Valerie G. Press|Andrea A. Pappalardo|Walter D. Conwell|Amber T. Pincavage|Meryl Prochaska|Vineet M. Arora
Interventions to Improve Outcomes for Minority Adults with Asthma: A Systematic Review
University of Chicago|Comer Children's Hospital|University of Colorado Denver|University of Chicago|Loyola University Chicago|University of Chicago
abstract objectives systematically review literature characterize interventions potential improve outcomes minority patients asthma data sources medline psycinfo cinahl cochrane trial databases expert review reference review meeting abstracts study eligibility criteria participants inteventions medical subject heading mesh terms related asthma combined terms identify intervention studies focused minority populations inclusion criteria adult population intervention studies majority nonwhite participants study appraisal synthesis methods study quality assessed using downs black db checklists examined heterogeneity studies comparing study population study design intervention characteristics outcomes results twentyfour articles met inclusion criteria mean quality score 210 study populations targeted primarily african american 14 followed latinoa 4 asian americans 1 combination 5 commonly reported postintervention outcome use health care resources followed symptom control selfmanagement skills common interventiontype studied patient education although lessthan half culturally tailored languageappropriate education appeared particularly successful several systemlevel interventions focused specialty clinics promising findings although health disparities collaboratives similarly promising results limitations publication bias may limit findings unable perform metaanalysis limiting reviews quantitative evaluation conclusions implications key findings overall education delivered health care professionals appeared effective improving outcomes minority patients asthma culturally tailored one included comparison group limiting conclusions drawn cultural tailoring systemredesign showed great promise particularly use teambased specialty clinics longterm followup acute care visits future research evaluate role tailoring educational strategies focus patientcentered education incorporate outpatient followup andor teambased approach