Alicea-Alvarez Norma, Foppiano Palacios Carlo, Ortiz Melanie, Huang Diana, Reeves Kathleen
a Lewis Katz School of Medicine at Temple University , Philadelphia , PA , USA.
b Internal Medicine/Pediatrics, University of Maryland Medical Center , Baltimore , MD , USA.
J Asthma. 2017 Apr;54(3):273-278. doi: 10.1080/02770903.2016.1216564. Epub 2016 Aug 2.
Minority children with asthma who live in low-income urban communities bear a disproportionate burden of the disease. This study explores the perceived health care needs related to asthma care, identifies asthma triggers, potential barriers to care, and assesses the need for additional community resources.
We conducted a cross-sectional survey of Hispanic and African American adults (n = 53) who take care of a child with asthma and live in an urban community of North Philadelphia. Input from community leaders was obtained in the development the survey tool resulting in a unique 'community-centric' questionnaire. The survey was also available in Spanish. All surveys were conducted in the community setting.
Variables were used to measure asthma severity and triggers. Children were categorized with intermittent (n = 24, 45.3%), mild persistent (n = 13, 24.5%), or moderate-to-severe persistent asthma (n = 16, 30.2%). Most children with persistent asthma were enrolled under Medicaid or CHIP (n = 24, p = 0.011) and reflected a low-income socioeconomic status. Persistent asthma was found to be associated with most triggers: pets, dust mites, mice, mold, and cockroaches. There was no significant association between environmental tobacco smoke and persistent asthma. Children with persistent asthma and 2 or more triggers were more likely to be hospitalized and go to the Emergency Department.
Urban minority children living in low-income communities face neighborhood-specific asthma triggers and challenges to care. Studies conducted in urban neighborhoods, with collaboration from community members, will highlight the need of comprehensive services to account for community-centric social determinants.
生活在低收入城市社区的患有哮喘的少数族裔儿童承受着与其人口比例不相称的疾病负担。本研究探讨了与哮喘护理相关的感知医疗需求，确定了哮喘触发因素、护理的潜在障碍，并评估了对额外社区资源的需求。
我们对居住在北费城城市社区、照顾患有哮喘儿童的西班牙裔和非裔美国成年人（n = 53）进行了横断面调查。在开发调查工具时获得了社区领袖的意见，从而形成了一份独特的“以社区为中心”的问卷。该调查也有西班牙语版本。所有调查均在社区环境中进行。
使用变量来衡量哮喘严重程度和触发因素。儿童被分类为间歇性哮喘（n = 24，45.3%）、轻度持续性哮喘（n = 13，24.5%）或中度至重度持续性哮喘（n = 16，30.2%）。大多数患有持续性哮喘的儿童参加了医疗补助计划或儿童健康保险计划（n = 24，p = 0.011），反映出低收入的社会经济地位。发现持续性哮喘与大多数触发因素相关：宠物、尘螨、老鼠、霉菌和蟑螂。环境烟草烟雾与持续性哮喘之间没有显著关联。患有持续性哮喘且有2种或更多触发因素的儿童更有可能住院和前往急诊科。
生活在低收入社区的城市少数族裔儿童面临特定社区的哮喘触发因素和护理挑战。在城市社区开展的、有社区成员合作的研究将突出以社区为中心的社会决定因素对综合服务的需求。
