Comprehensive Community-Based Intervention and Asthma Outcomes in African American Adolescents

Naar, Sylvie; Ellis, Deborah A.; Cunningham, Phillippe B.; Pennar, Amy L.; Lam, Phebe; Brownstein, Naomi C.; Bruzzese, Jean-Marie

doi:10.1542/peds.2017-3737

Cited by 20 publications

(51 citation statements)

References 43 publications

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“…Potential Interventions Reducing exposure to psychosocial stressors and improving response to them are potential targets for intervention. A randomized clinical trial of Multisystemic Therapy-an intensive family and community-based approach-found that the intervention significantly improved lung function, adherence, and control for black adolescents with poorly controlled asthma [141] consistent with other evidence supporting family therapy for health [142]. Early data suggests other interventions to improve coping, such as mindfulness-based stress reduction, may be beneficial [143,144].…”

Section: Psychosocial Stress: Childhood Adversity and Community Violencementioning

confidence: 56%

Structural and Social Determinants of Health in Asthma in Developed Economies: a Scoping Review of Literature Published Between 2014 and 2019

Sullivan

Thakur

2020

Curr Allergy Asthma Rep

121

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Purpose of Review Using the WHO Conceptual Framework for Action on the Social Determinants of Health, this review provides a discussion of recent epidemiologic, mechanistic, and intervention studies of structural and social determinants of health and asthma outcomes covering the period from 2014 to 2019. Recent Findings A majority of studies and interventions to date focus on the intermediary determinants of health (e.g., housing), which as the name suggests, exist between the patient and the upstream structural determinants of health (e.g., housing policy). Race/ethnicity remains a profound social driver of asthma disparities with cumulative risk from many overlapping determinants. A growing number of studies on asthma are beginning to elucidate the underlying mechanisms that connect social determinants to human disease. Several effective interventions have been developed, though a need for large-scale policy research and innovation remains. Summary Strong evidence supports the key role of the structural determinants, which generate social stratification and inequity, in the development and progression of asthma; yet, interventions in this realm are challenging to develop and therefore infrequent. Proximal, intermediary determinants have provided a natural starting point for interventions, though structural interventions have the most potential for major impact on asthma outcomes. Further research to investigate the interactive effect of multiple determinants, as well as intervention studies, specifically those that are cross-sector and propose innovative strategies to target structural determinants, are needed to address asthma morbidities, and more importantly, close the asthma disparity gap.

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Section: Psychosocial Stress: Childhood Adversity and Community Violencementioning

confidence: 56%

Structural and Social Determinants of Health in Asthma in Developed Economies: a Scoping Review of Literature Published Between 2014 and 2019

Sullivan

Thakur

2020

Curr Allergy Asthma Rep

121

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“…Where AYA are struggling to successfully self‐manage their asthma, psychological interventions using a CBT based or multi‐systemic therapy approach can be recommended to improve asthma knowledge, improve adherence, self‐management and symptom control (Grade B) 39‐42 . This is based on a small number of randomized controlled asthma trials.…”

Section: Transition Specific To Allergic Conditions And/or Asthmamentioning

confidence: 99%

EAACI Guidelines on the effective transition of adolescents and young adults with allergy and asthma

