Retrospective review of 200 children hospitalised with acute asthma. Identification of intervention points: A single centre study

Giarola, Blake F; McCallum, Gabrielle B.; Bailey, Emily J.; Morris, Peter S.; Maclennan, Carolyn; Chang, Anne B.

doi:10.1111/jpc.12470

Cited by 8 publications

(8 citation statements)

References 20 publications

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“…Students in our study reported high exposure to tobacco smoke at home (63%), far exceeding nationally reported data (7.8%) ( 2 ). This is consistent with our previous study on children hospitalized for asthma, which reported high exposure to tobacco smoke at home (Indigenous 95.2% and non-Indigenous 45.7%) ( 35 ). Our results highlight the importance of integrating interventions during adolescence to target social norms, behaviors, and attitudes ( 36 ) to prevent the uptake of tobacco smoking and prevent poorer long-term outcomes [e.g., chronic respiratory diseases such as bronchiectasis ( 35 ) and cardiovascular disease] ( 37 ).…”

Section: Discussionsupporting

confidence: 93%

Feasibility of a Peer-Led Asthma and Smoking Prevention Project in Australian Schools with High Indigenous Youth

et al. 2017

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BackgroundThe high global burden of asthma and tobacco smoking among Indigenous people may potentially be reduced by appropriate interventions that target prevention of tobacco smoke uptake and improved asthma management. The latter includes targeted treatment based on airway inflammation. We undertook a feasibility study in two Darwin schools with a high proportion of Indigenous youth to determine the feasibility of an innovative, peer-led, school-based education program called the Asthma and Smoking Prevention Project (ASPP). A subset of children with reported persistent respiratory symptoms were also clinically evaluated to determine the lower airway inflammatory profile and optimize asthma management.MethodsThe ASPP is founded on an evidence-based three-step program and targets improving asthma management and preventing the uptake of tobacco smoking. The program uses a student-centered approach in which senior students (peer leaders) deliver the ASPP to Grade 7 students using activities, videos, and games. Students completed questionnaires related to asthma and smoking at baseline and 3 months after program delivery. Students with respiratory symptoms at 3 months were invited for a comprehensive clinical evaluation and tests including sputum induction.ResultsThe ASPP was well received. Of the 203 students involved, 56 (28%) were Indigenous and 70% completed baseline and follow-up questionnaires. Self-reported asthma was high (19%), 10% of students reported smoking and 63% reported exposure to tobacco at home. Of the 22 students who were clinically evaluated, 41% were Indigenous. Clinically important airway inflammation was high; 23% had Fractional Exhaled Nitric Oxide Levels ≥35 ppb, 88% had airway neutrophilia (>15%), and 29% had airway eosinophilia (>2.5%). Optimization of medication and management was required in 59% of students.ConclusionOur study has demonstrated the implementation of the ASPP was well received by the schools as well as by the students. The high prevalence of clinically important airway inflammation and suboptimal asthma management highlights the need for a community-based study on persistent respiratory symptoms in adolescents to reduce the burden of chronic lung disease particularly for Indigenous Australians.

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Section: Discussionsupporting

confidence: 93%

Feasibility of a Peer-Led Asthma and Smoking Prevention Project in Australian Schools with High Indigenous Youth

et al. 2017

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“…5,10,11 For example, the hospitalization and mortality rate for asthma is 2-3 times higher in indigenous Australians. 12 The poorer clinical outcomes have also been documented in indigenous children of New Zealand, Canada and USA as well as other minority groups globally. 5,13 There is little data on whether the risk factors for having asthma in indigenous children are identical to that in non-indigenous children.…”

Section: Asthmamentioning

confidence: 99%

“…5 An Australian study of 200 children hospitalized for asthma found that intrinsic biological factors are unlikely to account for the poorer asthma outcomes as there was no significant difference between indigenous and non-Indigenous children in the length of hospitalisation and risk factors (eg prematurity), other than environmental tobacco smoke (ETS) exposure. 12 The retrospective Australian study also identified possible intervention points to improve the management of asthma, particularly in indigenous children. These included better identification, documentation and management of ETS exposure, and improvement of acute management and discharge planning including education and utilisation of asthma action plans.…”

Section: Asthmamentioning

confidence: 99%

“…These included better identification, documentation and management of ETS exposure, and improvement of acute management and discharge planning including education and utilisation of asthma action plans. 12 Improvement in asthma outcomes for indigenous children will need to focus on better individual management and systems that support such care. Despite major advances in the understanding of M a n u s c r i p t 6 the pathogenesis of asthma (with relatively large amounts of research dollars), the accompanying benefits from public health initiatives have arguably been less than expected.…”

Section: Asthmamentioning

confidence: 99%

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Lung disease in indigenous children

Chang

Brown

Toombs

et al. 2014

Paediatric Respiratory Reviews

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A c c e p t e d M a n u s c r i p t 2 EDUCATIONAL AIMSThe reader will be able to:• Discuss the common respiratory problems encountered by indigenous children.• Appreciate the similarities and differences in the aetiology, associations and management of these common respiratory problems.• Understand the many facets that impact on the clinical outcomes of common respiratory conditions affecting indigenous children.• Discuss potential intervention targets that can reduce the morbidity and mortality of respiratory diseases in indigenous children. Page 3 of 27A c c e p t e d M a n u s c r i p t 3 SUMMARY Children in indigenous populations have substantially higher respiratory morbidity than nonindigenous children. Indigenous children have more frequent respiratory infections that are, more severe and, associated with long-term sequelae. Post-infectious sequelae such as chronic suppurative lung disease and bronchiectasis are especially prevalent among indigenous groups and have lifelong impact on lung function. Also, although estimates of asthma prevalence among indigenous children are similar to non-indigenous groups the morbidity of asthma is higher in indigenous children. To reduce the morbidity of respiratory illness, best-practice medicine is essential in addition to improving socio-economic factors, (eg household crowding), tobacco smoke exposure, and access to health care and illness prevention programs that likely contribute to these issues. Although each indigenous group may have unique health beliefs and interfaces with modern health care, a culturally sensitive and community-based comprehensive care system of preventive and long term care can improve outcomes for all these conditions. This article focuses on common respiratory conditions encountered by indigenous children living in affluent countries where data is available.

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“…Distinctive challenges related to geographic barriers contribute to the uncertainty experience for native Hawaiian parents living on rural islands. Aboriginal peoples (First Nations, Inuit, and Métis) of Canada (Watson et al, 2012), indigenous New Zealand Māori (Jones, Ingham, Cram, Dean, & Davies, 2013), and Aborginal and Torres Strait Islander people of Australia (Giarola et al, 2014) live in remote areas and encounter similar geographic barriers to hospitals and spirometry testing (Castleden et al, 2016), social and health services (Ely & Gorman, 2010), specialty medical services (Chang et al, 2000), and asthma education and support (Watson et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

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Asian Pac Isl Nurs Js

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Retrospective review of 200 children hospitalised with acute asthma. Identification of intervention points: A single centre study

Cited by 8 publications

References 20 publications

Feasibility of a Peer-Led Asthma and Smoking Prevention Project in Australian Schools with High Indigenous Youth

Feasibility of a Peer-Led Asthma and Smoking Prevention Project in Australian Schools with High Indigenous Youth

Lung disease in indigenous children

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