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 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.

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.

Community Change Process

2017 ◽  
Author(s):  
Leslie Hollingsworth ◽  
Larry M. Gant ◽  
Patricia L. Miller
Keyword(s):  
Needs Assessment ◽  
Change Process ◽  
Planning Process ◽  
Action Plan ◽  
Community Change ◽  
Community Needs ◽  
Community Needs Assessment ◽  
Planning Phase

Abstract: This chapter summarizes and discusses the planning phase of the community change process that comprised the three Good Neighborhoods phases (planning, readiness, and transformation). The purpose of the planning phase was to engage neighborhood residents and stakeholders in a community-wide planning process that would result in a community goal and action plan that was community-owned and -driven. In this chapter, the authors describe and discuss the process by which engagement of the community, needs assessment, and planning took place. The authors use the Osborn neighborhood as the case, recognizing that, as much as possible, the same process was followed in each of the six neighborhoods.

Family asthma management in urban children and its association with sleep outcomes

2021 ◽  
pp. 136749352110147
Author(s):  
Maria T Coutinho ◽  
Clara G Sears ◽  
Rebecca Noga ◽  
Elizabeth L McQuaid ◽  
Sheryl J Kopel ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Duration ◽  
Management Practices ◽  
Environmental Control ◽  
Asthma Management ◽  
Persistent Asthma ◽  
Structured Interview ◽  
Urban Children ◽  
Quality Data ◽  
Management Interventions

Asthma symptoms impact children’s sleep quality. However, it is unclear how families’ daily management of their child’s asthma is associated with sleep quality. We examine associations between family asthma management components and sleep duration and quality for urban children (ages 7–9 years). Additionally, we examine these associations by racial/ethnic group. Data were collected as part of a longitudinal study that examined the co-occurrence of asthma, allergic rhinitis, sleep quality, and academic functioning for urban children diagnosed with persistent asthma ( N = 196). A semi-structured interview assessed family asthma management practices. Sleep quality data were collected via actigraphy. Our visual depiction of sleep outcomes show that those with higher family asthma management ratings present with longer sleep duration and better sleep quality. Among specific family asthma management components, we found a significant association between children’s adherence to asthma medications and number of nighttime awakenings. For non-Latino Black (NLB) children, we found a significant association between environmental control and sleep duration. For urban children with asthma, clinical strategies to enhance overall family asthma management have the potential to support improved sleep quality. Additionally, for NLB children, asthma management interventions that provide environmental control practices may increase sleep duration.

scholarly journals The convergence of racial and income disparities in health insurance coverage in the United States

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
De-Chih Lee ◽  
Hailun Liang ◽  
Leiyu Shi
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Combined Effect ◽  
Medical Expenditure ◽  
The Us ◽  
Race Ethnicity ◽  
Vulnerability Measure

Abstract Objective This study applied the vulnerability framework and examined the combined effect of race and income on health insurance coverage in the US. Data source The household component of the US Medical Expenditure Panel Survey (MEPS-HC) of 2017 was used for the study. Study design Logistic regression models were used to estimate the associations between insurance coverage status and vulnerability measure, comparing insured with uninsured or insured for part of the year, insured for part of the year only, and uninsured only, respectively. Data collection/extraction methods We constructed a vulnerability measure that reflects the convergence of predisposing (race/ethnicity), enabling (income), and need (self-perceived health status) attributes of risk. Principal findings While income was a significant predictor of health insurance coverage (a difference of 6.1–7.2% between high- and low-income Americans), race/ethnicity was independently associated with lack of insurance. The combined effect of income and race on insurance coverage was devastating as low-income minorities with bad health had 68% less odds of being insured than high-income Whites with good health. Conclusion Results of the study could assist policymakers in targeting limited resources on subpopulations likely most in need of assistance for insurance coverage. Policymakers should target insurance coverage for the most vulnerable subpopulation, i.e., those who have low income and poor health as well as are racial/ethnic minorities.

Presence through absence? Understanding the role of capital in the African Human Rights Action Plan

2020 ◽  
Vol 58 (4) ◽  
pp. 579-600
Author(s):  
Obiora Chinedu Okafor ◽  
Sanaa Ahmed ◽  
Sylvia Bawa ◽  
Ibironke Odumosu-Ayanu
Keyword(s):  
Human Rights ◽  
Low Income ◽  
Action Plan ◽  
Significant Degree ◽  
Universal Declaration ◽  
Low Income Countries ◽  
Significant Extent ◽  
Global Capital ◽  
Market Practices

