The Breathmobile™:: A novel comprehensive school-based mobile asthma care clinic for urban underprivileged children
The Breathmobile™:: A novel comprehensive school-based mobile asthma care clinic for urban underprivileged children
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DOI：
10.1111/j.1746-1561.2006.00119.x
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发表时间：
2006-08-01
影响因子：
2.2
通讯作者：
Galant, Stanley P.
中科院分区：
文献类型：
--
作者：
Liao, Otto;Morphew, Tricia;Galant, Stanley P.
城市少数民族儿童哮喘发病率较高，原因是多方面的。许多以学校为基础的项目已经得到资助，以改善哮喘管理，特别是对这些“高危”的市中心哮喘儿童。在这里，我们报告的结果橙子县儿童医院呼吸移动的计划，这是一个以学校为基础的哮喘计划，结合使用移动的诊所和儿科哮喘专家。基线评估包括详细的病史和体格检查、常见过敏原皮肤点刺试验、肺功能测定和基于现行国家哮喘教育和预防计划指南的哮喘严重程度分类。从2002年4月到2005年9月，共有1321名儿童接受了哮喘评估。对1112名（84%）被诊断为哮喘的儿童的分析显示，人群平均年龄为7.8岁，81%为拉丁裔，73%为持续性疾病。在基线时，只有24%的持续性哮喘儿童每天服用抗炎药物，到第一次随访时增加到78%。在进入该计划的前一年，64%的人因哮喘缺课（38% > 10天），45%的人急诊（28% > 1次），19%的人住院（9% > 1次）。与计划实施前和实施后相比，急诊室就诊、住院和缺课的年发生率显著降低（p <0.001）。这些数据表明，一个移动的哮喘货车诊所在学校的网站与哮喘专家可能是一个有效的模式，在减少发病率，在服务不足的儿童哮喘。有必要进一步研究，以确定这一模式是否适用于其他市中心的设置。
Urban minority children have higher rates of asthma morbidity due to multiple factors. Many school-based programs have been funded to improve asthma management, especially for these "high-risk" inner-city children with asthma. Here we report the outcomes of the Children's Hospital of Orange County Breathmobile program, which is a school-based asthma program that combines the use of a mobile clinic and a pediatric asthma specialist. Baseline evaluations included a detailed history and physical, skin prick test to common allergens, spirometry measurements, and asthma severity classification based on the current National Asthma Education and Prevention Program guidelines. From April 2002 to September 2005, a total of 1321 children were evaluated for asthma. Analysis of the 1112 (84%) children diagnosed with asthma showed a population mean age of 7.8 years, 81% Latino ethnicity, and 73% with persistent disease. At baseline, only 24% of children with persistent asthma were on daily anti-inflammatory medications, which increased to 78% by the first follow-up visit. In the year prior to entry into the program, 64% had school absenteeism related to asthma (38% > 10 days), 45% had emergency room (ER) visits (28% > 1), and 19% had hospitalizations (9% > 1). There was a significant reduction (p < .001) in the annual rates of ER visits, hospitalizations, and school absenteeism when comparing pre- and postentry into the program. These data suggest that a mobile asthma van clinic at the school site with an asthma specialist could be an effective model in reducing morbidity, in the underserved child with asthma. Further studies are necessary to determine whether this model is applicable to other inner-city settings.