title: Racial disparities at the point of care for urban children with persistent asthma.
abstract: Little is known about disparities in preventive asthma care delivery at the time of an office visit. Our objective was to better understand what treatments are delivered at the point of care for urban children with asthma, and whether there are racial disparities. We enrolled 100 Black and 77 White children (2-12 years) with persistent asthma from 6 primary care practices. We evaluated how frequently providers delivered guideline-based asthma actions at the index visit. We also assessed asthma morbidity prior to the index visit and again at 2 month follow-up. Black children had greater symptom severity and were less likely to report having a preventive medication at baseline, but were no more likely to report a preventive medication action at the time of an office visit. Symptoms persisted for Black children at follow-up, suggesting additional preventive actions were needed. Further efforts to promote consistent guideline-based preventive asthma care are critical.
authors.affiliation: Department of Pediatrics, Strong Memorial Hospital, University of Rochester School of Medicine and Dentistry, Box 777, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
authors.forename: Porschea
authors.initials: P
authors.lastname: Lewis
authors.forename: Maria
authors.initials: M
authors.lastname: Fagnano
authors.forename: Alana
authors.initials: A
authors.lastname: Koehler
authors.forename: Jill S
authors.initials: JS
authors.lastname: Halterman
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000208:ethnology* / Q000517:prevention & control; D017028:Caregivers / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000208:ethnology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D009518:New York; D009819:Office Visits / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000592:standards* / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D014028:Tobacco Smoke Pollution / Q000009:adverse effects / Q000706:statistics & numerical data*; D014504:Urban Health / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data*
chemical_list: D018927:Anti-Asthmatic Agents; D014028:Tobacco Smoke Pollution