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识字能力提升对服务不足儿童哮喘相关结局的影响。

The impact of literacy enhancement on asthma-related outcomes among underserved children.

作者信息

Robinson Lawrence D, Calmes Daphne P, Bazargan Mohsen

机构信息

David Geffen UCLA School of Medicine, USA.

出版信息

J Natl Med Assoc. 2008 Aug;100(8):892-6. doi: 10.1016/s0027-9684(15)31401-2.

Abstract

STATEMENT OF PROBLEM

Despite the availability of improved healthcare access, self-management programs, disease management protocols, and advances in pharmacologic and immunotherapy therapy, the prevalence of asthma in the urban inner city remains one of the major health disparities in the United States. Additionally, sustainability of effective intervention programs after the funding has ended remains a significant issue for asthma programs.

OBJECTIVE

This study examines the effectiveness of a longitudinal intervention program that was designed with the assumption that improved literacy plays a role in improving asthma-related health outcomes among high-risk children with the most severe forms of asthma.

METHODS

A longitudinal intervention over 6 months prospectively addressed the literacy and asthma self-management skills of 110 minority children in South Los Angeles utilizing weekly Saturday-school format.

RESULTS

The results demonstrated that there was a statistically significant decrease in both hospitalization and emergency department (ED) visits during the intervention. In addition, all the children showed significant improvement in their reading level and self-efficacy. Multivariate logistic analysis demonstrated that enhanced self-efficacy was directly related to decreased hospitalizations and ED visits.

CONCLUSION

This intervention demonstrated that literacy enhancement is an important factor in improving self-efficacy and impacting asthma-related outcomes. Improved literacy is a sustainable factor that will not only improve asthma outcomes but will enhance the potential for educational success.

摘要

问题陈述

尽管获得改善医疗服务的途径、自我管理项目、疾病管理方案以及药物和免疫治疗取得了进展,但美国城市中心区哮喘的患病率仍然是主要的健康差距之一。此外,资金结束后有效干预项目的可持续性仍是哮喘项目的一个重大问题。

目的

本研究检验了一项纵向干预项目的有效性,该项目的设计基于这样的假设,即提高读写能力在改善患有最严重哮喘形式的高危儿童的哮喘相关健康结局方面发挥作用。

方法

一项为期6个月的纵向干预以前瞻性方式,利用每周六学校的形式,针对南洛杉矶110名少数族裔儿童的读写能力和哮喘自我管理技能。

结果

结果表明,在干预期间,住院率和急诊就诊率均有统计学意义的下降。此外,所有儿童的阅读水平和自我效能感都有显著提高。多因素逻辑分析表明,自我效能感增强与住院率和急诊就诊率下降直接相关。

结论

该干预表明,提高读写能力是提高自我效能感和影响哮喘相关结局的重要因素。提高读写能力是一个可持续的因素,不仅能改善哮喘结局,还能增强教育成功的潜力。

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