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Biomedical subjects

N M Clark

Publications and source records attributed to N M Clark.

At least 73 records · Page 4Linked to original sources
PubMed1987

The impact of passive smoking on emergency room visits of urban children with asthma.

Baseline data obtained from a study of 276 children with asthma from 259 low income families were analyzed to test the hypothesis that passive smoking is associated with frequency of emergency room (ER) visits, hospitalizations, and impaired pulmonary function. The data were analyzed using multiple regression techniques. We controlled for other variables that might affect the frequency of ER visits, including smoking by the children themselves and the presence of other irritants or allergens in the child's home. Passive smoking was positively associated with ER visits (p less than 0.01), but not with hospitalizations or abnormalities in pulmonary function. The frequency of days with symptoms of asthma per month was also directly associated with ER visits (p less than 0.02). The estimated mean annual increase in ER visits attributable to the presence of one or more smokers in the household was 1.34 +/- 0.50, an increase of 63% over nonsmoking households. The estimated annual health care cost for emergency care of children with asthma that can be attributed to passive smoking is 92 dollars (95% confidence interval from 24 to 160 dollars) for families with 1 or more smokers.

Adolescent↗
PubMed1987

A school health education program for children with asthma aged 8-11 years.

It was hypothesized that a health education program for children with asthma aged 8-11 years that was delivered in elementary schools, would increase children's asthma management skills, self-efficacy and influence on parents' management decisions; reduce school absences and improve school performance. The study population consisted of 239 low-income, predominantly Hispanic and black children from 12 elementary schools (six experimental and six control) in New York City. Parents did not attend educational sessions but received written materials. The program emphasized the child's responsibility for recognizing symptoms and taking appropriate management steps. Follow-up data obtained one year after the program showed that compared to controls experimental group children had higher scores on an index of asthma management (p less than 0.05), greater self-efficacy with respect to asthma management skills (p less than 0.05), more influence on parents' asthma management decisions (p less than 0.05), better grades in school (p = 0.05), and fewer episodes of asthma (p less than 0.01) of shorter average duration (p less than 0.01). No differences were observed for changes in number of school absences. These findings show that asthma health education designed for delivery to children can significantly increase management skills, reduce symptoms of asthma, and improve school performance.

Asthma↗
PubMed1986

The impact of health education on frequency and cost of health care use by low income children with asthma.

A sample of 310 low income urban children with asthma from 290 families was randomized into a control group and an experimental group that received health education to improve asthma management at home. No significant decreases in subsequent health care use were observed when the experimental group was compared to the control group without regard to previous hospitalization. When the comparison was restricted to children who had been hospitalized during the preceding year, however, the experimental group was found to have decreased its use of the emergency room significantly more than the control group (p less than 0.05) and to have experienced a significantly greater reduction in the mean number of hospitalizations (p less than 0.05) during the year of follow-up. The program reduced health care costs for children with one or more hospitalizations, saving $11.22 for every $1.00 spent to deliver health education.

Adolescent↗
PubMed1986

Managing better: children, parents, and asthma.

To evaluate a health education program to improve family management of asthma, 310 children with asthma and their 290 parents were randomly assigned to a program or control group. Program families participated in health education designed to resolve specific management problems and build self-confidence in the ability to manage asthma. Following education, program parents scored better on an asthma self-management index than parents in the control group (+1.57 versus -0.83, P less than 0.0001). Program parents also scored better on two subindices of the self-management index: attack management (+0.87 vs. +0.42, P less than 0.05) and preventive measures (+0.42 vs. -0.35, P less than 0.05). Also, program parents reported significantly more use of guidelines to determine appropriate levels of physical activity for children. Following education, program children reported more use of three management steps than control children: productive cough or postural drainage (59% vs. 35%, P less than 0.004), breathing and relaxation exercises (80% vs. 65%, P less than 0.05), and attempts to stay calm (12% vs. 2%, P less than 0.05). Program children reported significantly less worry than control children about the limitations asthma imposes and about making mistakes at school.

Adolescent↗
PubMed1986

Transferring a clinic-based health education program for children with asthma to a school setting.

