Improving asthma self-efficacy: Developing and testing a pilot community-based asthma intervention for African American adults

Martin, Molly A.; Catrambone, Cathy; Kee, Romina; Evans, Arthur T.; Sharp, Lisa K.; Lyttle, Christopher S.; Rucker-Whitaker, Cheryl; Weiss, Kevin B.; Shannon, John J.

doi:10.1016/j.jaci.2008.10.057

Cited by 67 publications

(98 citation statements)

References 39 publications

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“…(18) In that study, although there were several educational moments for the patient, environmental control, which was the objective of our study, was not addressed.…”

Section: Discussionmentioning

confidence: 97%

Repercussão de uma intervenção educativa com agentes comunitários de saúde nas condições ambientais de domicílios de crianças asmáticas

et al. 2011

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OBJETIVO: Verificar o impacto de uma intervenção educativa problematizadora sobre o controle ambiental para aeroalérgenos, conduzida por agentes comunitários de saúde, nos domicílios de crianças com asma. MÉTODOS: Estudo prospectivo de intervenção. Foram visitados 95 domicílios com crianças (faixa etária de 2-10 anos) com episódios recorrentes de dispneia e sibilância no município de Iguatu (CE). A intervenção educativa envolveu grupos focais com agentes comunitários de saúde com a problematização sobre medidas educativas a serem implementadas. Após a intervenção, 84 domicílios foram revisitados e reavaliados. RESULTADOS: Após a intervenção, houve uma redução significativa na limpeza do piso com vassoura (p = 0,02), no uso de fogão a carvão (p = 0,001) e no número de bichos de pelúcia no domicílio (p = 0,05). Houve uma melhoria significativa no controle ambiental para aeroalérgenos nos quartos das crianças após a intervenção (p = 0,003). CONCLUSÕES: A intervenção educativa mostrou ser uma importante ferramenta junto à população estudada, minimizando os aspectos negativos das condições ambientais dos domicílios das crianças asmáticas

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“…(18) In that study, although there were several educational moments for the patient, environmental control, which was the objective of our study, was not addressed.…”

Section: Discussionmentioning

confidence: 97%

Repercussão de uma intervenção educativa com agentes comunitários de saúde nas condições ambientais de domicílios de crianças asmáticas

et al. 2011

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“…Using a previously published categorization of DB scores, 46 16 (67 %) were in the very good range (≥20), 6 (25 %) in the good range (15-19), 2 (8 %) in the fair range (10)(11)(12)(13)(14), and none (0 %) were rated as poor (<10). The ten randomized clinical trials were the most highly rated (range [16][17][18][19][20][21][22][23][24][25][26] …”

Section: Study Qualitymentioning

confidence: 99%

“…The majority of the interventions were education-based (n = 15);five were culturally tailored; three defined by the studies' authors 22,23,25 and two by our review. 24,26 None of the CTE studies included a comparison group. Three focused on the African American population, [22][23][24] one on the Latino community, 25 and one used language-appropriate education for different Asian populations.…”

Section: Intervention Sub-typesmentioning

confidence: 99%

“…24,26 None of the CTE studies included a comparison group. Three focused on the African American population, [22][23][24] one on the Latino community, 25 and one used language-appropriate education for different Asian populations. 26 Four CTE interventions demonstrated improved outcomes.…”

Section: Intervention Sub-typesmentioning

confidence: 99%

“…26 Four CTE interventions demonstrated improved outcomes. [23][24][25][26] The remaining ten educational interventions were not specifically culturally tailored, but did include a majority of non-white participants; most included a majority of African American participants, though one included a majority of Latino/a participants. Of these ten interventions, all but one took place at least partially in the hospital setting, 29 in contrast to the CTE interventions that were primarily outpatient-based.…”

