The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62758

Paula Kriner, MPH¹, Yolanda Bernal, BA¹, Amy Binggeli, MPH, RD, CHES¹, and India J. Ornelas, MPH². (1) Imperial County Public Health Department, 935 Broadway, El Centro, CA 92243, (760) 482-4904, pakriner@aol.com, (2) California Office of Binational Border Health, Centers for Disease Control and Prevention, 3851 Rosecrans St, PO Box 85524, MS P511B, San Diego, CA 92138

Asthma is a serious and growing problem in Imperial County, California. The rural county has reported among the highest asthma hospitalization rates in the state. Factors such as poverty, access to care, poor self-management skills, and ethnocultural beliefs may influence asthma exacerbations. Provider and adult asthmatic attitudes, beliefs, and practices regarding asthma were examined using a mixed-methods approach: a survey to evaluate provider conformance with national guidelines, and focus groups targeting medical practitioners and adult asthmatics. Half of all providers who treat asthmatics (42) completed a self-administered survey about asthma diagnosis; clinical monitoring of patients; treatment; patient education; and use of practice guidelines. Provider focus groups further explored survey results regarding provider practices, asthma-care utilization, and patient education. Adult asthmatics participated in Spanish-language focus groups exploring cultural beliefs, attitudes, and practices. Focus group data were transcribed and content analyzed for emerging themes using grounded theory and axial coding methods. Survey results indicate that some national guidelines have been incorporated into clinical practice, while others have not. Provider focus group themes emerged around perceptions that asthma was a common, serious health problem in the community; barriers to patient care; and recommendations to improve care. Patient focus group themes emerged around ethnocultural beliefs regarding asthma triggers (hot/cold, nerves, contagion, psychological), and treatments such as herbal teas and hot coffee to alleviate symptoms and chihuahua dogs and birds to cure asthma. Themes emerging from this study may be useful in refining asthma self-management programs, improving provider standard of care, and enhancing patient education.

Learning Objectives:

• At the conclusion of the session, participants will be able to:
• 3. Describe barriers to care and treatment for adult asthmatics living in a rural California county located next to the U.S.-Mexico border.
  7. Identify at least four areas where providers can improve asthma care and treatment practices to reduce asthma exacerbations and hospitalizations in a high-risk, predominantly Latino community.
  11. List at least three examples of ethnocultural beliefs regarding asthma triggers and treatments in a Latino population living along the U.S.-Mexico border.

Keywords: Asthma, Latino Health

Presenting author's disclosure statement:
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.