Other

Background: Asthma continues to be a significant public health issue for children. The extent to which tailored evidence-based interventions address the needs of children at varied levels of risk in the community is unclear.

Objective: Using data from five impoverished communities with high levels of pediatric asthma morbidity, this study assessed morbidity outcomes associated with tailored evidence-based interventions after stratifying children for risk based on two variables that reflect control, severity, and behavior: hospitalizations and daily use of a controller medication.

Methods: A pre/post evaluation (n=721) was used to categorize and analyze change in outcomes for four groups of patients: patients with one or more hospitalizations in the past 12 months with or without a baseline controller medication use, and no hospitalizations in the past 12 months with or without baseline controller medication use.

Results: Patients with one or more hospitalizations in the past 12 months and no baseline controller use made the biggest gains in several areas, including the largest percent increase in daily controller medication usage and asthma action plans, and the largest decrease in days and nights of symptoms. However, other groups made larger gains in reducing school days missed and emergency department visits and increasing parent confidence, consistent with the notion that community-based interventions can help a diverse set of patients make progress.

Conclusion: Practitioners in low-income communities where there are varying levels of resources and disease severity can tailor interventions to each child's needs and make substantial gains in outcomes across a range of risk profiles

Click here to view the full study.

We are excited to announce that in collaboration with Frontiers in Public Health, section Public Health Education and Promotion, we are organizing a Research Topic titled "Online Training for Public Health Capacity Building among Professionals Working with Youth”.

As host editors, we would like to encourage you to contribute to this topic. Please find more information about Research Topics below, including the publishing fees that apply. You can also visit the homepage we have created on the Frontiers website, which defines the focus of the topic, and where all published articles will appear.

http://www.frontiersin.org/Public_Health_Education_and_Promotion/researchtopics/Online_Training_for_Public_Hea/3975

Please note the submission deadlines for this Research Topic are:

Abstracts - June 30, 2015
Full draft manuscripts - August 31, 2015
Revisions on accepted manuscripts - Dec 31, 2015

Should you wish to participate--and we hope that you will--we request that you submit an abstract in advance of any manuscript submission you choose to make.  The deadline for abstracts is identified at our Research Topic homepage and in the list above. Abstracts should be submitted from this webpage:

http://journal.frontiersin.org/researchtopic/online-training-for-public-health-capacity-building-among-professionals-working-with-youth-3975

METHODS

As part of the Children’s Health Study, we measured lung function annually in 2120 children from three separate cohorts corresponding to three separate calendar periods: 1994–1998, 1997–2001, and 2007–2011. Mean ages of the children within each cohort were 11 years at the beginning of the period and 15 years at the end. Linear-regression models were used to examine the relationship between declining pollution levels over time and lung-function development from 11 to 15 years of age, measured as the increases in forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) during that period (referred to as 4-year growth in FEV1 and FVC).

RESULTS

Over the 13 years spanned by the three cohorts, improvements in 4-year growth of both FEV1 and FVC were associated with declining levels of nitrogen dioxide (P<0.001 for FEV1 and FVC) and of particulate matter with an aerodynamic diameter of less than 2.5 μm (P= 0.008 for FEV1 and P<0.001 for FVC) and less than 10 μm (P<0.001 for FEV1 and FVC). These associations persisted after adjustment for several potential confounders. Significant improvements in lung-function development were observed in both boys and girls and in children with asthma and children without asthma. The proportions of children with clinically low FEV1 (defined as <80% of the predicted value) at 15 years of age declined significantly, from 7.9% to 6.3% to 3.6% across the three periods, as the air quality improved (P=0.001).

CONCLUSIONS

We found that long-term improvements in air quality were associated with statistically and clinically significant positive effects on lung-function growth in children. (Funded by the Health Effects Institute and others.)