RESUMO
Background: School-based asthma programs effectively address poorly controlled asthma and asthma disparities, especially when coupled with screening for and addressing social determinants of health (SDOH) needs. Existing screening tools are tailored to clinical settings; therefore, we sought to develop a community-based SDOH screening tool. Design/Methods: We used a four-phase iterative design process to develop and pilot a community-based screening tool. We used a modified Delphi process to identify screening tool domains, identified validated items for inclusion, and developed an appropriate tool layout for populations with limited health/general literacy. Community advisory boards reviewed and refined a draft tool. Next, we conducted a qualitative pilot test of acceptability to parents and feasibility for staff in a community health center. Results: Six domains are included in our SDOH screening tool: health care access, transportation, food insecurity, public benefits, housing, and utilities. In the pilot test, 41 screenings were completed, and 36 parents (16.7% Spanish speaking) provided feedback. Most families understood the purpose of the screening; felt that the questions were clear, appropriate, and quick to complete; and liked the pictures. The clinic's care coordinator expressed a preference for the pilot tool compared to their existing screening tool and recommended improvements to encourage honest reporting by patients. Conclusion: This community-based screening tool addresses key SDOH needs that impact asthma and is acceptable to families. The next steps are to implement the tool in school-based asthma programs to support improvements in asthma outcomes and disparities by identifying and addressing families' unmet SDOH needs.
Assuntos
Asma , Avaliação das Necessidades , Serviços de Saúde Escolar , Determinantes Sociais da Saúde , Humanos , Asma/diagnóstico , Projetos Piloto , Serviços de Saúde Escolar/organização & administração , Colorado , Criança , Feminino , Masculino , Acessibilidade aos Serviços de Saúde , Técnica Delphi , Programas de Rastreamento/métodos , Insegurança Alimentar , PaisRESUMO
Se realiza un estudio retrospectivo para obtener una primera aproximación a la prevalencia de insuficiencia renal crónica(IRC) en nuestro medio. Evaluamos a todos los pacientes provenientes del área de influencia del Hospital de Apoyo Cayetano Heredia, con el diagnóstico de IRC durante los años 1982 a 1984. Se encontraron tasas marcadamente inferiores a las reportadas en la literatura. La prevalencia fue de 37.7 casos por millón de habitantes y correlacionó positivamente con la edad. Las mujeres tuvieron tasas más altas