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Parent-based intervention improved minority asthma outcomes
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Minority children with asthma whose parents participated in a mentor program experienced fewer episodes of wheezing, asthma exacerbations and ED visits, according to findings from a new study.
“Parent mentors may be a promising, cost-effective means for reducing childhood asthma disparities,” the researchers wrote.
They randomly assigned 220 black and Latino children who presented in the ED with a diagnosis of asthma to either an intervention (n=112) or control (n=108) group. The parents of intervention participants met monthly with a trained mentor and shared their experiences in caring for asthmatic children, strategies for keeping children with asthma out of hospitals and other related issues. Other facets of the intervention included asthma education sessions and opportunities for asthmatic children and their families to interact socially. Sixty-seven children in the intervention group and 64 children in the control group completed the study.
Intervention costs were reasonable, according to the researchers, with a mean of $60.42 per month and yielded net savings of $46.16 for high participants.
Although all intervention participants experienced significant reductions in rapid-breathing episodes, asthma exacerbations, ED visits and the number of hours parents missed from work at one year follow-up, intervention group patients with high participation rates experienced greater improvements in these areas. High participants also reported improved self-recognition that serious breathing problems could be controlled at home.
Despite these benefits, four other asthma outcomes yielded inconclusive findings. High participants and children in the control group had fewer missed school days, fewer coughing episodes and improved scores on the Pediatric Quality of Life Inventory at one year follow-up; however, decreased difficulty breathing was reported among high and low participants.
“For these four outcomes, larger sample sizes and multicenter studies may be required to determine definitively whether parent mentors can improve outcomes,” the researchers wrote.
Differences in baseline data between high-participating and low-participating intervention group children may provide clues as to why the intervention was more effective for some than for others, according to the researchers, who found that participants who were very involved in the program were more likely than low participants or controls to have experienced a wheezing episode in the month before the study. Additional research into factors that motivate participation may help improve intervention efforts in the future.
Flores G. Pediatrics. 2009;124:1522-1532.