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社区哮喘防治行动评估:一项通过减少家庭环境中哮喘诱发因素来改善儿童哮喘相关健康状况的社区卫生工作者干预措施。

Evaluation of Community Action Against Asthma: a community health worker intervention to improve children's asthma-related health by reducing household environmental triggers for asthma.

作者信息

Parker Edith A, Israel Barbara A, Robins Thomas G, Mentz Graciela, Brakefield-Caldwell Wilma, Ramirez Erminia, Edgren Katherine K, Salinas Maria, Lewis Toby C

机构信息

School of Public Health, Ann Arbor, Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.

出版信息

Health Educ Behav. 2008 Jun;35(3):376-95. doi: 10.1177/1090198106290622. Epub 2007 Aug 29.

Abstract

This article describes the evaluation of a community-based participatory research (CBPR) community health worker (CHW) intervention to improve children's asthma-related health by reducing household environmental triggers for asthma. After randomization to an intervention or control group, 298 households in Detroit, Michigan, with a child, aged 7 to 11, with persistent asthma symptoms participated. The intervention was effective in increasing some of the measures of lung function (daily nadir Forced Expiratory Volume at one second [p = .03] and daily nadir Peak Flow [p = .02]), reducing the frequency of two symptoms ("cough that won't go away," "coughing with exercise"), reducing the proportion of children requiring unscheduled medical visits and reporting inadequate use of asthma controller medication, reducing caregiver report of depressive symptoms, reducing concentrations of dog allergen in the dust, and increasing some behaviors related to reducing indoor environmental triggers. The results suggest a CHW environmental intervention can improve children's asthma-related health, although the pathway for improvement is complex.

摘要

本文描述了一项基于社区参与式研究(CBPR)的社区卫生工作者(CHW)干预措施的评估,该措施旨在通过减少家庭环境中引发哮喘的因素来改善儿童与哮喘相关的健康状况。在随机分为干预组或对照组后,密歇根州底特律市的298户有一名7至11岁患有持续性哮喘症状儿童的家庭参与了研究。该干预措施在提高一些肺功能指标(一秒用力呼气量每日最低点[p = 0.03]和每日最高呼气流量最低点[p = 0.02])、减少两种症状(“持续咳嗽”、“运动时咳嗽”)的发生频率、降低需要进行非计划医疗就诊的儿童比例以及报告哮喘控制药物使用不足的比例、减少照顾者报告的抑郁症状、降低灰尘中狗过敏原的浓度以及增加一些与减少室内环境触发因素相关的行为方面有效。结果表明,社区卫生工作者的环境干预措施可以改善儿童与哮喘相关的健康状况,尽管改善途径较为复杂。

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