Roberts

Vazquez‐Ortiz

Knibb

et al. 2020

Allergy

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Adolescent and young adult (AYA) patients need additional support, while they experience the challenges associated with their age. They need specific training to learn the knowledge and skills required to confidently self‐manage their allergies and/or asthma. Transitional care is a complex process, which should address the psychological, medical, educational and vocational needs of AYA in the developmentally appropriate way. The European Academy of Allergy and Clinical Immunology has developed a clinical practice guideline to provide evidence‐based recommendations for healthcare professionals to support the transitional care of AYA with allergy and/or asthma. This guideline was developed by a multidisciplinary working panel of experts and patient representatives based on two recent systematic reviews. It sets out a series of general recommendations on operating a clinical service for AYA, which include the following: (a) starting transition early (11‐13 years), (b) using a structured, multidisciplinary approach, (c) ensuring AYA fully understand their condition and have resources they can access, (d) active monitoring of adherence and (e) discussing any implications for further education and work. Specific allergy and asthma transition recommendations include (a) simplifying medication regimes and using reminders; (b) focusing on areas where AYA are not confident and involving peers in training AYA patients; (c) identifying and managing psychological and socio‐economic issues impacting disease control and quality of life; (d) enrolling the family in assisting AYA to undertake self‐management; and (e) encouraging AYA to let their friends know about their allergies and asthma. These recommendations may need to be adapted to fit into national healthcare systems.

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“…Twelve papers reporting on nine studies explored the impact of psychological interventions on adolescents with asthma ( Figure 1). [17][18][19][20][21][22][23][24][25][26][27][28] Eight papers were from the USA, three from Iran and one from Germany. All but two of the studies were randomized controlled trials; Hempel et al 17 employed a nonrandomized controlled design and Hemati et al 18,19 conducted alternate allocation to intervention or control group.…”

Section: Psychological Interventionsmentioning

confidence: 99%

“…Three papers reported findings from a prospective randomized controlled trial using Multisystemic Therapy for African American adolescents with moderately to severe poorly controlled asthma. [25][26][27] This therapy incorporates cognitive behavioural therapy to promote behavioural changes and coping skills, delivered at home over 6 months. Adherence, asthma knowledge, asthma symptoms and hospitalizations were found to significantly improve in the intervention compared with the control group, [25][26][27] with a per protocol analysis showing a medium effect on adherence.…”

Section: Psychological Interventionsmentioning

confidence: 99%

The effectiveness of interventions to improve self‐management for adolescents and young adults with allergic conditions: A systematic review

Knibb

Alviani

Garriga‐Baraut

et al. 2020

Allergy

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Background: This systematic review aimed to review the literature on interventions for improving self-management and well-being in adolescents and young adults (11-25 years) with asthma and allergic conditions. Methods: A systematic literature search was undertaken across eight databases. References were checked by two reviewers for inclusion. Study data were extracted, and their quality was assessed in duplicate. A narrative synthesis was undertaken. Results: A total of 30 papers reporting data from 27 studies were included. Interventions types were psychological (k = 9); e-health (k = 8); educational (k = 4); peer-led (k = 5); breathing retraining (k = 1). All interventions were for asthma. Psychological interventions resulted in significant improvements in the intervention group compared with the control group for self-esteem, quality of life, self-efficacy, coping strategies, mood and asthma symptoms. E-Health interventions reported significant improvements for inhaler technique, adherence and quality of life. General educational interventions demonstrated significantly improved quality of life, management of asthma symptoms, controller medication use, increased use of a written management plan and reduction in symptoms. The peer-led interventions included the Triple A (Adolescent Asthma Action) programme and a peer-led camp based on the Power Breathing Programme. Improvements were found for self-efficacy, school absenteeism and quality of life. Conclusion: Although significant improvements were seen for all intervention types, many were small feasibility or pilot studies, few studies reported effect sizes and no studies for allergic conditions other than asthma met the inclusion criteria. Research using large longitudinal interventional designs across the range of allergic conditions is required to strengthen the evidence base.

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Comprehensive Community-Based Intervention and Asthma Outcomes in African American Adolescents

Cited by 20 publications

References 43 publications

Structural and Social Determinants of Health in Asthma in Developed Economies: a Scoping Review of Literature Published Between 2014 and 2019

Structural and Social Determinants of Health in Asthma in Developed Economies: a Scoping Review of Literature Published Between 2014 and 2019

EAACI Guidelines on the effective transition of adolescents and young adults with allergy and asthma

The effectiveness of interventions to improve self‐management for adolescents and young adults with allergic conditions: A systematic review

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