Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street Talbot 3W, Boston, MA, 02118, USA.
Department of Pediatrics, Boston Medical Center/Boston University School of Medicine, Boston, MA, USA.
J Urban Health. 2017 Dec;94(6):824-834. doi: 10.1007/s11524-017-0186-6.
Asthma disproportionately affects low-income, minority youth, with notable disparities among children <5 years of age. Understanding the perceptions of urban community health centers (CHCs) regarding treating young children with asthma could improve care for these patients. This study uses data from semi-structured focus groups with staff from eight urban CHCs. Themes emerged in three domains. Within the parent/family domain, providers noted low rates of follow-up visits, low health literacy, and-for young children specifically-misunderstanding about the diagnosis. At the CHC level, providers needed more staff, space, and comfort with applying the guidelines to infants and young children. CHCs reported asthma registries, population health oversight, and an asthma champion improved care. At the system level, providers wanted improved communication with emergency departments and community outreach programs. Reducing these multi-level barriers may improve care.
哮喘在低收入、少数族裔青年中发病率不成比例,5 岁以下儿童的差异尤为明显。了解城市社区健康中心(CHC)对治疗哮喘幼儿的看法,可以改善对这些患者的护理。本研究使用了来自八个城市 CHC 工作人员的半结构化焦点小组的数据。主题出现在三个领域。在父母/家庭领域,提供者注意到随访访问的比例低、健康素养低,并且——特别是对于年幼的孩子——对诊断存在误解。在 CHC 层面,提供者需要更多的人员、空间和应用指南的舒适度,以便为婴儿和幼儿提供服务。CHC 报告称,哮喘登记册、人口健康监督和哮喘拥护者改善了护理。在系统层面,提供者希望改善与急诊部门和社区外展计划的沟通。减少这些多层次的障碍可能会改善护理。