Asthma in Head Start children: effects of the Breathmobile program and family communication on asthma outcomes.
Asthma in Head Start children: effects of the Breathmobile program and family communication on asthma outcomes.
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DOI：
10.1016/j.jaci.2011.10.013
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发表时间：
2012-03
期刊：
影响因子：
--
通讯作者：
Riekert KA
中科院分区：
文献类型：
--
作者：
Eakin MN;Rand CS;Bilderback A;Bollinger ME;Butz A;Kandasamy V;Riekert KA
城市中心的儿童哮喘发病率和死亡率很高。缺乏常规的初级保健提供者（PCP）访问，获得护理的机会少，以及患者与医生沟通不畅可能是促成因素。本研究评价了仅提供Breathmobile服务、仅提供易化哮喘沟通干预（FACI）或Breathmobile+FACI对哮喘结局的影响（相对于标准治疗）。哮喘儿童（n=322，平均年龄=4岁，53%男性，97%非裔美国人）从巴尔的摩市的Head Start项目中招募，并随机分为四组。结果指标包括无哮喘天数、紧急护理使用（急诊室就诊和住院）和药物使用（口服类固醇疗程和哮喘控制药物比例），由护理人员在基线、6个月和12个月评估时报告。进行广义估计方程模型，以检查与标准治疗相比，Breathmobile和FACI的差异治疗效果。联合治疗组（Breathmobile+FACI）的儿童无菌天数（SFD）增加了1.7（6.6%），但在12个月时没有维持。在意向治疗分析中，仅FACI组6个月时的艾德访视次数增加，但在12个月时或事后治疗分析中不存在。与标准治疗组相比，干预组在所有其他结局指标上均无显著差异。除了Breatmobile+FACI组在6个月时SFD略有改善外，干预组分并未导致哮喘管理或哮喘发病率的任何显著改善。
Asthma morbidity and mortality rates are high among young inner-city children. Lack of routine primary care provider (PCP) visits, poor access to care, and poor patient-physician communication may be contributing factors. This study evaluated the effects of providing Breathmobile services only, a Facilitated Asthma Communication Intervention (FACI) only, or both Breathmobile+FACI on asthma outcomes, relative to standard care. Children with asthma (n=322, mean age=4 years, 53% male, 97% African American) were recruited from Head Start programs in Baltimore City and randomized into four groups. Outcome measures included symptom-free days, urgent care use (emergency department visits and hospitalizations) and medication use (courses of oral steroids and proportion on an asthma controller medication) as reported by caregivers at baseline, 6-, and 12-month assessments. Generalized Estimating Equations models were conducted to examine the differential treatment effects of Breathmobile and FACI compared to standard care. Children in the combined treatment group (Breathmobile+FACI) had an increase of 1.7 (6.6%) symptom-free days (SFD) that was not maintained at 12 months. In intent-to-treat analyses, the FACI-only group had an increase in the number of ED visits at 6 months, which was not present at 12 months or in the post hoc as-treated analyses. No significant differences were found between the intervention groups as compared to standard care on all other outcome measures. Other than a slight improvement in SFD at 6 months in the Breatmobile+FACI group, the intervention components did not result in any significant improvements in asthma management or asthma morbidity.
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影响因子：
2.2
作者：
Murray, Nancy G.;Low, Barbara J.;Davis, Sally M.
通讯作者：
Davis, Sally M.
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作者：
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作者：
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影响因子：
2.2
作者：
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影响因子：
5.9
作者：
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通讯作者：
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