Section: Intervention Sub-typesmentioning

confidence: 99%

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Interventions to Improve Outcomes for Minority Adults with Asthma: A Systematic Review

et al. 2012

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OBJECTIVES:To systematically review the literature to characterize interventions with potential to improve outcomes for minority patients with asthma. DATA SOURCES: Medline, PsycINFO, CINAHL, Cochrane Trial Databases, expert review, reference review, meeting abstracts. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTEVENTIONS: Medical Subject Heading (MeSH) terms related to asthma were combined with terms to identify intervention studies focused on minority populations. Inclusion criteria: adult population; intervention studies with majority of non-White participants. STUDY APPRAISAL AND SYNTHESIS OF METHODS:Study quality was assessed using Downs and Black (DB) checklists. We examined heterogeneity of studies through comparing study population, study design, intervention characteristics, and outcomes. RESULTS: Twenty-four articles met inclusion criteria. Mean quality score was 21.0. Study populations targeted primarily African American (n=14), followed by Latino/a (n=4), Asian Americans (n=1), or a combination of the above (n=5). The most commonly reported post-intervention outcome was use of health care resources, followed by symptom control and self-management skills. The most common intervention-type studied was patient education. Although less-than half were culturally tailored, language-appropriate education appeared particularly successful. Several system-level interventions focused on specialty clinics with promising findings, although health disparities collaboratives did not have similarly promising results. LIMITATIONS: Publication bias may limit our findings; we were unable to perform a meta-analysis limiting the review's quantitative evaluation. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS:Overall, education delivered by health care professionals appeared effective in improving outcomes for minority patients with asthma. Few were culturally tailored and one included a comparison group, limiting the conclusions that can be drawn from cultural tailoring. Systemredesign showed great promise, particularly the use of team-based specialty clinics and long-term follow-up after acute care visits. Future research should evaluate the role of tailoring educational strategies, focus on patient-centered education, and incorporate outpatient follow-up and/or a team-based approach.

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Community Health Worker Home Visits for Adults With Uncontrolled Asthma

2015

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IMPORTANCE Asthma is often poorly controlled. Home visitation by community health workers (CHWs) to improve control among adults has not been adequately evaluated. OBJECTIVE To test the hypothesis that CHW home visits for adults with uncontrolled asthma improve outcomes relative to usual care. DESIGN, SETTING, AND PARTICIPANTS Randomized parallel group study with 1-year follow-up, conducted 2008 through 2011 at homes of low-income adults aged 18 to 65 years with uncontrolled asthma living in King County, Washington. INTERVENTIONS The CHWs provided a mean of 4.9 home visits during a 1-year period to assess asthma control, self-management, and home environment and to support asthma self-management practices. MAIN OUTCOMES AND MEASURES Primary prespecified outcomes were symptom-free days (number of 24-hour periods in prior 2 weeks without asthma symptoms), asthma-related quality of life (Mini Asthma Quality of Life Questionnaire), and asthma-related unscheduled health care use. RESULTS Of 463 individuals who completed eligibility screening, 443 were eligible, 366 participated (177 in intervention and 189 in control groups), and 333 completed the study (91%). The intervention group had significantly greater increases in mean symptom-free days per 2 weeks (2.02 [95% CI, 0.94-3.09]; P < .001) and quality of life (0.50 [95% CI, 0.28-0.71] points; P < .001) relative to the control group, adjusted for age, sex, race/ethnicity, and education level. The number needed to treat to increase symptom-free days by 2 days per 2 weeks was 7.4 and to improve quality of life by 0.5 points was 2.6. Mean urgent health care use episodes in the past 12 months decreased significantly and similarly in both groups, from a mean of 3.46 to 1.99 episodes in the intervention group (mean change, −1.47 [95% CI, −2.28 to −0.67]; P < .001) and from a mean of 3.30 to 1.96 episodes in the control group (mean change, −1.34 [95% CI, −2.00 to −0.72]; P < .001) (P = .83 comparing groups). CONCLUSIONS AND RELEVANCE The provision of in-home asthma self-management support by CHWs to low-income adults with uncontrolled asthma improves asthma control and quality of life but not unscheduled health care use. Additional studies are needed to confirm these findings and determine the value of wider implementation of this approach. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01783028

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Improving asthma self-efficacy: Developing and testing a pilot community-based asthma intervention for African American adults

Abstract: Background-Low-income African American adults in Chicago have disproportionately high asthma morbidity and mortality rates. Interventions that improve asthma self-efficacy for appropriate self-management behaviors may ultimately improve asthma control in this population.

Cited by 67 publications

References 39 publications

Repercussão de uma intervenção educativa com agentes comunitários de saúde nas condições ambientais de domicílios de crianças asmáticas

Repercussão de uma intervenção educativa com agentes comunitários de saúde nas condições ambientais de domicílios de crianças asmáticas

Interventions to Improve Outcomes for Minority Adults with Asthma: A Systematic Review

Community Health Worker Home Visits for Adults With Uncontrolled Asthma

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