Recruitment, asthma characteristics, and medication behaviors in Midwestern Puerto Rican youth: data from Project CURA

Martin, Molly A.; Olson, Daniel J.; Mosnaim, Giselle; Ortega, Dorian; Rothschild, Steven K.

doi:10.1016/j.anai.2012.06.005

Cited by 17 publications

(32 citation statements)

References 32 publications

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“…The original cohort, the Community United to Challenge Asthma (CURA, Clinical Trials ID NCT01065883 and NCT01061424), was a randomized controlled trial in Puerto Rican youth. 39–42 CURA recruited 51 elementary and 50 high school participants from December 2009 to January 2011. 39 Participants were between 5–18 years old, self-identified as Puerto Rican, and had uncontrolled and/or persistent asthma over the past year.…”

Section: Methodsmentioning

confidence: 99%

“…39–42 CURA recruited 51 elementary and 50 high school participants from December 2009 to January 2011. 39 Participants were between 5–18 years old, self-identified as Puerto Rican, and had uncontrolled and/or persistent asthma over the past year. 5,39 The second cohort, Community United to Raise Awareness: Asthma and Active Living (CURA 2), was a follow-up study for children with both asthma and obesity.…”

Section: Methodsmentioning

confidence: 99%

“…39 Participants were between 5–18 years old, self-identified as Puerto Rican, and had uncontrolled and/or persistent asthma over the past year. 5,39 The second cohort, Community United to Raise Awareness: Asthma and Active Living (CURA 2), was a follow-up study for children with both asthma and obesity. Seventy-seven children were recruited from November 2011 to December 2013.…”

Section: Methodsmentioning

confidence: 99%

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What Really Happens in the Home: The Medication Environment of Urban, Minority Youth

Pappalardo

Karavolos

Martin

2017

The Journal of Allergy and Clinical Immunology: In Practice

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Background Asthma disproportionately affects minority youth. Understanding the home medication environment and its relation to medication adherence can shape interventions to improve health outcomes. Objective To describe the asthma medication environment in the homes of urban minority youth and to determine predictors of medication use and technique in this population. Methods Baseline data from two cohorts of minority youth with asthma in Chicago were combined for cross-sectional analysis. Bilingual research assistants (RAs) collected data in the home. RAs asked caregivers and children to self-report medications using pictures and observed children’s asthma medications and inhaler technique. Results The sample contained 175 mainly Latino youth (85.6%) ranging from 5–18 years old. Most were on public insurance (80%) and had uncontrolled asthma by self-report (89.7%). Only 27.4% had a spacer, 74.9% had a quick relief medicine and 48.6% had any controller medicine. RA observations of controllers agreed with children (36%) and parental self-report (42.3%) but did not match the specific observed controllers. Children reported less parental help with medications (43%) than their parents (58.1%). One child was able to properly demonstrate 100% of the inhaler steps and 35.6% achieved >70% of inhaler steps. Better medication technique was associated with having a controller (b=12.2, SE=3.0, p <0.0001), quick reliever (b=8.05, SE=3.5, p=0.023) and a spacer (b=9.3, SE=3.54, p=0.009). Conclusions This rigorous evaluation of the home medication environment of high risk youth demonstrated that many families lack critical medications, devices, and technique for proper management of asthma.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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What Really Happens in the Home: The Medication Environment of Urban, Minority Youth

Pappalardo

Karavolos

Martin

2017

The Journal of Allergy and Clinical Immunology: In Practice

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“…17 Objective measurement of medication adherence—especially among African American and Hispanic youth—is rare. 18–20 Interventions to improve adherence have not been rigorously tested in this population. 7 …”

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confidence: 99%

The Impact of Peer Support and mp3 Messaging on Adherence to Inhaled Corticosteroids in Minority Adolescents with Asthma: A Randomized, Controlled Trial

