Parent experiences with a nurse-supervised community health worker asthma home-visiting program

Abstract

Objective: This study seeks to identify helpful components of a nurse-supervised Community Health Worker asthma home-visiting program, obtain feedback from parents and families about their experiences, and receive suggestions for new services that the program could provide. Methods:Likert scale ratings and semi-structured qualitative interviews were conducted with parents who were selected from a representative sample and previously participated in the program. Five-point Likert scale ratings from 1 (not helpful) to 5 (very helpful) were obtained for 11 program components. Interviews were analyzed using a grounded theory participatory approach. Data were analyzed and themes were identified by two different coders using Dedoose software.Results: 22 participants were enrolled and 20 participants completed Likert scale ratings and qualitative interviews. Likert scale ratings (mean, [SD]) show that program strengths include asthma education (4.75, [0.55]), supplies (4.65, [0.99]), help with housing conditions (3.94 [1.56], pest management (3.79, [1.69]) and greater access to community resources (3.70, [1.30]). The ratings suggest that families need more help with other social determinants of health, such as school, lack of enough money or food, and mental health and behavioral concerns (3.05, [1.78]). Interviews echoed these ratings and revealed several themes about family and parental stress, children's activity limitations, desire for outreach after the 12-month intervention, a need for help with other social determinants and more emotional support. Conclusions:This study shows that the program was well received and reveals the importance of addressing social determinants of health and behavioral health concerns.

Research Agenda for Implementation of Principles of Care for Children and Youth With Special Health Care Needs

“…20 Research gaps include lack of knowledge of how care expectations extend to community-based roles and the necessary training to sustain these roles. As an example, community-based health workers may be important partners in the care of CYSHCN to address social determinants of health, 31,32 with opportunities to address how such team members may be deployed to address a broad range of diagnoses and settings. Finally, additional knowledge gaps exist about how to train such care teams and assure bidirectional communication between team members.…”