Minority Children ◽  
Caregiver Health ◽  
Children With Asthma ◽  
The Impact

Feasibility study of a communication and education asthma intervention for general practitioners in Australia

2010 ◽  
Vol 16 (1) ◽  
pp. 75 ◽  
Author(s):  
Smita Shah ◽  
Brett G. Toelle ◽  
Susan M. Sawyer ◽  
Jessica K. Roydhouse ◽  
Peter Edwards ◽  
...  
Keyword(s):  
General Practitioners ◽  
Controlled Trial ◽  
Communication Strategies ◽  
Asthma Management ◽  
Doctor Patient Communication ◽  
Children With Asthma ◽  
The Usa ◽  
Randomised Controlled ◽  
Communication Behaviours ◽  
The Impact

The Physician Asthma Care Education (PACE) program significantly improved asthma prescribing and communication behaviours of primary care paediatricians in the USA. We tested the feasibility and acceptability of a modified PACE program with Australian general practitioners (GP) and measured its impact on self-reported consulting behaviours in a pilot study. Recruitment took place through a local GP division. Twenty-five GP completed two PACE Australia workshops, which incorporated paediatric asthma management consistent with Australian asthma guidelines and focussed on effective communication strategies. Program feasibility, usefulness and perceived benefit were measured by questionnaires before the workshop and 1 month later, and an evaluation questionnaire after each workshop. GP were universally enthusiastic and supportive of the workshops. The most useful elements they reported were communication skills, case studies, device demonstrations and the toolkit provided. GP self reports of the perceived helpfulness of the key communication strategies and their confidence in their application and reported frequency of use increased significantly after the workshops. The PACE program shows promise in improving the way in which Australian GP manage asthma consultations, particularly with regard to doctor–patient communication. The impact of the modified PACE Australia program on the processes and outcomes of GP care of children with asthma is now being measured in a randomised controlled trial.

scholarly journals Asthma prevalence and the impact of nutritional status on prescribed asthma medications in children

2020 ◽  
Vol 73 (9-10) ◽  
pp. 265-270
Author(s):  
Vesna Petrovic ◽  
Vesna Vujic-Aleksic ◽  
Tanja Rozek-Mitrovic ◽  
Aleksandra Hristov
Keyword(s):  
Nutritional Status ◽  
Normal Weight ◽  
Asthma Prevalence ◽  
Obese Children ◽  
Primary Health Center ◽  
Cross Sectional ◽  
Asthma Symptoms ◽  
Children With Asthma ◽  
Nutritional Status Of Children ◽  
The Impact

Introduction. Asthma and obesity are the most common chronic health disorders in children. Although heredity plays a significant role in their development, environmental factors and early exposure have contributed to the increasing incidence of both disorders in recent decades. The aim of the study was to estimate asthma prevalence in schoolchildren in Indjija, Srem District, Serbia, and to investigate differences in nutritional status of children with asthma as well as differences between their nutritional status and prescribed asthma medications. Material and Methods. A cross-sectional retrospective cohort study was conducted at the Primary Health Center in Indjija. Of all the medical records of children aged 6 - 14 years, a cohort of children with asthma was formed. The retrospective study evaluated their nutritional status and the prescribed asthma medications. Results. The prevalence of asthma in children aged 6 - 14 was 6.9%. Children with asthma were significantly more overweight and obese (40.5%) than children without asthma. Boys accounted for 63.7% of children with asthma, with a statistically significant gender difference. Abnormal nutritional status was found in 44.3% of children with asthma and boys with asthma were significantly more obese (23%) compared to girls (7.8%). Overweight and obese children with asthma were not prescribed significantly more medications to relieve asthma symptoms than normal-weight children. Conclusion. The prevalence of asthma among schoolchildren in Indjija was 6.9%. Children with asthma were more likely to be overweight and obese than children without asthma, whereas boys with asthma were significantly more obese than girls. No significant differences were found between their nutritional status and prescribed asthma medications.

scholarly journals Cockroach exposure and childhood asthma:  Is the effect an artifact of confounding by stress?

2020 ◽  
Author(s):  
Felicia Rabito ◽  
Derek Werthmann ◽  
Hua He ◽  
Aubrey S. Madkour ◽  
Whitney D. Arroyave ◽  
...  
Keyword(s):  
Strong Association ◽  
High Stress ◽  
Asthma Management ◽  
Stress Path ◽  
Mediation Effect ◽  
Asthma Morbidity ◽  
Modifiable Factors ◽  
Children With Asthma ◽  
Ed Visits ◽  
The Impact

