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Adherence and Self-management Interventions among Systemically Marginalized and Underserved Youth with Asthma
Rachel Sweenie1, Heather Hoch De Keyser2, Ana M Gutiérrez-Colina3
1Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center.
Clinical Practice in Pediatric Psychology
|June 5, 2023
Summary
Interventions for underserved youth with asthma show mixed results. Enhancing symptom recognition and self-management skills is key, alongside addressing social determinants of health for better asthma equity.
Area of Science:
- Pediatric Psychology
- Health Equity
- Asthma Management
Background:
- Asthma disproportionately affects underserved youth due to systemic racism and social determinants of health.
- Health disparities in asthma management persist among marginalized populations.
- Effective interventions are needed to address these inequities.
Purpose of the Study:
- To synthesize findings from interventions for underserved youth with asthma.
- To identify effective intervention strategies for improving asthma outcomes.
- To provide recommendations for promoting health equity in pediatric asthma care.
Main Methods:
- Systematic literature search of randomized trials involving youth (≤18 years) with asthma.
- Studies focused on medication adherence and/or self-management behaviors.
- Descriptive statistics were used to synthesize study characteristics and outcomes.
Main Results:
- Twenty-four articles representing 21 unique interventions were included.
- Forty-six percent of interventions reported significant improvements in adherence or self-management.
- Self-management interventions focusing on symptom recognition and monitoring were most effective (71.4% significant findings).
Conclusions:
- Interventions for underserved youth with asthma are not consistently effective.
- Pediatric psychologists can improve outcomes by enhancing symptom recognition, self-management skills, and addressing triggers.
- Addressing systemic, structural, and social determinants of health is crucial for asthma equity.
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