Graduation Date

Fall 12-15-2023

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Health Promotion and Disease Prevention Research

First Advisor

Regina Idoate, PhD

Second Advisor

Hyo Jung Tak, PhD

Third Advisor

Chad Abresch, PhD

Fourth Advisor

Eleanor Rogan

MeSH Headings

Asthma, Child Health, Environment and Public Health

Abstract

Pediatric asthma is the leading chronic disease among children in the United States, and the incidence of pediatric asthma is increasing every year. Nebraska has an asthma prevalence comparable to the United States average; however, the state has significant disparities by county, race, and geographic location, with prevalence rates much higher than the national average. Douglas County is a hot spot for increased pediatric asthma rates, with further differences in rates by race and geographic location within the county. The University of Nebraska Medical Center, in partnership with Healthy Housing Omaha and the Nebraska Asthma Coalition, collaborated to conduct this study to 1) synthesize the literature on comprehensive models of care, including models that incorporate environmental assessments; 2) assess community readiness to address pediatric asthma in Douglas County; and 3) analyze pre-existing (secondary) survey data from the multi-level intervention, Asthma In-home Response, to determine program efficacy. These studies aim to inform future efforts to address pediatric asthma in Douglas County, Nebraska, utilizing a community-based participatory research approach. Twenty-one comprehensive models of pediatric asthma care were identified through an integrative review of the literature; thirteen included an environmental assessment similar to the Asthma In-home Response intervention. A Community Readiness Assessment was conducted through semi-structured interviews with eight individuals from the community and analyzed following the Community Readiness Model. The overall score was vague awareness. Evaluation of the Asthma In-home Response intervention's efficacy found that asthma attacks, emergency room visits, and hospitalizations decreased significantly by 31%, 15%, and 11% six months post-intervention. The findings of these studies will be utilized to inform the next steps in addressing pediatric asthma disparities in Douglas County. The long-term goals of these studies are to enhance community capacity in developing a comprehensive model of pediatric asthma care that includes environmental interventions and readiness to address pediatric asthma and demonstrate a novel and localized community-engaged research approach to address pediatric asthma.

Comments

2023 Copyright, the authors

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