Abstract Background Nonpharmacologic interventions for asthma management rely on identification and mitigation of important asthma triggers. Cockroach exposure is strongly associated with asthma morbidity. It is also associated with stress, another risk factor for asthma. Despite high prevalence of both in vulnerable populations, the impact of joint exposure has not been examined. Methods Participants included 173 children with asthma in New Orleans, Louisiana. Cockroach exposure was based on visual inspection using standard protocols. Caregiver stress was measured using Cohen’s 4-item Perceived Stress Scale. Outcomes included unscheduled clinic or emergency department (ED) visits, hospitalization, and pulmonary function. Multivariable logistic regression was performed to assess independent effects of the exposure on the outcome and effect modification was examined in stratified analysis based on stress. Path analysis to explore the mediation effect by stress was performed using a probit link with parameters based on Bayes’ method with non-informative priors. Results Adjusting for stress and other covariates, cockroach exposure was associated with unscheduled clinic/ED visits (aOR = 6.2; 95% CI 1.8, 21.7). Positive associations were also found for hospitalization and FEV1 < 80%. High stress modified the relationship with unscheduled clinic/ED visits (high aOR = 7.7 95% CI 1.0, 60.2, versus normal aOR = 4.1 95% CI 0.8, 21.9). Path models identified direct and indirect effects (p = 0.05) indicating that a majority of the total effect on unscheduled clinic/ED visits is attributed directly to cockroach exposure. Conclusion The strong association between cockroach exposure and asthma morbidity is not due to uncontrolled confounding by stress. The combination of cockroach exposure and high stress, common in urban homes, are modifiable factors associated with poor asthma outcomes.

scholarly journals Whole genome sequencing of pharmacogenetic drug response in racially and ethnically diverse children with asthma

2017 ◽  
Author(s):  
Angel C.Y. Mak ◽  
Marquitta J. White ◽  
Zachary A. Szpiech ◽  
Walter L. Eckalbar ◽  
Sam S. Oh ◽  
...  
Keyword(s):  
African Americans ◽  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Drug Response ◽  
Puerto Ricans ◽  
Ethnically Diverse ◽  
Asthma Prevalence ◽  
Whole Genome ◽  
Minority Children ◽  
Children With Asthma

ABSTRACTAsthma is the most common chronic disease of children, with significant racial/ethnic differences in prevalence, morbidity, mortality and therapeutic response. Albuterol, a bronchodilator medication, is the first-line therapy for asthma treatment worldwide. We performed the largest whole genome sequencing (WGS) pharmacogenetics study to date using data from 1,441 minority children with asthma who had extremely high or low bronchodilator drug response (BDR). We identified population-specific and shared pharmacogenetic variants associated with BDR, including genome-wide significant (p < 3.53 x 10-7) and suggestive (p < 7.06 x 10-6) loci near genes previously associated with lung capacity (DNAH5), immunity (NFKB1 and PLCB1), and β-adrenergic signaling pathways (ADAMTS3 and COX18). Functional analyses centered on NFKB1 revealed potential regulatory function of our BDR-associated SNPs in bronchial smooth muscle cells. Specifically, these variants are in linkage disequilibrium with SNPs in a functionally active enhancer, and are also expression quantitative trait loci (eQTL) for a neighboring gene, SLC39A8. Given the lack of other asthma study populations with WGS data on minority children, replication of our rare variant associations is infeasible. We attempted to replicate our common variant findings in five independent studies with GWAS data. The age-specific associations previously found in asthma and asthma-related traits suggest that the over-representation of adults in our replication populations may have contributed to our lack of statistical replication, despite the functional relevance of the NFKB1 variants demonstrated by our functional assays. Our study expands the understanding of pharmacogenetic analyses in racially/ethnically diverse populations and advances the foundation for precision medicine in at-risk and understudied minority populations.AUTHOR SUMMARYAsthma is the most common chronic disease among children. Albuterol, a bronchodilator medication, is the first-line therapy for asthma treatment worldwide. In the U.S., asthma prevalence is the highest among Puerto Ricans, intermediate among African Americans and lowest in Whites and Mexicans. Asthma disparities extend to mortality, which is four- to five-fold higher in Puerto Ricans and African Americans compared to Mexicans [1]. Puerto Ricans and African Americans, the populations with the highest asthma prevalence and death rate, also have the lowest albuterol bronchodilator drug response (BDR). We conducted the largest pharmacogenetic study using whole genome sequencing data from 1,441 minority children with asthma who had extremely high or low albuterol bronchodilator drug response. We identified population-specific and shared pharmacogenetic variants associated with BDR. Our findings help inform the direction of future development of asthma medications and our study advances the foundation of precision medicine for at-risk, yet understudied, racially/ethnically diverse populations.

