Identification of gaps in the diagnosis and treatment of childhood asthma using a community-based participatory research approach |
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Authors: | Toby C Lewis Thomas G Robins Christine L M Joseph Edith A Parker Barbara A Israel Zachary Rowe Katherine K Edgren Maria A Salinas Michael E Martinez Randall W Brown |
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Institution: | (1) Department of Pediatrics and Communicable Diseases, University of Michigan School of Medicine, Ann Arbor;(2) Department of Health Behavior/Health Education, University of Michigan School of Public Health, Ann Arbor;(3) Department of Environmental Health Sciences, University of Michigan School of Public Health, 1500 East Medical Center Drive, L2221 Women's, Box 0212, 48109-0212 Ann Arbor, MI;(4) Department of Biostatistics and Epidemiology, Henry Ford Health System, Detroit, Michigan;(5) Friends of Parkside, Detroit, Michigan |
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Abstract: | The goal of this investigation was to use a community-based participatory research approach to develop, pilot test, and administer
an asthma screening questionnaire to identify children with asthma and asthma symptoms in a community setting. This study
was conducted as the recruitment effort for Community Action Against Asthma, a randomized trial of a household intervention
to reduce exposure to environmental triggers of asthma and was not designed as a classic prevalence study. An asthma screening
questionnaire was mailed and/or hand delivered to parents of 9,627 children, aged 5 to 11 years, in two geographic areas of
Detroit, Michigan, with predominantly African American and Hispanic populations. Additional questionnaires were distributed
via community networking. Measurements included parent report of their child's frequency of respiratory symptoms, presence
of physician diagnosis of asthma, and frequency of doctor-prescribed asthma medication usage. Among the 3,067 completed questionnaires,
1,570 (51.2% of returned surveys, 16.3% of eligible population) were consistent with asthma of any severity and 398 (12.9%
of returned surveys, 4.1% of eligible population) met criteria, for moderate-to-severe asthma. Among those meeting criteria
for moderate-to-severe asthma, over 30% had not been diagnosed by a physician, over one half were not taking daily asthma
medication, and one quarter had not taken any physician-prescribed asthma medication in the past year. Screening surveys conducted
within the context of a community-based participatory research partnership can identify large numbers of children with undiagnosed
and/or undertreated moderate-to-severe asthma. These children are likely to benefit from interventions to reduce morbidity
and improve quality of life. |
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Keywords: | Asthma Child Community-based participatory research Screening Urban |
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