A school-based case identification process for identifying inner city children with asthma: the Breathmobile program.
Background: Striking increases in the prevalence and morbidity of asthma among inner city children have been documented.Objective: To establish and evaluate a large-scale, school-based case-detection process designed to efficiently and reliably identify inner city children with asthma.Methods: A bil...
| Published in: | CHEST Vol. 125; no. 3; pp. 924 - 935 |
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| Main Authors: | , , , , , , , , , , , , , |
| Format: | questionnaire/scale research tables/charts Journal Article |
| Published: |
American College of Chest Physicians
Mar2004
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106592635&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106592635 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00123692 1G4 jtl: CHEST issn: 00123692 maglogo: N pubinfo: dt: Mar2004 vid: 125 iid: 3 pid: 2556 pub: American College of Chest Physicians place: Glenview, Illinois artinfo: ui: 106592635 106592635 NLM15006951 2005049047 10.1378/chest.125.3.924 NLM15006951 106592635 ppf: 924 ppct: 11 formats: tig: atl: A school-based case identification process for identifying inner city children with asthma: the Breathmobile program. aug: au: Jones CA Morphew T Clement LT Kimia T Dyer M Li M Hanley-Lopez J Jones, Craig A Morphew, Tricia Clement, Loran T Kimia, Tania Dyer, Marc Li, Marilyn Hanley-Lopez, Jean affil: Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA sug: subj: Asthma Diagnosis Health Screening Instrument Validation School Health Services Urban Health Services Adolescence Algorithms California Chi Square Test Child Child, Preschool Data Analysis Software Female Male Mann-Whitney U Test Mobile Health Units Multivariate Analysis Odds Ratio Predictive Value of Tests Prevalence Questionnaires Relative Risk Sensitivity and Specificity Severity of Illness Univariate Statistics Validation Studies Validity Funding Source Human Adolescent: 13-18 years Child: 6-12 years Child, Preschool: 2-5 years Female Male ab: Background: Striking increases in the prevalence and morbidity of asthma among inner city children have been documented.Objective: To establish and evaluate a large-scale, school-based case-detection process designed to efficiently and reliably identify inner city children with asthma.Methods: A bilingual, seven-question, self-administered, parental asthma screening survey was developed. Clinical validation was achieved in a sample of 675 consecutive parents bringing a child to the school-based Breathmobile Program for initial evaluation, using a comprehensive evaluation by a physician specialist (ie, allergist) as the standard. Survey response patterns were used to construct a novel seven-model, tiered scoring algorithm and an abbreviated algorithm that predict the probability of a child being clinically classified as "yes asthma" or "no asthma." A systematic survey distribution process administered by a single coordinator was developed, and the impact of a classroom-oriented incentive offering a 25 dollars school supply gift certificate for survey return rates of >or= 80% was evaluated.Results: A total of 636 parents provided one or more survey responses and information sufficient for clinical classification. The scoring algorithm correctly identified children with asthma (>or= 80% probability) with a sensitivity of 86.5%, a specificity of 83.6%, and a misclassification rate of 14.3% (91 of 636 children). The sensitivity for identifying persistent asthma was 91.3%. Asthma prevalence estimates derived using survey results from a larger sampling of the general population were similar to rates previously reported for comparable populations. The inclusion of an inexpensive incentive increased the median survey return rates from 35.3 to 65% (z= -11.9; p <.001). The screening process has been used to conduct 27,526 surveys at inner city schools.Conclusions: The Breathmobile case-detection process offers a validated, comprehensive, large-scale method with which to identify children with asthma at their school sites. pubtype: Academic Journal doctype: questionnaire/scale research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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