Ruvalcaba Elizabeth, Chung Shang-En, Rand Cynthia, Riekert Kristin A, Eakin Michelle
a Division of Pulmonary and Critical Care Medicine , Johns Hopkins School of Medicine , Baltimore , MD , USA.
J Asthma. 2019 Feb;56(2):218-226. doi: 10.1080/02770903.2018.1443467. Epub 2018 Mar 15.
Asthma disproportionately affects minority groups, low income populations, and young children under 5. Head Start (HS) programs predominantly serve this high-risk population, yet staff are not trained on asthma management. The objective of this study was to assess a 5-year, multicomponent HS staff asthma education program in Baltimore City HS programs.
All HS programs were offered annual staff asthma education by a medical research team that included didactic lectures and hands-on training. Attendees received continuing education credits. HS staff were anonymously surveyed on asthma knowledge and skills and asthma medication management practices in Year 1 (preimplementation) and Year 5.
There was an estimated response rate of 94% for Year 1 and 82% for Year 5. Compared to staff in Year 1, Year 5 staff were significantly more likely to report they had very good knowledge and skills related to asthma [odds ratio (OR) 1.63; p < 0.05] and were engaged in asthma care activities (OR 2.02; p < 0.05). Self-reported presence of asthma action plans for all children with asthma was 82% at Year 1 and increased to 89% in Year 5 (p = 0.064).
Year 5 HS staff reported higher self-assessed knowledge and skills, self-reports of asthma medication management practices, and self-reports of asthma activities compared to Year 1 staff. HS serves high-risk children with asthma, and a multicomponent program can adequately prepare staff to manage asthma in the child care setting. Our results indicate the feasibility of providing efficacious health skill education into child care provider training to reduce asthma knowledge gaps.
哮喘对少数族裔、低收入人群以及5岁以下幼儿的影响尤为严重。“启智计划”(HS)项目主要服务于这一高危人群,但工作人员未接受过哮喘管理方面的培训。本研究的目的是评估巴尔的摩市HS项目中一项为期5年的多组分HS工作人员哮喘教育项目。
所有HS项目都由一个医学研究团队提供年度工作人员哮喘教育,内容包括理论讲座和实践培训。参与者可获得继续教育学分。在第1年(实施前)和第5年,对HS工作人员进行匿名调查,了解他们的哮喘知识和技能以及哮喘药物管理实践情况。
第1年的估计回复率为94%,第5年为82%。与第1年的工作人员相比,第5年的工作人员更有可能报告他们拥有与哮喘相关的非常好的知识和技能[优势比(OR)1.63;p<0.05],并且参与了哮喘护理活动(OR 2.02;p<0.05)。自我报告的所有哮喘儿童哮喘行动计划的存在率在第1年为82%,在第5年增至89%(p = 0.064)。
与第1年的工作人员相比,第5年的HS工作人员报告的自我评估知识和技能、哮喘药物管理实践的自我报告以及哮喘活动的自我报告更高。HS为患有哮喘的高危儿童提供服务,一个多组分项目可以充分让工作人员做好在儿童保育环境中管理哮喘的准备。我们的结果表明,在儿童保育提供者培训中提供有效的健康技能教育以减少哮喘知识差距是可行的。