Addressing asthma and obesity in children with community health workers: proof-of-concept intervention development

BMC Pediatrics

Research Article

Lucretia M. Hoffman¹  Jose Luis Rodriguez²  Katherine Kaufer Christoffel³  Anna Barnes³  Militza M. Pagán⁴  Elizabeth Lynch⁵  Steven K. Rothschild⁵  Kelly Karavolos⁵  Diana Plata⁶  Molly A Martin⁷  Sandra Villalpando⁸  Antonieta Diaz⁹ 

[1] Forsyth County Department of Public Health, 201 N Chestnut St, Winston-Salem, NC, USA;Greater Humboldt Park Community of Wellness, 1116 N. Kedzie, 60651, Chicago, IL, USA;Lurie Children’s Hospital, 225 E Chicago Ave, 60611, Chicago, IL, USA;Puerto Rican Cultural Center, 2700 W Haddon Ave, 60622, Chicago, IL, USA;Rush University Medical Center, 1700 W Van Buren, Suite 470, 60612, Chicago, IL, USA;Rush University Medical Center, College of Medicine, 600 S Paulina St, 60612, Chicago, IL, USA;University of Illinois at Chicago, 840 South Wood Street, M/C 856, 60612, Chicago, IL, USA;University of Illinois at Chicago, College of Medicine, 808 S Wood St, 60612, Chicago, IL, USA;University of Illinois at Chicago, Jane Addams College of Social Work, 1040 West Harrison Street, 60607, Chicago, IL, USA;

关键词: Asthma;    Obesity;    Pediatrics;    Community health worker;   

DOI  :  10.1186/s12887-016-0745-0

 received in 2015-07-01, accepted in 2016-11-29,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe objective of this study was to design and test the feasibility and impact of a community health worker (CHW) intervention for comorbid asthma and obesity.MethodsUsing a proof of concept study design, we collected pre/post outcomes from a single intervention cohort of urban low-income in a single community area. A community-based participatory research approach was employed. Forty-six children and their caregivers were recruited. Children were 5–12 years old with physician-diagnosed asthma and body mass index (BMI) > 85%. Families were offered 12 home visits from CHWs that integrated asthma and obesity core curriculums. The primary asthma outcome was asthma control, measured via the Childhood Asthma Control Test (cACT). The primary obesity outcome was child body mass index (BMI).ResultsFamilies received a median of 10 out of the 12 home visits over 1 year. At 1 year, there was a significant improvement in the number of children with controlled asthma as measured via cACT (85.7% at 1 year compared to 61.9% at baseline, p = 0.01). Activity limitations and emergency utilization were reduced while inhaler technique improved (p < 0.01 for all). Child BMI z-score was reduced: mean = 1.97 (SD 0.79) at 1 year compared to mean = 2.13 (SD 0.40) at baseline, p < 0.01. No association was seen between change in child BMI and change in asthma control. Worse baseline child depression scores were associated with less improvement in asthma control (p = 0.003) and higher baseline caregiver post-traumatic stress disorder scores were associated with increased child BMI (p = 0.012).ConclusionsThe CHW intervention has promise for improving asthma and weight outcomes in high-risk children with comorbid asthma and obesity; this model warrants further development and investigation.

【 授权许可】

CC BY   
© The Author(s). 2016