The influence of community violence and protective factors on asthma morbidity and healthcare utilization in high-risk children
| Autor: | Philip Osteen, Melissa H. Bellin, Cassie Land, Joan Kub, Arlene Butz, Kathryn S. Collins |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Gerontology
Adult Male medicine.medical_specialty Emergency Medical Services Health (social science) Urban Population Psychological intervention Poison control Violence Occupational safety and health Article law.invention Randomized controlled trial law Epidemiology Injury prevention Medicine Humans Child Poverty Asthma business.industry Latent growth modeling Public Health Environmental and Occupational Health Models Theoretical Patient Acceptance of Health Care Protective Factors medicine.disease United States Urban Studies Black or African American Caregivers Social Conditions Child Preschool Physical therapy Female Morbidity business |
| Zdroj: | Journal of urban health : bulletin of the New York Academy of Medicine. 91(4) |
| ISSN: | 1468-2869 |
| Popis: | We examined the longitudinal effects of community risk and protective factors on asthma morbidity and healthcare utilization. Three hundred urban caregivers of children with poorly controlled asthma were enrolled in a randomized controlled trial testing the effectiveness of a behavioral/educational intervention and completed measures of exposure to community violence (ECV), social cohesion (SC), informal social control (ISC), child asthma control, child asthma symptom days/nights, and healthcare utilization. Latent growth curve modeling examined the direct and interaction effects of ECV, SC, and ISC on the asthma outcomes over 12 months. Caregivers were primarily the biological mother (92 %), single (70 %), and poor (50 % earned less than $10,000). Children were African American (96 %) and young (mean age = 5.5 years, SD = 2.2). ECV at baseline was high, with 24.7 % of caregivers reporting more than two exposures to violence in the previous 6 months (M = 1.45, SD = 1.61). Caregiver ECV-predicted asthma-related healthcare utilization at baseline (b = 0.19, SE = 0.07, p = 0.003) and 2 months (b = 0.12, s.e. = 0.05, p = 0.04). ISC and SC moderated the effect of ECV on healthcare utilization. Our findings suggest that multifaceted interventions that include strategies to curb violence and foster feelings of cohesion among low-income urban residents may be needed to reduce asthma-related emergency services. |
| Databáze: | OpenAIRE |
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