Mosnaim

Martin

et al. 2013

The Journal of Allergy and Clinical Immunology: In Practice

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Background Poor adherence to inhaled corticosteroids (ICS) is a critical risk factor contributing to asthma morbidity among low-income minority adolescents. Objective This trial tested whether peer support group meetings and peer asthma messages delivered via mp3 players improved adherence to ICS. Methods Low-income African American and/or Hispanic adolescents, ages 11–16, with persistent asthma, and poor (≤ 48%) adherence to prescription ICS during the 3-week run-in were randomized to intervention or attention control groups (ATG) for the 10-week treatment. During treatment, the intervention arm participated in weekly coping peer group support sessions and received mp3 peer-recorded asthma messages promoting adherence. The ATG participated in weekly meetings with a research assistant and received an equivalent number of mp3 doctor-recorded asthma messages. Adherence was measured using self-report and the DoserCT, (Meditrac, Inc.), an electronic dose counter. The primary outcome was the difference in adherence at 10 weeks between the two arms. Results Thirty-four subjects were randomized to each arm. At 10 weeks, no statistical difference in objectively measured adherence could be detected between the two arms adjusting for baseline adherence (P = 0.929). Adherence declined in both groups over the course of the active treatment period. Participants’ in both study arms self-reported adherence was significantly higher than their objectively measured adherence at week 10 (P < 0.0001). Conclusion Improving medication adherence in longitudinal studies is challenging. Peer support and mp3-delivered peer asthma messages may not be of sufficient dose to improve outcomes.

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“…A community-based participatory research approach was employed to design and oversee the study. The study built off of partnerships developed in previous research in a low income community area in Chicago with high documented asthma prevalence and morbidity [10, 13]. The study team included clinician researchers with expertise in behavioral interventions, asthma, obesity, and child development.…”

Section: Methodsmentioning

confidence: 99%

Addressing asthma and obesity in children with community health workers: proof-of-concept intervention development

et al. 2016

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BackgroundThe objective of this study was to design and test the feasibility and impact of a community health worker (CHW) intervention for comorbid asthma and obesity.MethodsUsing a proof of concept study design, we collected pre/post outcomes from a single intervention cohort of urban low-income in a single community area. A community-based participatory research approach was employed. Forty-six children and their caregivers were recruited. Children were 5–12 years old with physician-diagnosed asthma and body mass index (BMI) > 85%. Families were offered 12 home visits from CHWs that integrated asthma and obesity core curriculums. The primary asthma outcome was asthma control, measured via the Childhood Asthma Control Test (cACT). The primary obesity outcome was child body mass index (BMI).ResultsFamilies received a median of 10 out of the 12 home visits over 1 year. At 1 year, there was a significant improvement in the number of children with controlled asthma as measured via cACT (85.7% at 1 year compared to 61.9% at baseline, p = 0.01). Activity limitations and emergency utilization were reduced while inhaler technique improved (p < 0.01 for all). Child BMI z-score was reduced: mean = 1.97 (SD 0.79) at 1 year compared to mean = 2.13 (SD 0.40) at baseline, p < 0.01. No association was seen between change in child BMI and change in asthma control. Worse baseline child depression scores were associated with less improvement in asthma control (p = 0.003) and higher baseline caregiver post-traumatic stress disorder scores were associated with increased child BMI (p = 0.012).ConclusionsThe CHW intervention has promise for improving asthma and weight outcomes in high-risk children with comorbid asthma and obesity; this model warrants further development and investigation.

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Recruitment, asthma characteristics, and medication behaviors in Midwestern Puerto Rican youth: data from Project CURA

Cited by 17 publications

References 32 publications

What Really Happens in the Home: The Medication Environment of Urban, Minority Youth

What Really Happens in the Home: The Medication Environment of Urban, Minority Youth

The Impact of Peer Support and mp3 Messaging on Adherence to Inhaled Corticosteroids in Minority Adolescents with Asthma: A Randomized, Controlled Trial

Addressing asthma and obesity in children with community health workers: proof-of-concept intervention development

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