Community health workers’ role in supporting pediatric asthma management: A review.

Abstract

Community health workers (CHWs) have been effective in improving health outcomes in vulnerable communities by providing health education and management services. We review CHW-led asthma education and management interventions for children and their families. Next, we describe the selection and training of CHWs in pediatric asthma management in the Rhode Island Asthma Integrated Response Program (RI-AIR). Method: We queried the MEDLine, Cochrane, PubMed, and EMBASE databases with keywords (community health worker, asthma, health worker, lay worker, pediatric, child, and childhood) from inception until September 2019. Criteria for study inclusion included the following: published in English, conducted in the United States, approved with an ethics notification, published in a peer-reviewed journal, and involved CHWs as the interventionists. The initial search identified 216 articles. Fifteen studies met criteria for inclusion. Results: CHWs provide asthma management and education services, including home environmental trigger assessments, strategies to reduce environmental trigger exposure, resource linkage, and community referrals. We describe RI-AIR and its CHW-led asthma education and management interventions. Conclusions: CHWs are effective and vital supports for positive asthma outcomes. More research is needed to guide models of intervention using CHWs, specifically addressing integration in interdisciplinary teams, training, and reimbursement for CHW services. Implications for Impact StatementCommunity health workers (CHWs) are effective in helping children with asthma and their families learn to manage asthma. It is important to develop programs that prepare CHWs to work with other medical professionals and health care models to pay for their services.

Evaluation and Image Analysis of Enterprise Human Resource Management Based on the Simulated Annealing‐Optimized BP Neural Network

“…Fowler et al put forward the need to carry out research on human resource soft management as early as 1992 [ 4 ]. Coutinho et al developed the human resource utility index using the data of the human resource management system to evaluate the effectiveness of human resource management [ 5 ]. Ming et al evaluated human resource management through the organizational health report index [ 6 ].…”

Introduction to the special issue: Clinical approaches to address health disparities in pediatric psychology.

“…Additionally, CHWs actively participate in recruitment and outreach events and contribute to coordinating the child's asthma care across the home, school, and medical setting. Coutinho et al's (2020) work demonstrates the utility of integrating CHWs within an interdisciplinary team to reach families across a variety of settings. Moreover, their model highlights how CHWs can enhance health care access for children and, importantly, improve the cultural appropriateness of health interventions.…”

“…The last three articles in this special issue (Barnett, Kia-Keating, Ruth, & Garcia, 2020; Chacko, Hopkins, Acri, Mendelsohn, & Dreyer, 2020; Coutinho, Subzwari, McQuaid, & Koinis-Mitchell, 2020) focus on increasing access to existing programs and services through paraprofessionals, including wellness navigators (WNs), family peer advocates (FPAs), and community health workers (CHWs). Paraprofessionals are typically identified as individuals without postgraduate training, and often members of the same community they are treating, who are trained to provide a high level of care across home and medical settings (Hattie, Sharpley, & Rogers, 1984).…”

“…In the third study, Coutinho et al (2020) first reviews the literature on the use of CHWs in pediatric asthma management and then describe a model of CHW-led asthma education and management interventions that they have implemented through the Rhode Island Asthma Integrated Response Program. CHWs deliver two evidence-based programs, a home-visiting program and a school-based program.…”

“…FPAs had access to ongoing supplemental training as well throughout the study. The CHWs in the study by Coutinho et al (2020) participated in a 40-hr training that addressed core CHW competencies and motivational interviewing. They also received training in environmental assessment, home visiting safety, and child abuse and neglect reporting.…”