Mary R Janevic1, Alan P Baptist2, Tyra Bryant-Stephens3, Marielena Lara4,5, Victoria Persky6, Gilberto Ramos-Valencia7, Kimberly Uyeda8, Rebecca Hazan1, Ashley Garrity1, Floyd J Malveaux9. 1. a School of Public Health, University of Michigan , Ann Arbor , MI , USA. 2. b Division of Allergy and Clinical Immunology , University of Michigan Medical School , Ann Arbor , MI , USA. 3. c Children's Hospital of Philadelphia , Philadelphia , PA , USA. 4. d Children's Hospital of Los Angeles, University of Southern California , Los Angeles , CA , USA. 5. e RAND Corporation , Santa Monica , CA , USA. 6. f University of Illinois at Chicago School of Public Health , Chicago , IL , USA. 7. g School of Public Health, University of Puerto Rico , San Juan , Puerto Rico. 8. h Los Angeles Unified School District , Los Angeles , CA , USA. 9. i Merck Childhood Asthma Network, Inc. , Washington, DC , USA.
Abstract
OBJECTIVE: Disparities by race and socioeconomic status persist in pediatric asthma morbidity, mortality, and treatment. Improving parent/provider communication and parents' asthma-management confidence may result in better asthma control in vulnerable populations. The Merck Childhood Asthma Network, Inc. funded an initiative to implement medical-social care coordination to improve asthma outcomes at sites in four low-income, urban communities (Los Angeles, CA; Philadelphia, PA; Chicago, IL; and San Juan, PR.) As part of a cross-site evaluation of this effort, pre- post-program changes in parents' reports of asthma care and management were assessed. METHODS: Across sites, 805 parents or other caregivers responded to a baseline survey that was repeated one year later following their child's participation in care coordination. Parents' asthma-management confidence, as well as their perceptions of provider access, trust, and communication, were measured with Likert scales. Linear mixed models were used to assess improvement in these variables, across and within sites, adjusting for sociodemographics. RESULTS: Pooled across sites, the adjusted mean estimate for all outcomes showed a significant improvement (p <.05) from baseline to follow-up. Knowledge and Between-Provider Communication improved significantly (p <.05) within all four sites; Access improved significantly in Chicago, Philadelphia, and Puerto Rico; Trust improved significantly in Chicago, Los Angeles, and Philadelphia; and Patient-Provider Communication improved significantly in Philadelphia only. CONCLUSION: Pediatric asthma care coordination, as implemented variously in diverse settings, was associated with improvement in parents' perceptions of asthma care and self-reported asthma-management knowledge and confidence. This positive impact on parents may help sustain care coordination's impact on children.
OBJECTIVE: Disparities by race and socioeconomic status persist in pediatric asthma morbidity, mortality, and treatment. Improving parent/provider communication and parents' asthma-management confidence may result in better asthma control in vulnerable populations. The Merck Childhood Asthma Network, Inc. funded an initiative to implement medical-social care coordination to improve asthma outcomes at sites in four low-income, urban communities (Los Angeles, CA; Philadelphia, PA; Chicago, IL; and San Juan, PR.) As part of a cross-site evaluation of this effort, pre- post-program changes in parents' reports of asthma care and management were assessed. METHODS: Across sites, 805 parents or other caregivers responded to a baseline survey that was repeated one year later following their child's participation in care coordination. Parents' asthma-management confidence, as well as their perceptions of provider access, trust, and communication, were measured with Likert scales. Linear mixed models were used to assess improvement in these variables, across and within sites, adjusting for sociodemographics. RESULTS: Pooled across sites, the adjusted mean estimate for all outcomes showed a significant improvement (p <.05) from baseline to follow-up. Knowledge and Between-Provider Communication improved significantly (p <.05) within all four sites; Access improved significantly in Chicago, Philadelphia, and Puerto Rico; Trust improved significantly in Chicago, Los Angeles, and Philadelphia; and Patient-Provider Communication improved significantly in Philadelphia only. CONCLUSION: Pediatric asthma care coordination, as implemented variously in diverse settings, was associated with improvement in parents' perceptions of asthma care and self-reported asthma-management knowledge and confidence. This positive impact on parents may help sustain care coordination's impact on children.
Authors: Alayna P Tackett; Michael Farrow; Sheryl J Kopel; Maria T Coutinho; Daphne Koinis-Mitchell; Elizabeth L McQuaid Journal: J Asthma Date: 2020-07-01
Authors: Isabelle P Sico; Amber Oberle; Sheila M Thomas; Thomas Barsanti; Lisa Egbuonu-Davis; Daniel T Kennedy; Leah L Zullig; Hayden B Bosworth Journal: Patient Prefer Adherence Date: 2021-04-07 Impact factor: 2.711