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7. Oregon School-Based Health Centers: A Follow-Up Report.

Author

Stout, James W., White, Lisa C., and Alexander, Tammy

Abstract

A follow-up study evaluated the impact of School-Based Health Centers (SBHC) on health behaviors (including emotional and reproductive health and substance abuse), school attendance and academic performance, and health service use. The study compared these behaviors between 1990 and 1992 in several Oregon high schools with and without SBHCs. Findings indicated that health risk behaviors are already prevalent in ninth grade, implying that primary prevention needs to be initiated at a younger age. Significant gender differences were found in mental health indicators, with females reporting consistently worse emotional health. These clinics serve students with the greatest need, and those students seeking mental health or reproductive health services have worse self-esteem, higher levels of distress and more suicidal thoughts and attempts than their counterparts who seek these services at outside providers. The survey revealed high levels of satisfaction with the SBHC service, and that almost half of students have used the service. In one of the three sites studied, the SBHC was associated with global improvements in health behaviors, including decreases in substance use and sexual activity and improvements in reproductive health attitudes and behaviors. (A copy of the Adolescent Health Survey instrument and charts of the resulting statistics are appended.) (JPB)

Published
1996

16. Performance and usability of a new mobile application for measuring respiratory rate in young children with acute lower respiratory infections

Author

Spurr, Rebecca, primary, Ng, Erin, additional, Onchiri, Frankline M., additional, Rapha, Ben, additional, Nakatumba‐Nabende, Joyce, additional, Rosenfeld, Margaret, additional, Najjingo, Irene, additional, Stout, James W., additional, Nantanda, Rebecca, additional, and Ellington, Laura E., additional

Published
2022
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19. Health workers’ perspectives of a mobile health tool to improve diagnosis and management of paediatric acute respiratory illnesses in Uganda: a qualitative study

Author

Ellington, Laura Elizabeth, primary, Najjingo, Irene, additional, Rosenfeld, Margaret, additional, Stout, James W, additional, Farquhar, Stephanie A, additional, Vashistha, Aditya, additional, Nekesa, Bridget, additional, Namiya, Zaituni, additional, Kruse, Agatha J, additional, Anderson, Richard, additional, and Nantanda, Rebecca, additional

Published
2021
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21. 2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group

Author

Cloutier, Michelle M., primary, Baptist, Alan P., additional, Blake, Kathryn V., additional, Brooks, Edward G., additional, Bryant-Stephens, Tyra, additional, DiMango, Emily, additional, Dixon, Anne E., additional, Elward, Kurtis S., additional, Hartert, Tina, additional, Krishnan, Jerry A., additional, Lemanske, Robert F., additional, Ouellette, Daniel R., additional, Pace, Wilson D., additional, Schatz, Michael, additional, Skolnik, Neil S., additional, Stout, James W., additional, Teach, Stephen J., additional, Umscheid, Craig A., additional, and Walsh, Colin G., additional

Published
2020
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29. Asthma: moving toward a global children's charter

Author

Lenney, Warren, primary, Adachi, Yuichi, additional, Bush, Andrew, additional, Fischer, Gilberto B, additional, Hong, Jianguo, additional, Ostrem, Anders, additional, Pedersen, Soren, additional, Sly, Peter D, additional, Szefler, Stanley J, additional, Tilak, Raj, additional, Zar, Heather J, additional, Akinbami, Lara J, additional, Blake, Kathryn V, additional, Cabana, Michael, additional, Cicutto, Lisa C, additional, Custovic, Adnan, additional, Doull, Iolo, additional, Fitzgerald, Dominic A, additional, Fletcher, Monica, additional, Grigg, Jonathan, additional, Hughes, Rod, additional, Keen, Christina, additional, Leather, David A, additional, Lemanske, Rob F, additional, Lenney, Warren, additional, Garcia-Marcos, Louis, additional, Mazyck, Donna J, additional, Rubin, Bruce K, additional, Sheikh, Aziz, additional, Shen, Kunling, additional, Sly, Peter, additional, Stein, Renato T, additional, Stout, James W, additional, Subbarao, Padmaja, additional, Winders, Tonya, additional, and Williams, Sian, additional

Published
2019
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30. Diagnosis and treatment of acute respiratory illness in children under five in primary care in low-, middle-, and high-income countries: A descriptive FRESH AIR study.

