The 130th Annual Meeting of APHA

Abstract #43275

Maryam Navaie-Waliser, DrPH¹, Cynthia Mersman, RN, PhD², Mark Misener, MD, MPH³, Priscilla Lincoln, RN, PhD², and Latha Chandran, MD⁴. (1) Center for Home Care Policy and Research, Visiting Nurse Service of New York, 5 Penn Plaza, 11th Floor, New York, NY 10001, 212-290-3540, mnavaie@vnsny.org, (2) Children and Family Services, Visiting Nurse Service of New York, 5 Penn Plaza, 18th Floor, New York, NY 10001, (3) Department of Preventive Medicine, State University of New York at Stony Brook, School of Medicine, HSC Level 5, Stony Brook, NY 11790, (4) Department of Pediatrics, State University of New York at Stony Brook, Health Sciences Center, Level 11, Rm 080, School of Medicine, Stony Brook, NY 11794-8111

Objective. This study examined the sociodemographic and health characteristics of children with asthma receiving home care, their service utilization, home environmental triggers, and caregiver knowledge about asthma management. Methods. Medical records of children, £19 year of age receiving home care for asthma (n=1,078) were reviewed to identify 1,007 (93%) eligible children. Results. The majority of children with asthma in home care were £5 years of age (58%), male (61%), racial/ethnic minorities (63%), and referred by a hospital (78%). One in four children with asthma suffered from additional co-morbidities, and one in five had known allergies. The children experienced multiple asthma-related symptoms including cough (66%), wheezing (56%), shortness of breath (46%), tightness(24%), retractions (24%) and flaring (11%). On average, the children had two emergency or hospital visits within three months of home care admission. The children received an average of 3 home visits (SD=13) and were in care for 35 days (SD=25). The most common environmental triggers were seasonal (42%), dust (41%), cockroaches (35%), stuffed toys (33%), upholstery (28%), cigarette smoke (21%), and perfumes (21%). Most caregivers lacked adequate knowledge about asthma symptoms (82%); asthma triggers (73%); asthma management (74%); and use of peak flow meters (66%), inhalers (56%), and nebulizers (52%). Conclusions. Children with asthma in home care are young, suffer from multiple asthma-related symptoms, face a myriad of home triggers, receive few home visits, and have caregivers who lack adequate knowledge about asthma management. Home care providers can help children and families better manage asthma through targeted educational interventions.

Learning Objectives:

• To discuss the sociodemographic and health characteristics of children with asthma in a home care setting
• To identify home environmental hazards that exacerbate asthma in children
• To recognize the degree to which caregivers of children with asthma lack adequate asthma management skills and knowledge

Keywords: Asthma, Home Visiting

Related Web page: www.vnsny.org/research

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Visiting Nurse Service of New York
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.