Identification of gaps in the diagnosis and treatment of childhood asthma using a community-based participatory research approach
Identification of gaps in the diagnosis and treatment of childhood asthma using a community-based participatory research approach
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DOI：
10.1093/jurban/jth131
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发表时间：
2004-09-01
影响因子：
6.6
通讯作者：
Brown, RW
中科院分区：
文献类型：
--
作者：
Lewis, TC;Robins, TG;Brown, RW
这项调查的目标是使用基于社区的参与性研究方法来开发、试点测试和管理哮喘筛查问卷，以识别社区环境中患有哮喘和哮喘症状的儿童。这项研究是作为“社区反哮喘行动”的招募工作而进行的，这是一项旨在减少哮喘环境诱因的家庭干预的随机试验，并不是作为经典的患病率研究而设计的。我们向密歇根州底特律的两个地理区域（主要是非裔美国人和西班牙裔人口）的 9,627 名 5 至 11 岁儿童的家长邮寄和/或亲自递交了哮喘筛查问卷。通过社区网络分发了额外的调查问卷。测量包括家长报告孩子出现呼吸道症状的频率、医生诊断为哮喘的情况以及医生处方哮喘药物的使用频率。在 3,067 份已完成的调查问卷中，1,570 份（返回调查的 51.2%，合格人群的 16.3%）符合任何严重程度的哮喘，398 份（返回调查的 12.9%，合格人群的 4.1%）符合中度至重度哮喘的标准。在符合中度至重度哮喘标准的人中，超过30%的人没有被医生诊断，超过一半的人没有每天服用哮喘药物，四分之一的人在过去一年没有服用任何医生开的哮喘药物。在基于社区的参与性研究伙伴关系的背景下进行的筛查调查可以识别大量患有未确诊和/或治疗不足的中重度哮喘的儿童。这些儿童可能会受益于降低发病率和提高生活质量的干预措施。
The goal of this investigation was to use a community-based participatory research approach to develop, pilot test, and administer an asthma screening questionnaire to identify children with asthma and asthma symptoms in a community setting. This study was conducted as the recruitment effort for Community Action Against Asthma, a randomized trial of a household intervention to reduce exposure to environmental triggers of asthma and was not designed as a classic prevalence study. An asthma screening questionnaire was mailed and/or hand delivered to parents of 9,627 children, aged 5 to 11 years, in two geographic areas of Detroit, Michigan, with predominantly African American and Hispanic populations. Additional questionnaires were distributed via community networking. Measurements included parent report of their child's frequency of respiratory symptoms, presence of physician diagnosis of asthma, and frequency of doctor-prescribed asthma medication usage. Among the 3,067 completed questionnaires, 1,570 (51.2% of returned surveys, 16.3% of eligible population) were consistent with asthma of any severity and 398 (12.9% of returned surveys, 4.1% of eligible population) met criteria for moderate-to-severe asthma. Among those meeting criteria for moderate-to-severe asthma, over 30% had not been diagnosed by a physician, over one half were not taking daily asthma medication, and one quarter had not taken any physician-prescribed asthma medication in the past year. Screening surveys conducted within the context of a community-based participatory research partnership can identify large numbers of children with undiagnosed and/or undertreated moderate-to-severe asthma. These children are likely to benefit from interventions to reduce morbidity and improve quality of life.