Toward a new model of childhood asthma care: community needs assessment in an underserved urban population

Abstract

Objectives

The objective of this study was to utilize a community-engaged research approach to better understand gaps and opportunities for improving asthma care from the perspectives of patients, caregivers, community organization representatives, and healthcare providers in a predominantly minority community.

Methods

Forty-one participants from four groups (patients, caregivers, community organization representatives, healthcare providers) participated in interviews or focus groups. A phenomenological approach to this qualitative research allowed the research team to better understand the lived experiences of families seeking asthma care in this community.

Results

Five gaps and five corresponding opportunities were identified. The gaps identified were unequal healthcare resource distribution; underrepresentation of health professionals from diverse backgrounds; experiences of environmental racism; mistrust, bias, and discrimination in healthcare encounters; and systemic marginalization of communities. The opportunities identified include increasing healthcare infrastructure and accessibility; increasing racially, culturally, and linguistically congruent healthcare; implementing equitable improvements to the built environment; building relationships with communities and individuals; and acknowledging communities’ strengths and resilience.

Conclusion

This study identified systemic gaps to asthma care that are of prominent concern to the community.

Keywords:

• Asthma
• childhood
• pediatric
• minority health
• needs assessment

Acknowledgements

The authors would like to thank Dr. Russell Hopp, Toni Blazek, and Winnie Dupree for their contributions to this study. We would also like to thank Girls, Inc. of Omaha, Healthy Housing Omaha, and Nebraska Medicine for their support of this research.

Authors’ Contribution

Drs. Hana Niebur and Chad Abresch led the design of this study. Aislinn Rookwood and Bibhusha Karki led the acquisition and analysis of data. All authors contributed to the analysis and final interpretation of findings as presented. All authors contributed to the drafting, revising, and final approval of the version of this manuscript to be published.

Disclosure Statement

Dr. Hana Niebur serves on the marketing advisory boards for Genentech, Inc. and Enzyvant Therapeutics, and the executive committee of the Nebraska Asthma Coalition. Aislinn Rookwood, Bibhusha Karki, and Chad Abresch have no competing interests to declare.

Data Availability Statement

The participants of this study did not give written consent for their data to be shared publicly, so due to the sensitive nature of the research, supporting data is not available.

Additional information

Funding

This work was supported by the Child Health Research Institute under a pilot grant.