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A randomized clinical trial to reduce asthma morbidity among inner-city children: results of the National Cooperative Inner-City Asthma Study.
Evans, R; Gergen, P J; Mitchell, H; Kattan, M; Kercsmar, C; Crain, E; Anderson, J; Eggleston, P; Malveaux, F J; Wedner, H J.
Afiliação
  • Evans R; Children's Memorial Hospital, Chicago, Illinois 60614, USA.
J Pediatr ; 135(3): 332-8, 1999 Sep.
Article em En | MEDLINE | ID: mdl-10484799
OBJECTIVE: To evaluate a family-focused asthma intervention designed for inner-city children 5 to 11 years old with moderate to severe asthma. STUDY DESIGN: Randomized, multisite, controlled trial to minimize symptom days (wheeze, loss of sleep, reduction in play activity) measured by a 2-week recall assessed at 2-month intervals over a 2-year follow-up period. The intervention was tailored to each family's individual asthma risk profile assessed at baseline. RESULTS: Averaged over the first 12 months, participants in the intervention group (n = 515) reported 3.51 symptom days in the 2 weeks before each follow-up interview compared with 4.06 symptom days for the control group (n = 518), a difference of 0.55 (95% CI, 0.18 to 0.92, P =.004). The reduction among children with severe asthma was approximately 3 times greater (1.54 d/2 wk). More children in the control group (18.9%) were hospitalized during the intervention compared with children in the intervention group (14. 8%), a decrease of 4.19% (CI, -8.75 to 0.36, P =.071). These improvements were maintained in the intervention group during the second year of follow-up, during which they did not have access to the asthma counselor. CONCLUSIONS: We demonstrated that an individually tailored, multifaceted intervention carried out by Masters-level social workers trained in asthma management can reduce asthma symptoms among children in the inner city.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pais / Asma / Serviço Social / Serviços Urbanos de Saúde / Aconselhamento Tipo de estudo: Clinical_trials / Etiology_studies / Evaluation_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Limite: Child / Child, preschool / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Revista: J Pediatr Ano de publicação: 1999 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pais / Asma / Serviço Social / Serviços Urbanos de Saúde / Aconselhamento Tipo de estudo: Clinical_trials / Etiology_studies / Evaluation_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Limite: Child / Child, preschool / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Revista: J Pediatr Ano de publicação: 1999 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos