Effectiveness of Breathmobile and family communication in preschoolers with asthma
Published Online: November 21, 2011
Low-income minority children have worse asthma outcomes. Lack of access to specialty care and poor doctor-patient communication may be contributing factors. Improving access to care, by offering free mobile health services, or enhancing doctor-family communication may help.
In a recent article in The Journal of Allergy & Clinical Immunology (JACI), Eakin et. al. evaluated the effects of providing Breathmobile services only, a Facilitated Asthma Communication Intervention (FACI) only, or both Breathmobile+FACI on asthma outcomes, relative to standard care. They recruited 322 children with asthma from Head Start programs in Baltimore City. The child’s caregiver completed a survey at baseline, 6-, and 12-months. Symptom-free days were the primary outcome. Other outcomes examined were emergency department visits and hospitalizations, courses of oral steroids and proportion of children on an asthma controller medication.
Despite free services, multiple locations, and multiple attempts to schedule families, less than half of participants eligible to receive the Breathmobile scheduled an appointment and only one in five attended a visit. Similarly, despite offering assistance to schedule and travel to appointments for the FACI group, 35% families did not attend a doctor appointment. There was a slight improvement in symptom-free days at 6 months in the Breathmobile+FACI group. Otherwise, there were no significant differences between the groups on outcomes.
These results highlight that offering free community asthma services, such as Breathmobile care or family asthma education, may not be enough to engage all parents of children with asthma to use these services. Novel community-focused approaches need to be developed that result in meaningful and sustainable improvements.
The Journal of Allergy and Clinical Immunology (JACI) is the official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.