Browsing by Author "Moore, Quianta L."
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Item America’s Children: Responding to the Crisis Now with the Future in Mind(2020) Moore, Quianta L.; Greeley, Christopher; James A. Baker III Institute for Public PolicyItem Asthma in Children: A Chronic Condition Requiring a Multi-Faceted Approach(James A. Baker III Institute for Public Policy, 2015) Johnson, Ashleigh; Moore, Quianta L.; James A. Baker III Institute for Public PolicyBackground: Asthma is a serious chronic disease with physical, academic, and economic consequences that affected more than 7 million children in 2010.[1] The physical consequences of asthma are estimated to have caused more than 1,700 childhood deaths between 2002 and 2007.[2] One of the ways to reduce the impact of asthma is to avoid triggers—including exercise, allergens, viral infections, excitement/stress, and environmental triggers such as air pollution, allergens, and cold weather—that exacerbate asthma symptoms.[3] Unfortunately, many children are regularly exposed to potential triggers, which can have a negative impact on their health and well-being.[4] Asthma also negatively impacts school attendance and school performance. Children with asthma are more likely to be absent when compared to their non-asthmatic peers, with more than 10.5 million missed days of school due to asthma in 2008.[5,6] Furthermore, pediatric asthma costs the United States about $27 billion every year, largely to due health care expenditures.[7] In 2007, children experienced nearly 151,000 hospitalizations; 640,000 emergency department (ED) visits; and 6.7 million doctor visits that were asthma-related.[8,9] While the impact of asthma is significant, affected children can manage the disease with proper medical care and by avoiding potential triggers.[10] The Centers for Disease Control and Prevention (CDC) has reported that teaching people how to independently manage asthma is one of the most important aspects of controlling this disease.[11] Proper asthma management education can reduce the number of asthma-related deaths, hospitalizations, emergency room visits, and missed days of school.[12,13] A focus on children is important because this population is at a higher risk for poor asthma management, due in part to the disconnect that occurs between children and the adults supporting their asthma management. Properly managed asthma in children leads to improved health outcomes, contributing to decreased economic costs and improved quality of life.[14] Technology provides an inexpensive, accessible conduit for educational programs; and with children’s increased access to technology both in and out school, there is a valuable opportunity to incorporate these resources in asthma interventions, management, and education for this population. This paper aims to review the literature on asthma management programs for children, highlight successful interventions incorporating the use of technology, and discuss policies to aid in improved asthma management. We will also provide recommendations for asthma management programs, future research, and policy development. Methods: A systematic review examining asthma management programs/policies that targeted school-age children was conducted. The terms “best/practices,” “asthma,” “school,” “education,” “interventions,” “public/policy,” and “children/pediatric” were entered into the PubMed database. Inclusion criteria for search results were: 1) topic, i.e., articles that addressed best practice for asthma management, and 2) population, i.e., interventions targeted toward children or adolescents. Our search yielded 2,381 articles meeting inclusion criteria. We then excluded articles that 1) were written in a language other than English, 2) provided only vague descriptions of interventions, 3) focused primarily on chronic obstructive pulmonary disease (COPD) and other non-asthma respiratory diseases, and/or 4) did not characterize results. Using the exclusion criteria, our results narrowed to 44 articles. Results: This review demonstrates that asthma management programs, which reportedly led to significant improvements in the targeted health-related outcomes, incorporated one or more of the components recommended by the National Heart, Lung, and Blood Institute (NHLBI) Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. The NHLBI states that effective asthma management requires 1) measures of assessment and monitoring of asthma severity and controls, 2) education supporting a partnership in asthma care, 3) control of environmental factors affecting asthma, and 4) pharmacologic therapy.[15] Based on the articles reviewed, this paper demonstrates the possibility for innovative programs, particularly those using technology, to be used in schools. The results suggest that the NHLBI components as well as innovation should be considered critical to developing a successful asthma management program targeting children. Discussion: Proper asthma management results in improved health outcomes for asthmatic children, leading to decreased absenteeism from school, decreased economic costs, and an improved quality of life. [16] However, proper management requires multiple components addressing various aspects of this disease.[17] This includes measures of assessment and monitoring of asthma severity and controls, education supporting a partnership in asthma care, control of environmental factors affecting asthma, and pharmacologic therapy.[18] While interventions incorporating one or two of these components may still report positive outcomes, longterm sustainable effects are still a concern.[19,20] Multi-faceted asthma management programs could encourage long-term use and improved health outcomes. Schools, in particular, provide a valuable opportunity to incorporate programs targeting school-age children because they allow families, school staff, clinicians, and school nurses to work together to manage asthma. The use of technology, such as Web-based education and monitoring, provides additional opportunity to develop programs that incorporate all of the NHLBI recommended components. Furthermore, policies that support multi-faceted asthma management, interventions, and education for children are crucial to improving management of asthma.Item Best Practices for Using Health Education to Change Behavior(2015) Moore, Quianta L.; Johnson, Ashleigh; James A. Baker III Institute for Public PolicyBackground: Noncommunicable diseases (NCDs), such as cardiovascular disease, diabetes, and chronic respiratory diseases, account for over 85% of all deaths in the United States.