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与里士满社区互动以减少儿科哮喘差异:社区参与式需求评估的结果。

Engaging with the Richmond Community to Reduce Pediatric Asthma Disparities: Findings from a Community-engaged Needs Assessment.

机构信息

Virginia Commonwealth University, Richmond, VA, USA.

University of North Carolina, Chapel Hill, NC, USA.

出版信息

Am J Community Psychol. 2020 Dec;66(3-4):222-231. doi: 10.1002/ajcp.12439. Epub 2020 Jun 24.

Abstract

Childhood asthma disparities persist, with children living in low-income areas experiencing worse morbidity. We partnered with a community-academic research team and stakeholders to conduct a needs assessment to understand barriers and supports to asthma treatment. We convened a community advisory board, comprised of parents of children with asthma, youth with asthma, and members of key community organizations. Two focus groups with parents of children with asthma and four focus groups with youth with asthma were conducted, and a survey was administered to 100 parents. A visual mapping process was used to gather qualitative data about barriers, strategies, and outcomes, and allowed advisory board members to interpret focus group and survey data within the lived experiences of families. Focus group themes included parent stress/anxiety, concerns about school nurses, and lack of trust in providers. Findings from focus groups and surveys suggested that emergency department visits were not perceived negatively by families, although health providers and researchers generally view them as such. Public health implications include systemic changes that allow the healthcare system to address families' acute needs and worry. A community program focused on education and coordination among families, schools, and medical homes might improve asthma outcomes at the population level.

摘要

儿童哮喘的差异仍然存在,生活在低收入地区的儿童发病率更高。我们与一个社区学术研究团队和利益相关者合作,进行需求评估,以了解哮喘治疗的障碍和支持因素。我们召集了一个社区咨询委员会,由哮喘儿童的父母、患有哮喘的青年以及主要社区组织的成员组成。我们进行了两次有哮喘儿童父母参加的焦点小组讨论和四次有哮喘青年参加的焦点小组讨论,并向 100 名父母发放了一份调查问卷。可视化映射过程用于收集有关障碍、策略和结果的定性数据,并使咨询委员会成员能够在家庭的实际生活经验中解释焦点小组和调查数据。焦点小组的主题包括父母的压力/焦虑、对学校护士的担忧以及对提供者的不信任。焦点小组和调查的结果表明,尽管卫生保健提供者和研究人员普遍认为急诊就诊是负面的,但家庭并不认为急诊就诊是负面的。公共卫生的影响包括进行系统改革,使医疗体系能够解决家庭的急性需求和担忧。一个专注于家庭、学校和医疗保健机构之间教育和协调的社区项目可能会改善哮喘的整体治疗效果。

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