Improving preventive care in high risk children with asthma: Lessons learned

Arlene Manns Butz, Jill Halterman, Melissa Bellin, Joan Kub, Mona Tsoukleris, Kevin Frick, Richard Thompson, Cassia Land, Mary E. Bollinger

Research output: Contribution to journalArticle

Abstract

Objectives: Rates of preventive asthma care after an asthma emergency department (ED) visit are low among inner-city children. The objective of this study was to test the efficacy of a clinician and caregiver feedback intervention (INT) on improving preventive asthma care following an asthma ED visit compared to an attention control group (CON). Methods: Children with persistent asthma and recent asthma ED visits (N=300) were enrolled and randomized into a feedback intervention or an attention control group and followed for 12 months. All children received nurse visits. Data were obtained from interviews, child salivary cotinine levels and pharmacy records. Standard t-test, chi-square and multiple logistic regression tests were used to test for differences between the groups for reporting greater than or equal to two primary care provider (PCP) preventive care visits for asthma over 12 months. Results: Children were primarily male, young (3-5 years), African American and Medicaid insured. Mean ED visits over 12 months was high (2.29 visits). No difference by group was noted for attending two or more PCP visits/12 months or having an asthma action plan (AAP). Children having an AAP at baseline were almost twice as likely to attend two or more PCP visits over 12 months while controlling for asthma control, group status, child age and number of asthma ED visits. Conclusions: A clinician and caregiver feedback intervention was unsuccessful in increasing asthma preventive care compared to an attention control group. Further research is needed to develop interventions to effectively prevent morbidity in high risk inner-city children with frequent ED utilization.

Original languageEnglish (US)
Pages (from-to)498-507
Number of pages10
JournalJournal of Asthma
Volume51
Issue number5
DOIs
StatePublished - 2014

Fingerprint

Preventive Medicine
Asthma
Hospital Emergency Service
Primary Health Care
Control Groups
Caregivers
Cotinine
Medicaid
Chi-Square Distribution
African Americans
Logistic Models
Nurses

Keywords

  • Management/control
  • Pediatrics
  • Prevention

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Pediatrics, Perinatology, and Child Health
  • Immunology and Allergy

Cite this

Improving preventive care in high risk children with asthma : Lessons learned. / Butz, Arlene Manns; Halterman, Jill; Bellin, Melissa; Kub, Joan; Tsoukleris, Mona; Frick, Kevin; Thompson, Richard; Land, Cassia; Bollinger, Mary E.

In: Journal of Asthma, Vol. 51, No. 5, 2014, p. 498-507.

Research output: Contribution to journalArticle

Butz, AM, Halterman, J, Bellin, M, Kub, J, Tsoukleris, M, Frick, K, Thompson, R, Land, C & Bollinger, ME 2014, 'Improving preventive care in high risk children with asthma: Lessons learned', Journal of Asthma, vol. 51, no. 5, pp. 498-507. https://doi.org/10.3109/02770903.2014.892608
Butz, Arlene Manns ; Halterman, Jill ; Bellin, Melissa ; Kub, Joan ; Tsoukleris, Mona ; Frick, Kevin ; Thompson, Richard ; Land, Cassia ; Bollinger, Mary E. / Improving preventive care in high risk children with asthma : Lessons learned. In: Journal of Asthma. 2014 ; Vol. 51, No. 5. pp. 498-507.
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