Trivedi Michelle, Fung Vicki, Kharbanda Elyse O, Larkin Emma K, Butler Melissa G, Horan Kelly, Lieu Tracy A, Wu Ann Chen
a Division of Pediatric Pulmonology and Quantitative Health Sciences , University of Massachusetts Medical School , Worcester , MA , USA.
b Mongan Institute for Health Policy , Massachusetts General Hospital and Harvard Medical School , Boston , MA , USA.
J Asthma. 2018 Apr;55(4):424-429. doi: 10.1080/02770903.2017.1337790. Epub 2017 Jul 14.
Black and Latino children experience significantly worse asthma morbidity than their white peers for multifactorial reasons. This study investigated differences in family-provider interactions for pediatric asthma, based on race/ethnicity.
This was a cross-sectional study of parent surveys of asthmatic children within the Population-Based Effectiveness in Asthma and Lung Diseases Network. Our study population comprised 647 parents with survey response data. Data on self-reported race/ethnicity of the child were collected from parents of the children with asthma. Outcomes studied were responses to the questions about family-provider interactions in the previous 12 months: (1) number of visits with asthma provider; (2) number of times provider reviewed asthma medications with patient/family; (3) review of a written asthma treatment plan with provider; and (4) preferences about making asthma decisions.
In multivariate adjusted analyses controlling for asthma control and other co-morbidities, black children had fewer visits in the previous 12 months for asthma than white children: OR 0.63 (95% CI 0.40, 0.99). Additionally, black children were less likely to have a written asthma treatment plan given/reviewed by a provider than their white peers, OR 0.44 (95% CI 0.26, 0.75). There were no significant differences by race in preferences about asthma decision-making nor in the frequency of asthma medication review.
Black children with asthma have fewer visits with their providers and are less likely to have a written asthma treatment plan than white children. Asthma providers could focus on improving these specific family-provider interactions in minority children.
由于多种因素，黑人及拉丁裔儿童的哮喘发病率明显高于白人同龄人。本研究基于种族/族裔调查了儿科哮喘患者家庭与医疗服务提供者互动的差异。
这是一项对哮喘和肺病基于人群有效性网络中哮喘儿童家长调查的横断面研究。我们的研究人群包括647名有调查回复数据的家长。从哮喘儿童的家长那里收集了关于孩子自我报告的种族/族裔数据。研究的结果是对过去12个月中有关家庭与医疗服务提供者互动问题的回答：（1）与哮喘医疗服务提供者的就诊次数；（2）医疗服务提供者与患者/家庭一起回顾哮喘药物的次数；（3）与医疗服务提供者一起回顾书面哮喘治疗计划；以及（4）关于哮喘决策的偏好。
在控制哮喘控制情况和其他合并症的多变量调整分析中，黑人儿童在过去12个月中因哮喘就诊的次数少于白人儿童：比值比为0.63（95%置信区间为0.40, 0.99）。此外，黑人儿童比白人同龄人更不可能有医疗服务提供者给出/回顾的书面哮喘治疗计划，比值比为0.44（95%置信区间为0.26, 0.75）。在哮喘决策偏好和哮喘药物回顾频率方面，不同种族之间没有显著差异。
患有哮喘的黑人儿童与医疗服务提供者的就诊次数较少，并且比白人儿童更不可能有书面哮喘治疗计划。哮喘医疗服务提供者可以专注于改善少数族裔儿童中这些特定的家庭与医疗服务提供者的互动。
