TY - JOUR
T1 - Improving asthma outcomes in minority children
T2 - A randomized, controlled trial of parent mentors
AU - Flores, Glenn
AU - Bridon, Christina
AU - Torres, Sylvia
AU - Perez, Ruth
AU - Walter, Tim
AU - Brotanek, Jane
AU - Lin, Hua
AU - Tomany-Korman, Sandy
PY - 2009/12
Y1 - 2009/12
N2 - OBJECTIVE: Because asthma disproportionately affects minorities, we evaluated the effects of parent mentors (PMs) on asthma outcomes in minority children. METHODS: This randomized, controlled trial allocated minority asthmatic children to the PM intervention or traditional asthma care. Intervention families were assigned PMs (experienced parents of asthmatic children who received specialized training). PMs met monthly with children and families at community sites, phoned parents monthly, and made home visits. Ten asthma outcomes and costs were monitored for 1 year. Outcomes were examined by using both intention-to-treat analyses and stratified analyses for high participants (attending ≥25% of community meetings and completing ≥50% of PM phone interactions). RESULTS: Patients were randomly assigned to PMs (n = 112) or the control group (n = 108). In intention-to-treat analyses, intervention but not control children experienced significantly reduced rapid-breathing episodes, asthma exacerbations, and emergency department (ED) visits. High participants (but not controls or low participants) experienced significantly reduced wheezing, asthma exacerbations, and ED visits and improved parental efficacy in knowing when breathing problems are controllable at home. Mean reductions in missed parental work days were greater for high participants than controls. The average monthly cost per patient for the PM program was $60.42, and net savings of $46.16 for high participants. CONCLUSIONS: For asthmatic minority children, PMs can reduce wheezing, asthma exacerbations, ED visits, and missed parental work days while improving parental self-efficacy. These outcomes are achieved at a reasonable cost and with net cost savings for high participants. PMs may be a promising, cost-effective means for reducing childhood asthma disparities.
AB - OBJECTIVE: Because asthma disproportionately affects minorities, we evaluated the effects of parent mentors (PMs) on asthma outcomes in minority children. METHODS: This randomized, controlled trial allocated minority asthmatic children to the PM intervention or traditional asthma care. Intervention families were assigned PMs (experienced parents of asthmatic children who received specialized training). PMs met monthly with children and families at community sites, phoned parents monthly, and made home visits. Ten asthma outcomes and costs were monitored for 1 year. Outcomes were examined by using both intention-to-treat analyses and stratified analyses for high participants (attending ≥25% of community meetings and completing ≥50% of PM phone interactions). RESULTS: Patients were randomly assigned to PMs (n = 112) or the control group (n = 108). In intention-to-treat analyses, intervention but not control children experienced significantly reduced rapid-breathing episodes, asthma exacerbations, and emergency department (ED) visits. High participants (but not controls or low participants) experienced significantly reduced wheezing, asthma exacerbations, and ED visits and improved parental efficacy in knowing when breathing problems are controllable at home. Mean reductions in missed parental work days were greater for high participants than controls. The average monthly cost per patient for the PM program was $60.42, and net savings of $46.16 for high participants. CONCLUSIONS: For asthmatic minority children, PMs can reduce wheezing, asthma exacerbations, ED visits, and missed parental work days while improving parental self-efficacy. These outcomes are achieved at a reasonable cost and with net cost savings for high participants. PMs may be a promising, cost-effective means for reducing childhood asthma disparities.
KW - African-American
KW - Asthma
KW - Children
KW - Controlled trials
KW - Hispanic
KW - Minority groups
KW - Randomized
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UR - http://www.scopus.com/inward/citedby.url?scp=71949091997&partnerID=8YFLogxK
U2 - 10.1542/peds.2009-0230
DO - 10.1542/peds.2009-0230
M3 - Article
C2 - 19948624
AN - SCOPUS:71949091997
SN - 0031-4005
VL - 124
SP - 1522
EP - 1532
JO - Pediatrics
JF - Pediatrics
IS - 6
ER -