Family Caregiver Marginalization is Associated With Decreased Primary and Subspecialty Asthma Care in Head Start Children.
Family Caregiver Marginalization is Associated With Decreased Primary and Subspecialty Asthma Care in Head Start Children.
复制标题
DOI：
10.1016/j.acap.2018.04.135
复制
发表时间：
2018-11
影响因子：
3.1
通讯作者：
Eakin MN
中科院分区：
文献类型：
--
作者：
Sadreameli SC;Riekert KA;Matsui EC;Rand CS;Eakin MN
Urban minority children are at risk for poor asthma outcomes and may not receive appropriate primary or subspecialty care. We hypothesized that preschool children with asthma whose caregivers reported more barriers to care would be less likely to have seen their primary care provider (PCP) or an asthma subspecialist and more likely to have had a recent emergency department (ED) visit for asthma. The Barriers to Care Questionnaire (BCQ) measures expectations, knowledge, marginalization, pragmatics, and skills. We assessed asthma control via TRACK and these outcomes: PCP visits for asthma in past six months, subspecialty care (allergist or pulmonologist) in past two years, and ED visits in past three months. 395 caregivers (96% African-American, 82% low-income, 96% Medicaid) completed the BCQ. Sixty percent(N=236) of children had uncontrolled asthma, 86% had seen a PCP, 23% had seen a subspecialist, and 29% had an ED visit. Barriers related to marginalization were associated with decreased likelihood of PCP (OR 0.95, p=0.014) and subspecialty visits (OR 0.92, p=0.019). Overall BCQ score was associated with decreased likelihood of subspecialty care (OR 0.98, p=0.027). Barriers related to expectations, knowledge, pragmatics, and skills were not associated with any of the care outcomes. Among low-income, predominantly African-American preschool children with asthma, primary and subspecialty care were less likely if caregivers reported past negative experiences with the healthcare system (marginalization). Clinicians who serve at-risk populations should be sensitive to families’ past experiences and should consider designing interventions to target the most commonly reported barriers. In a group of preschool-age, urban, predominantly African-American children with asthma, caregiver-reported barriers related to marginalization were associated with decreased likelihood of primary and subspecialty asthma care, indicating a potential target for future interventions to improve asthma outcomes.
登录
查看更多内容
影响因子：
8
作者：
Mansour, ME;Lanphear, BP;DeWitt, TG
通讯作者：
DeWitt, TG
影响因子：
6.2
作者：
Baren, JM;Shofer, FS;Hollander, JE
通讯作者：
Hollander, JE
影响因子：
8
作者：
Akinbami, Lara J.;Moorman, Jeanne E.;Sondik, Edward J.
通讯作者：
Sondik, Edward J.
影响因子：
1.4
作者：
Grineski, Sara
通讯作者：
Grineski, Sara
影响因子：
1.9
作者：
SPERBER, K;IBRAHIM, H;CORN, B
通讯作者：
CORN, B