A pilot school-based health center intervention to improve asthma chronic care in high-poverty schools.
| Autor: | Holmes LC; Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA., Orom H; Department of Community Health and Health Behavior, University at Buffalo School of Public Health and Health Professions, Buffalo, NY, USA., Lehman HK; Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA., Lampkin S; Department of Pharmacy Practice, D'Youville College, Buffalo, NY, USA., Halterman JS; Department of Pediatrics, University of Rochester School of Medicine, Rochester, NY, USA., Akiki V; Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA., Supernault-Sarker AA; Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA., Butler SB; Catholic Health Systems, Buffalo, NY, USA., Piechowski D; John R. Oishei Children's Hospital, Kaleida Health, Buffalo, NY, USA., Sorrentino PM; John R. Oishei Children's Hospital, Kaleida Health, Buffalo, NY, USA., Chen Z; Department of Biostatistics, University at Buffalo School of Public Health and Health Professions, Buffalo, NY, USA., Wilding GE; Department of Biostatistics, University at Buffalo School of Public Health and Health Professions, Buffalo, NY, USA. |
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| Jazyk: | angličtina |
| Zdroj: | The Journal of asthma : official journal of the Association for the Care of Asthma [J Asthma] 2022 Mar; Vol. 59 (3), pp. 523-535. Date of Electronic Publication: 2021 Jan 06. |
| DOI: | 10.1080/02770903.2020.1864823 |
| Abstrakt: | Objective: To test the feasibility and effectiveness of a multifaceted intervention administered through school-based health centers (SBHCs) to improve asthma control for children in high-poverty schools with not well controlled asthma. Methods: Students 4-14 years old with persistent asthma were enrolled from three SBHCs. The centers' advanced practice providers received training on evidence-based asthma guidelines. Students randomized to the intervention received directly observed therapy of their asthma controller medication, medication adjustments as needed by the centers' providers, and daily self-management support. Students randomized to usual care were referred back to their primary care provider (PCP) for routine asthma care. Results: We enrolled 29 students. Students in the intervention group received their controller medication 92% of days they were in school. Ninety-four percent of follow-up assessments were completed. During the study, 11 of 12 intervention students had a step-up in medication; 2 of 15 usual care students were stepped up by their PCP. Asthma Control Test scores did not differ between groups, although there were significant improvements from baseline to the 7 month follow-up within each group (both p < .01). Both FEV Conclusions: Our pilot data suggest that a multifaceted intervention can be feasibly administered through SBHCs in communities with health disparities. Despite the small sample size, spirometry detected advantages in the intervention group. Further study is needed to optimize the intervention and evaluate outcomes. Trial Registration: clinicaltrials.gov Identifier: NCT03032744. |
| Databáze: | MEDLINE |
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