[1] Two NCDs in particular, obesity and asthma, are among the leading causes of preventable deaths in the United States.[2,3] Studies have shown that preventative measures taken during childhood may reduce the incidence of these diseases in adulthood. Moreover, obesity and asthma in childhood is associated with increased spending on annual prescription drugs, emergency rooms, and outpatient costs. Unfortunately, obesity directly affects over one-sixth of all children in the United States, with nearly 17% of all children aged 2 to 19 classified as obese in 2012.[4] In addition, over 7 million children have been diagnosed with asthma as of 2010, which can have significant consequences on their quality of life; approximately 640,000 asthma-related emergency room.[5,6] The morbidity and mortality associated with these diseases can be addressed by developing programs that incorporate effective health education geared toward behavior change.[7,8] Information related to health communication and health behavior change is extensive and is based on many behavioral change theories such as the transtheoretical model (TTM), health belief model (HBM), theory of reasoned action (TRA), theory of planned behavior (TPB), and social cognitive theory (SCT).[9] These theories have been integrated into various health education programs with varying degrees of impact.[10,11,12] Methods: A systematic literature review examining the most effective use of health education geared toward behavior change was conducted. Inclusion criteria for search results were: 1) topic, i.e., used health education to change behavior, or addressed best practices for health education development, 2) disease focus, i.e., target of intervention was asthma or obesity, and 3) population, i.e., interventions were targeted toward children or adolescents. There were 6,128 articles that met the inclusion criteria. We then excluded articles based on the following: 1) written in a language other than English, 2) provided only vague descriptions of intervention, 3) primarily surgical or medical intervention, rather than educational, and 4) did not characterize results. Using the exclusion criteria, our results narrowed to 102 articles. We divided them into three categories: 1) asthma-related interventions, 2) obesity-related interventions, and 3) general health education. Articles pertaining to general health education were then narrowed to those that focused specifically on the development of general health education materials. Results: The review yielded several consistent themes. First, health materials should be appropriate and understandable by the target population.[13] Second, communications are considered more effective if they are personally relevant,[14] tailored to the audience’s needs and interests,[15] and match their current level of reading comprehension.[16] Finally, development and implementation of health education should be based on the behavioral change theory most appropriate for the target population and the desired intervention outcomes.[17,18] These criteria should be considered when developing health materials, as studies have shown that tailoring communication is more effective than generic messages in changing behaviors.[19,20,21] Conclusion: Health education can very effectively inspire behavior change if the education utilizes proven behavioral change theories, and is tailored toward the target population. In order to be effective, health materials should be appropriate and understandable by the target population.[22] In addition, development and implementation of health education should be based on the behavioral change theory most appropriate for the target population and the desired intervention outcomes.[23,24] Therefore, prior to program implementation, researchers should have a strong understanding of this population in order to determine the best behavioral change theory to use during health education development. This in turn, along with researchers’ understanding of the target population, should strongly influence what and how information should be presented. By taking the proper steps to develop and present relevant health information effectively, individuals may be more inclined to make healthier decisions.[25] If individuals are empowered to make the health behavior changes necessary to avoid premature death and chronic diseases, such as obesity and asthma, they could extend their lifespan and improve their quality of life, which ultimately can lead to reduced health care costs.[26]Item Better Brains, Better Futures: Evidence-Based Policies for Supporting Children's Early Brain Development(James A. Baker III Institute for Public Policy, 2018) Engster, Daniel; Moore, Quianta L.; James A. Baker III Institute for Public PolicyItem Building a New Life in Uncertain Times: The Impact of COVID-19 on Refugees in the U.S.(James A. Baker III Institute for Public Policy, 2020) Norman, Kelsey; Moore, Quianta L.; Bakhiet, Zeinab; James A. Baker III Institute for Public PolicyItem Children with Medical Complexity: Can Utilizing Telemedicine in the Patient-centered Medical Home Model Reduce Cost of Care?(2017) Todd, Hannah; Moore, Quianta L.; Blagg, Tara; James A. Baker III Institute for Public PolicyItem Development of an Evidence-Based Early Childhood Development Strategy(Texas Children's Hospital;Baylor College of Medicine;James A. Baker III Institute for Public Policy, 2016) Moore, Quianta L.; Bocchini, Claire; Raphael, Jean; James A. Baker III Institute for Public PolicyItem Does Life in a Low-income Neighborhood Lead to Poor Health and Well-being for Residents?