Effects of pediatric asthma care coordination in underserved communities on parent perceptions of care and asthma-management confidence

Autor: Victoria Persky, Gilberto Ramos-Valencia, Floyd J. Malveaux, Ashley Garrity, Kimberly E. Uyeda, Rebecca Hazan, Alan P. Baptist, Mary R. Janevic, Tyra Bryant-Stephens, Marielena Lara
Rok vydání: 2016
Předmět:
Pulmonary and Respiratory Medicine
Male
Parents
medicine.medical_specialty
Health Knowledge
Attitudes
Practice
Adolescent
Urban Population
Interprofessional Relations
Asthma management
Trust
Asthma care
Health Services Accessibility
Likert scale
03 medical and health sciences
0302 clinical medicine
Nursing
Professional-Family Relations
030225 pediatrics
Asthma control
medicine
Immunology and Allergy
Humans
030212 general & internal medicine
Parental perception
Healthcare Disparities
Child
Socioeconomic status
Poverty
Pediatric asthma
Asthma
business.industry
Communication
Health Status Disparities
Continuity of Patient Care
medicine.disease
Self Efficacy
United States
respiratory tract diseases
Patient Satisfaction
Family medicine
Child
Preschool
Pediatrics
Perinatology and Child Health
Female
Perception
business
Zdroj: The Journal of asthma : official journal of the Association for the Care of Asthma. 54(5)
ISSN: 1532-4303
Popis: Disparities by race and socioeconomic status persist in pediatric asthma morbidity, mortality, and treatment. Improving parent/provider communication and parents' asthma-management confidence may result in better asthma control in vulnerable populations. The Merck Childhood Asthma Network, Inc. funded an initiative to implement medical-social care coordination to improve asthma outcomes at sites in four low-income, urban communities (Los Angeles, CA; Philadelphia, PA; Chicago, IL; and San Juan, PR.) As part of a cross-site evaluation of this effort, pre- post-program changes in parents' reports of asthma care and management were assessed.Across sites, 805 parents or other caregivers responded to a baseline survey that was repeated one year later following their child's participation in care coordination. Parents' asthma-management confidence, as well as their perceptions of provider access, trust, and communication, were measured with Likert scales. Linear mixed models were used to assess improvement in these variables, across and within sites, adjusting for sociodemographics.Pooled across sites, the adjusted mean estimate for all outcomes showed a significant improvement (p.05) from baseline to follow-up. Knowledge and Between-Provider Communication improved significantly (p.05) within all four sites; Access improved significantly in Chicago, Philadelphia, and Puerto Rico; Trust improved significantly in Chicago, Los Angeles, and Philadelphia; and Patient-Provider Communication improved significantly in Philadelphia only.Pediatric asthma care coordination, as implemented variously in diverse settings, was associated with improvement in parents' perceptions of asthma care and self-reported asthma-management knowledge and confidence. This positive impact on parents may help sustain care coordination's impact on children.
Databáze: OpenAIRE
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