Open Airways is a clinic-based health education program for low income, inner city families of children with asthma. The program was transferred to the public schools to test it in a setting more representative of school-age children with asthma, and to provide health education for families not receiving medical care for asthma. During the transfer, the program changed from placing primary responsibility for management on parents to a child-centered program independent of direct parental involvement. Children's attendance increased greatly and a significant number of families not receiving regular medical care for asthma enrolled. Preliminary analysis showed the child-centered program improved children's school performance and asthma management skills. The findings of this study suggest health education programs designed for medical care settings can be adapted successfully for use in the schools and reach new populations of children with chronic diseases.

Asthma↗
PubMed1984

Changes in children's school performance as a result of education for family management of asthma.

This paper describes the impact of an asthma self-management program for parents and children on the school performance and adjustment of children with asthma. Program participants were predominantly low income, minority families enrolled in four pediatric outpatient clinics. The educational content of the program was based on a needs assessment of the participants and recommendations of medical consultants. Parents and children participated separately in group sessions that focused on the development of self-management skills and problem solving. The program was organized into six themes including "how to help your child (yourself) do well in school." The program was evaluated with an experimental research design and yielded significant school related benefits. Children participating in the program maintained better grades. Math, reading and science grades were higher relative to control group children in the year following the program. Within a subgroup of children who received care from private practitioners, program children exhibited better social adjustment to school than did control group children.

Achievement↗
PubMed1984

A sense-making approach to understanding adolescents' selection of health information sources.

The authors propose that information sources are best understood as constructed by individuals in an attempt to find answers to questions of immediate relevance. Contact profiles, or patterns of source use for particular information, determine what constitutes a source for an individual. The study explores how adolescents acquire and use health information. Data analyses based on a probability sample of 200 adolescents identified nine contact profiles and supported four study hypotheses. Contact profiles differ according to health topics and are related to message sending and seeking regarding human sexuality and birth control. Adolescents with peer-media, home-oriented or multi-source contact profiles about human sexuality and birth control were more likely than others to be the peer advisors on this topic, and those with peer-media and multi-source profiles the ones more likely to be the information seekers about it. Contact profiles are also related to adolescents' health decision making capacity. Adolescents with peer-media and multi-source profiles for human sexuality and birth control information and those with home-oriented profiles for alcohol and smoking information engaged in more health decision making steps than those with other profiles. Finally, contact profiles are also related to awareness and contact with new information sources. Adolescents with peer-oriented and multi-source profiles were more likely than others to be aware of and have contacted a new peer education program in the school.

Adolescent↗
PubMed1982

Patient consent in seven medical-care institutions.

An exploratory study of the patient consent process was conducted in seven large medical-surgical institutions. Analysis of the most recent literature on consent and of data provided by knowledgeable persons in each facility led to the conclusions that (1) the primary intent of obtaining patient consent is to legally protect the hospital and the physician, (2) legal and educational objectives are confused and entangled in the consent process, (3) legal objectives are not adequately met in any facility, and (4) the potential for sophisticated patient education is dim given existing procedures.

Comprehension↗
PubMed1981

The effectiveness of education for family management of asthma in children: a preliminary report.

This paper reports preliminary findings in a convenience sample of one half the population enrolled in a study of self-management in low income families where a child has asthma. In initial evaluation data, parents participating in self-management education reported significantly less fear and anxiety associated with their children's wheezing episodes than did control families. They also reported that their children exhibited fewer signs of stress during wheezing episode. A trend toward reduced school absences and emergency room visits was noted among participating families. The actions taken by a family to manage the illness increased with the number of sessions attended.

Asthma↗
PubMed1980

Developing education for children with asthma through study of self-management behavior.

Bronchial asthma is the major cause of disability in childhood. Among its effects are impaired levels of physical activity and self-esteem, reduced school attendance and performance, and increased utilization of emergency health services. This paper describes the development of a health education program designed to test the hypothesis that better family self-management of asthma can reduce the negative impact of the disease. Three hundred low income Black and Hispanic families were enrolled in the study. Children and primary caretakers were interviewed separately to obtain baseline data on current levels of self-management and to assess needs for educational intervention. Data have been accumulated on a variety of topics concerning asthma self-management, including health practices and beliefs, coping skills, asthma knowledge, and locus of control. An Asthma Self-Management Index was developed to measure positive management behaviors by the family. The needs assessment indicated that six core themes were priorities for these families in terms of relevant skills and behaviors. These topics were incorporated as lesson plans in the intervention.

Asthma↗