(2021) Moore, Quianta L.; Kulesza, Christopher F.; James A. Baker III Institute for Public PolicyItem Ethical Considerations of a National Database for Children with Medical Complexity(James A. Baker III Institute for Public Policy, 2017) Moore, Quianta L.; Blagg, Tara; Todd, Hannah; James A. Baker III Institute for Public PolicyItem Guidance for Parents: Keeping Kids Safe and in School throughout the COVID-19 Pandemic(James A. Baker III Institute for Public Policy, 2021) Kulesza, Christopher F.; Moore, Quianta L.; James A. Baker III Institute for Public PolicyItem Hidden Figures: The Economic Impact of COVID-19 on Low-income Women and Their Children(2020) Moore, Quianta L.; Beebe, Joyce; Bakhiet, Zeinab; James A. Baker III Institute for Public PolicyItem Improving the Future of America’s Children(2016) Moore, Quianta L.; James A. Baker III Institute for Public PolicyItem Is there a need for more school-based health centers in low-income neighborhoods?(2015) Moore, Quianta L.; Johnson, Ashleigh; James A. Baker III Institute for Public PolicyItem Protecting the Future of the Next Generation(2021) Moore, Quianta L.; James A. Baker III Institute for Public PolicyItem Should high-risk adolescents be permitted to consent to HIV pre-exposure prophylaxis in Texas?(James A. Baker III Institute for Public Policy;Baylor College of Medicine, 2016) Moore, Quianta L.; James A. Baker III Institute for Public PolicyItem Sunnyside and South Park Comprehensive Needs Assessment Data Report(James A. Baker III Institute for Public Policy, 2019) Moore, Quianta L.; Bakhiet, Zeinab; James A. Baker III Institute for Public PolicyItem Tele-health in Schools: Increasing Access to Care in Urban Areas(2015) Moore, Quianta L.; Johnson, Ashleigh; James A. Baker III Institute for Public PolicyItem The Association Between New COVID-19 Cases and Google Searches for Mental Health(James A. Baker III Institute for Public Policy, 2020) Tennant, Patrick S.; Moore, Quianta L.; Gonzalez, Jennifer; Rowan, Melissa; Hilbelink, Catie; James A. Baker III Institute for Public PolicyItem The Role of Prosocial Behavior in Promoting Physical Activity, as an Indicator of Resilience, in a Low-Income Neighborhood(Taylor & Francis, 2020) Moore, Quianta L.; Kulesza, Christopher F.; Kimbro, Rachel Tolbert; Flores, Daphne; Jackson, FeliciaThe purpose of this study was to examine the effect of prosocial behavior on physical activity, as an indicator of resilience, in a low-income neighborhood with adverse built environment and social conditions. Resilience is an important factor that promotes the ability for individuals to overcome hardships, and understanding resilience as it relates to health behavior is important in the efforts to improve the health and wellbeing of vulnerable communities. There are many constructs of resilience, and we selected physical activity as an indicator of resilience because of the role of physical activity in health promotion. A community based participatory research approach was utilized to conduct a door knock survey in a sample of 2,457 households in a low-income, historically African-American neighborhood. Fifty-seven percent of residents completed the survey. Physical activity was the dependent variable and we controlled for key demographics, resident health, primary mode of transportation and neighborhood safety. Prosocial behavior was the primary independent variable. We conducted descriptive, bivariate and multivariate analyses and found prosocial behavior was significantly correlated with moderate physical activity, despite adverse conditions. Our results indicate that prosocial behavior plays an important role in an individual's ability to engage in health-promoting behaviors, such as physical activity, despite challenges.Item U.S. Health Care Technologies(James A. Baker III Institute for Public Policy, 2015) Moore, Quianta L.; Johnson, Ashleigh; James A. Baker III Institute for Public PolicyTechnology has permeated every sector of the market, making services and goods faster, cheaper and mobile. Not surprisingly, advancements in technology have also increased access to health information and self-monitoring for individual consumers, as well as increased health care providers’ ability to diagnose, monitor or treat their patients remotely. A plethora of health-related technology is available on the market. This brief summary provides a snapshot of the scope of what has been developed, which may also provide insight into the current needs or demands of patients and providers. Methods: We performed a search for health technology available to consumers and health care providers. The terms health or technology, equipment, consumer, portable, top and available were entered into the Google search engine. Inclusion criteria for search results were: 1) technology was available for purchase by consumers or health care providers, and 2) technology was used to monitor, prevent, diagnose or treat health issues or to increase access to health care treatment or information. The equipment category was then further divided into: 1) equipment for health care providers, 2) equipment for consumers, 3) equipment for consumers focused on physical fitness, and 4) equipment for consumers that has yet to be publicly released. We also performed a search for health technology mobile apps that are currently available for mobile use. The terms “health apps,” “health mobile apps,” “fitness apps,” “health apps physicians,” “health apps consult physicians,” and “top mobile health apps,” were entered into the Google, Apple store and Google Play search engines. Inclusion criteria for search results were: 1) the app was available for purchase by consumers or health care providers, and 2) the app was used to monitor, prevent, diagnose, or treat health issues or to increase access to health care treatment or information. The apps category was further divided into 1) consumer self-help apps, 2) consumer self-help apps focused on physical fitness, 3) apps connecting patients directly with health care providers, and 4) apps for health care providers. Our search results presented numerous options for consumers, patients and health care providers to address a variety of health concerns and increase access to health care. The results also demonstrated a particular demand for health technology focused on physical fitness.