Addressing asthma health disparities: a multilevel challenge.
Addressing asthma health disparities: a multilevel challenge.
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DOI：
10.1016/j.jaci.2009.02.043
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发表时间：
2009-06
影响因子：
14.2
通讯作者：
Rand, Cynthia S.
中科院分区：
文献类型：
--
作者：
Canino, Glorisa;McQuaid, Elizabeth L.;Rand, Cynthia S.
大量研究证明，与非拉丁裔白人相比，少数族裔人群在患病率、严重程度和发病率方面普遍存在差异。造成这些差异的根本原因还没有得到很好的理解，因此，解决这些差异的杠杆点仍然不清楚。为了促进未来的研究和临床实践，提出了一个整合哮喘健康差异研究的多层次框架。该模型的组成部分包括卫生保健政策和法规、卫生保健系统的运行、提供者/临床医生层面的因素、社会/环境因素以及个人/家庭的态度和行为。研究表明，哮喘差异有多重、复杂和相互关联的根源。当个人、环境、卫生系统和提供者因素随着时间的推移相互作用时，就会出现差异。鉴于哮喘差异的原因是复杂和多层次的，因此解决这些差异的临床策略必须是多层次的，并针对哮喘护理的许多方面。临床意义：本文描述了几种可应用于临床环境以减少哮喘差异的策略，包括对患者信念进行常规评估的必要性、疾病管理的经济障碍和健康素养，以及向卫生保健提供者团体提供文化能力培训和沟通技巧。
Substantial research has documented pervasive disparities in the prevalence, severity, and morbidity of asthma among minority populations compared to non-Latino whites. The underlying causes of these disparities are not well understood, and as a result, the leverage points to address them remain unclear. A multilevel framework for integrating research in asthma health disparities is proposed in order to advance both future research and clinical practice. The components of the proposed model include health care policies and regulations, operation of the health care system, provider/clinician-level factors, social/environmental factors, and individual/family attitudes and behaviors. The body of research suggests that asthma disparities have multiple, complex and inter-related sources. Disparities occur when individual, environmental, health system, and provider factors interact with one another over time. Given that the causes of asthma disparities are complex and multilevel, clinical strategies to address these disparities must therefore be comparably multilevel and target many aspects of asthma care. Clinical Implications: Several strategies that could be applied in clinical settings to reduce asthma disparities are described including the need for routine assessment of the patient’s beliefs, financial barriers to disease management, and health literacy, and the provision of cultural competence training and communication skills to health care provider groups.
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影响因子：
14.2
作者：
Chen, Edith;Hanson, Margaret D.;Miller, Gregory E.
通讯作者：
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DOI：
10.1164/rccm.200309-1293oc
发表时间：
2004-02-01
影响因子：
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作者：
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影响因子：
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作者：
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通讯作者：
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