AbstractThis study examines the African Human Rights Action Plan (AHRAP) through the lens of Upendra Baxi's germinal theory on the emergence in our time of a ‘trade-related, market-friendly human rights’ (TREMF) thesis that is challenging the specific understandings of ‘people-centric’ human rights that are predicated in the letter and spirit of the Universal Declaration of Human Rights (UDH). Baxi contends, instead, that the dominant strands of the contemporary understandings of human rights are – for the most part – designed to protect the interests of global capital. That said, human rights frameworks in low-income countries need to be studied with a view to what they say and don't say about global capital. Despite its attempt to facilitate a progressive realisation of human rights in Africa, the AHRAP does not rise far enough above the TREMF paradigm to re-locate itself within the UDH one. This is due to the AHRAP not adequately theorising and analysing the role of capital in the (non)realisation of human rights in Africa. By allowing trade and market practices to slip to a significant extent beyond its purview, the AHRAP privileges – to a significant degree – the needs/interests of capital over the human rights of ordinary Africans. That is, the victims of the excesses of capital in Africa are reincarnated in the AHRAP document by the fact of their exclusion from it.

scholarly journals 320 Obstetric clinician needs assessment for a postpartum patient navigation program for low-income patients

2021 ◽  
Vol 224 (2) ◽  
pp. S210
Author(s):  
Rachel S. Ruderman ◽  
Emma C. Dahl ◽  
Brittney R. Williams ◽  
Joe M. Feinglass ◽  
Michelle Kominiarek ◽  
...  
Keyword(s):  
Needs Assessment ◽  
Low Income ◽  
Patient Navigation ◽  
Navigation Program

scholarly journals Adapting the Community-based Health Planning and Services (CHPS) to engage poor urban communities in Ghana: protocol for a participatory action research study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049564
Author(s):  
Mary Abboah-Offei ◽  
Akosua Gyasi Darkwa ◽  
Andrews Ayim ◽  
Adelaide Maria Ansah-Ofei ◽  
Delanyo Dovlo ◽  
...  
Keyword(s):  
Action Research ◽  
Participatory Action Research ◽  
Urban Communities ◽  
Low Income ◽  
Urban Areas ◽  
Health Planning ◽  
Phase 1 ◽  
Participatory Action ◽  
Community Based ◽  
Key Stakeholders

IntroductionWith rapid urbanisation in low-income and middle-income countries, health systems are struggling to meet the needs of their growing populations. Community-based Health Planning and Services (CHPS) in Ghana have been effective in improving maternal and child health in rural areas; however, implementation in urban areas has proven challenging. This study aims to engage key stakeholders in urban communities to understand how the CHPS model can be adapted to reach poor urban communities.Methods and analysisA Participatory Action Research (PAR) will be used to develop an urban CHPS model with stakeholders in three selected CHPS zones: (a) Old Fadama (Yam and Onion Market community), (b) Adedenkpo and (c) Adotrom 2, representing three categories of poor urban neighbourhoods in Accra, Ghana. Two phases will be implemented: phase 1 (‘reconnaissance phase) will engage and establish PAR research groups in the selected zones, conduct focus groups and individual interviews with urban residents, households vulnerable to ill-health and CHPS staff and key stakeholders. A desk review of preceding efforts to implement CHPS will be conducted to understand what worked (or not), how and why. Findings from phase 1 will be used to inform and co-create an urban CHPS model in phase 2, where PAR groups will be involved in multiple recurrent stages (cycles) of community-based planning, observation, action and reflection to develop and refine the urban CHPS model. Data will be managed using NVivo software and coded using the domains of community engagement as a framework to understand community assets and potential for engagement.Ethics and disseminationThis study has been approved by the University of York’s Health Sciences Research Governance Committee and the Ghana Health Service Ethics Review Committee. The results of this study will guide the scale-up of CHPS across urban areas in Ghana, which will be disseminated through journal publications, community and government stakeholder workshops, policy briefs and social media content. This study is also funded by the Medical Research Council, UK.

The School Nurse Role in Asthma Management: Can the Action Plan Help?

2005 ◽  
Vol 21 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Anne Borgmeyer ◽  
Patricia Jamerson ◽  
Patricia Gyr ◽  
Nina Westhus ◽  
Emily Glynn
Keyword(s):  
Action Plan ◽  
Asthma Management ◽  
School Nurse ◽  
School Nurses ◽  
Direct Care ◽  
Continued Education ◽  
Nurse Role ◽  
Chronic Disorder ◽  
Asthma Action Plans ◽  
Valuable Role

Asthma is the most common chronic disorder in American schoolchildren, and school nurses play a valuable role in its management. A study was conducted in which school nurses were asked to describe their role in caring for students with asthma and their use of Asthma Action Plans (AAPs). The nurses indicated that they frequently provided direct care and education. They were comfortable with providing care to students with asthma and familiar with AAPs. Having an AAP increased their confidence in managing students with asthma. This emphasizes the need for continued education regarding the AAP and the development of policies that direct care and encourage use of an AAP at school.

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