UT Southwestern Medical Center researchers have found that informed adults can help families stave off complications associated with asthma. The findings, available online and in the December issue of Pediatrics, suggest that interventions by parent mentors -- caregivers of asthmatic children who have received specialized topical training -- can effectively reduce wheezing, asthma attacks, emergency room visits and missed adult workdays.
"Childhood asthma disproportionately affects urban minority children," said Dr. Glenn Flores, professor of pediatrics and the study's lead author. "Asthma mortality among African-American children alone is almost five times higher than for white children. The goal for this study was to determine whether parent mentors would be more effective than traditional asthma care in improving asthma outcomes for minority children."
Mentors in the study were parents or caregivers who got professional training from a nurse asthma specialist and a program coordinator on a variety of asthma-related topics. Training sessions and a manual were used to present examples of improving asthmatic care and focused on the importance of consistent treatment. The manual also discussed keeping asthmatic children out of hospitals, asthma medications and triggers, and cultural issues that can affect care.
A total of 220 African-American and Hispanic children from Milwaukee were assigned randomly to parent mentors. The children, ranging in age from 2 to 18, were asthmatic and had been seen for complications in urban emergency departments or were hospitalized at local children's hospitals. Mentors met twice with up to 10 families with asthmatic children and telephoned parents monthly until one year after the initial emergency department visit or hospitalization. For families without telephone access, mentors conducted only home visits. Mentors also communicated regularly with the asthma nurse specialist about issues that arose with participating families.
Children in the program experienced significant reductions in rapid-breathing episodes, asthma exacerbations and emergency department visits. Mentored parents or caregivers displayed greater knowledge about controlling their charger's breathing problems. "Not only did this program help the participating families, it also provided employment for those acting as parent mentors and allowed a community to address the health and needs of its children," said Dr. Flores, who holds the Judith and Charles Ginsburg Chair in Pediatrics. "The parent mentor interventions were successful social networking and show caregivers are receptive to hearing advice and instructions from their peers."
Dr. Flores said additional studies and trials will need to take place to evaluate the impact of mentors on health care treatment disparities seen for asthma and other pediatric conditions.
Study results also revealed that parent mentors not only are relatively inexpensive, costing an average of $60.42 per patient. The intervention group actually saved money, experiencing overall savings of $361.84 per patient for hospitalizations and $50.33 for emergency department visits.
Other UT Southwestern researchers involved in the study were biostatistician Dr. Hua Lin and senior program coordinator Christina Bridon.
The work was supported by the Commonwealth Fund and the Improving Chronic Illness Care program of the Robert Wood Johnson Foundation.
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