ISSN:

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United States

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Valerie G Press , Andrea A Pappalardo, Walter D Conwell, Amber T Pincavage, Meryl H Prochaska, Vineet M Arora; Valerie G Press , Andrea A Pappalardo, Walter D Conwell, Amber T Pincavage, Meryl H Prochaska, Vineet M Arora
2012-07-14 相关链接

摘要

AbstractOBJECTIVES:To systematically review the literature to characterize interventions with potential to improve outcomes for minority patients with asthma.DATA SOURCES:Medline, PsycINFO, CINAHL, Cochrane Trial Databases, expert review, reference review, meeting abstracts. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTEVENTIONS: Medical Subject Heading (MeSH) terms related to asthma were combined with terms to identify intervention studies focused on minority populations. Inclusion criteria: adult population; intervention studies with majority of non-White participants. STUDY APPRAISAL AND SYNTHESIS OF METHODS: Study quality was assessed using Downs and Black (DB) checklists. We examined heterogeneity of studies through comparing study population, study design, intervention characteristics, and outcomes.RESULTS:Twenty-four articles met inclusion criteria. Mean quality score was 21.0. Study populations targeted primarily African American (n?=?14), followed by Latino/a (n?=?4), Asian Americans (n?=?1), or a combination of the above (n?=?5). The most commonly reported post-intervention outcome was use of health care resources, followed by symptom control and self-management skills. The most common intervention-type studied was patient education. Although less-than half were culturally tailored, language-appropriate education appeared particularly successful. Several system-level interventions focused on specialty clinics with promising findings, although health disparities collaboratives did not have similarly promising results.LIMITATIONS:Publication bias may limit our findings; we were unable to perform a meta-analysis limiting the review's quantitative evaluation. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: Overall, education delivered by health care professionals appeared effective in improving outcomes for minority patients with asthma. Few were culturally tailored and one included a comparison group, limiting the conclusions that can be drawn from cultural tailoring. System-redesign showed great promise, particularly the use of team-based specialty clinics and long-term follow-up after acute care visits. Future research should evaluate the role of tailoring educational strategies, focus on patient-centered education, and incorporate outpatient follow-up and/or a team-based approach

asthma, disparities, interventions, culturally tailored

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