Health Planning That Magnifies the Community's Voice: Allies Against Asthma

2005 ◽  
Vol 32 (1) ◽  
pp. 113-128 ◽  
Author(s):  
Frances D. Butterfoss ◽  
Cynthia Kelly ◽  
Jude Taylor-Fishwick
Keyword(s):  
Needs Assessment ◽  
Low Income ◽  
Planning Process ◽  
Health Planning ◽  
Action Plan ◽  
Insurance Coverage ◽  
Asthma Management ◽  
Asthma Prevalence ◽  
Hampton Roads ◽  
Management Interventions

Allies Against Asthma, a working group of the Consortium for Infant and Child Health (CINCH), conducted a comprehensive asthma needs assessment in Hampton Roads, Virginia, in 2001. Results from extant data and parent surveys indicated that asthma prevalence was high (15% to 18%), 45% to 50% of children received primary care for asthma in the emergency department, 30% had been recently hospitalized, and most children were not adequately medicated. Focus groups revealed inadequate asthma education, low income, lack of resources and consistent care, disparities in insurance coverage, and noncompliance with national asthma guidelines. An integrated community asthma action plan was developed and funded. Members were satisfied with the planning process—88% felt the plan reflected the needs assessment, and 86% agreed the plan would effectively improve asthma management. Interventions commenced in January 2002. The inclusive process that led to these interventions will ensure that the project is successful and sustainable.

scholarly journals Between privilege and poverty: The affordances of mobility among aid worker children

2016 ◽  
Vol 25 (4) ◽  
pp. 489-506
Author(s):  
Anne-Meike Fechter
Keyword(s):  
Service Learning ◽  
Low Income ◽  
Personal Growth ◽  
Learning Activities ◽  
Low Income Countries ◽  
International Mobility ◽  
Life Chances ◽  
Local Elite ◽  
Parents And Children ◽  
The Impact

Contemporary research on children affected by migration in Southeast Asia has examined the impact of mobility on their life chances, choices and overall welfare. Extending this concern, this article seeks to address these questions in the context of privileged migration. Specifically, it asks how the mobility of children whose parents work for aid agencies in low-income countries shapes the way they understand and negotiate experiences of privilege, as well as their everyday encounters with poverty. Based on ethnographic research with young people and their families in Cambodia, the findings suggest that parents and children may envisage their international mobility as a chance for personal growth, specifically as manifest in the form of ‘open-mindedness.’ Such positive discourses are complicated, however, by a simultaneously engendered sense of superiority toward those who are less mobile. They are also intertwined with practices of ‘bracketing’ possible frictions arising from their interactions with children of local elite members. While the young people’s proximity to poverty provides opportunities for locally-based service-learning activities, connections with their parents’ work can remain abstract. The article therefore suggests that this form of international mobility may not, in itself, enable a critical engagement with poverty or with their own and others’ privilege.

scholarly journals Socio-demographics and asthma prevalence, management, and outcomes among children 1–11 years of age in California

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Jim E. Banta ◽  
Majed Ramadan ◽  
Noara Alhusseini ◽  
Khaled Aloraini ◽  
Naomi Modeste
Keyword(s):  
Language Proficiency ◽  
Low Income ◽  
English Language ◽  
Survey Design ◽  
Asthma Management ◽  
English Language Proficiency ◽  
California Health Interview Survey ◽  
Asthma Prevalence ◽  
Cross Sectional ◽  
Control Asthma

Abstract Background Asthma disproportionately affects minority and low-income children. We examined asthma prevalence, management and outcomes, focusing on race/ethnicity and acculturation of parents (particularly English language proficiency). Methods This cross-sectional, correlational analysis used a de-identified population-based survey, the California Health Interview Survey, for years 2001–2015. Survey-weighted analysis with SAS 9.4 was used to determine asthma prevalence among children 1 to 11 years of age. Descriptive analysis was conducted, adjusting for survey design and combination of multiple years of data. The Pearson test, using design-based F values was used to determine statistically significant differences between those having/not having a doctor diagnosis of asthma. Multivariable logistic regression, with jackknife approach to obtain confidence intervals, was used to examine associations of child and parental characteristics with asthma prevalence, management, and outcomes. Results The 61,625 completed surveys represented an estimated annual population of 5.7 million children, of which 12.9 % had asthma. There were significant (p < 0.001) differences by age, gender, race, and language proficiency, with higher asthma prevalence for children 6 to 11 years of age (15.5 %), males (15.3 %), African Americans (19.5 %), and parents speaking English very well (14.1 %). Compared to children whose parents spoke English very well, those whose parents spoke English not well or not at all were less likely to achieve optimal asthma management, i.e. to have received a management plan from doctor (OR 0.30; 95 % Confidence Interval 0.20–0.46)), to be currently taking medication to control asthma (OR 0.52; 95 % CI 0.36–0.74)), or to be not confident in ability to control asthma (OR 3.10; 95 % CI 1.49–6.42). Children whose parents spoke English fairly well rather than very well had worse outcomes, i.e. were more likely to have an emergency room visit in past 12 months (OR 1.92; 95 % CI 1.03–3.61) and were more likely to miss school due to asthma in past 12 months (OR 0.71; 1.01–2.94). Conclusions Socio-demographics had a limited role in explaining differences across a handful of asthma management and outcome measures in California. Parental English language proficiency had the most consistent influence, underscoring the need for culturally and linguistically competent care.

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