Author

Kjærgaard, Jesper, Anastasaki, Marilena, Stubbe Østergaard, Marianne, Isaeva, Elvira, Akylbekov, Azamat, Nguyen, Nhat Quynh, Reventlow, Susanne, Lionis, Christos, Sooronbaev, Talant, Pham, Le An, Nantanda, Rebecca, Stout, James W., and Poulsen, Anja

Subjects
RESPIRATORY infections, HIGH-income countries, PEDIATRIC respiratory diseases, ACUTE diseases, PRIMARY care
Abstract

Background: Respiratory disease and, specifically, pneumonia, is the major cause of mortality and morbidity in young children. Diagnosis of both pneumonia and asthma in primary care rests principally on clinical signs, history taking, and bronchodilator responsiveness. This study aimed to describe clinical practices in diverse global primary care settings concerning differential diagnosis of respiratory disease in young children, especially between pneumonia and asthma. Methods: Health professionals in Greece, Kyrgyzstan, Vietnam, and Uganda were observed during consultations with children aged 2–59 months, presenting with cough and/or difficult breathing. Data were analyzed descriptively and included consultation duration, practices, diagnoses and availability/use of medications and equipment. The study is part of the European Horizon 2020 FRESH AIR project. Results: In total, 771 consultations by 127 health professionals at 74 facilities in the four countries were observed. Consultations were shorter in Vietnam and Uganda (3 to 4 minutes) compared to Greece and Kyrgyzstan (15 to 20 minutes). History taking was most comprehensive in Greece. Clinical examination was more comprehensive in Vietnam and Kyrgyzstan and less in Uganda. Viral upper respiratory tract infections were the most common diagnoses (41.7% to 67%). Pneumonia was diagnosed frequently in Uganda (16.3% of children), and rarely in other countries (0.8% to 2.9%). Asthma diagnosis was rare (0% to 2.8%). Antibiotics were prescribed frequently in all countries (32% to 69%). Short acting β-agonist trials were seldom available and used during consultations in Kyrgyzstan (0%) and Uganda (1.8%), and often in Greece (38.9%) and Vietnam (12.6%). Conclusions: Duration and comprehensiveness of clinical consultations observed in this study seemed insufficient to guide respiratory diagnosis in young children. Appropriate treatment options may further not be available in certain studied settings. Actions aiming at educating and raising professional awareness, along with developing easy-to-use tools to support diagnosis and a general strengthening of health systems are important goals. [ABSTRACT FROM AUTHOR]

Published
2019
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32. Use of a Smartphone App to Assess Neonatal Jaundice

Author

Taylor, James A., primary, Stout, James W., additional, de Greef, Lilian, additional, Goel, Mayank, additional, Patel, Shwetak, additional, Chung, Esther K., additional, Koduri, Aruna, additional, McMahon, Shawn, additional, Dickerson, Jane, additional, Simpson, Elizabeth A., additional, and Larson, Eric C., additional

Published
2017
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34. Asthma: moving toward a global children's charter

Author

Adachi, Yuichi, Akinbami, Lara J, Blake, Kathryn V, Bush, Andrew, Cabana, Michael, Cicutto, Lisa C, Custovic, Adnan, Doull, Iolo, Fischer, Gilberto B, Fitzgerald, Dominic A, Fletcher, Monica, Grigg, Jonathan, Hong, Jianguo, Hughes, Rod, Keen, Christina, Leather, David A, Lemanske, Rob F, Lenney, Warren, Garcia-Marcos, Louis, Mazyck, Donna J, Ostrem, Anders, Pedersen, Soren, Rubin, Bruce K, Sheikh, Aziz, Shen, Kunling, Sly, Peter, Stein, Renato T, Stout, James W, Subbarao, Padmaja, Szefler, Stanley J, Tilak, Raj, Winders, Tonya, Williams, Sian, Zar, Heather J, and Sly, Peter D

Published
2019
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35. BiliCam

Author

de Greef, Lilian, primary, Goel, Mayank, additional, Seo, Min Joon, additional, Larson, Eric C., additional, Stout, James W., additional, Taylor, James A., additional, and Patel, Shwetak N., additional

Published
2014
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42. A randomized clinical trial of clinician feedback to improve quality of care for innercity children with asthma

Author

Kattan, Meyer, Crain, Ellen F., Steinbach, Suzanne, Visness, Cynthia M., Walter, Michelle, Stout, James W., Evans, Richard, III, Smartt, Ernestine, Gruchalla, Rebecca S., Morgan, Wayne J., O'Connor, George T., and Mitchell, Herman E.

Abstract

CONTEXT. Barriers impede translating recommendations for asthma treatment into practice, particularly in inner cities where asthma morbidity is highest. METHODS. The purpose of this study was to test the effectiveness of timely patient feedback in the form of a letter providing recent patient-specific symptoms, medication, and health service use combined with guideline-based recommendations for changes in therapy on improving the quality of asthma care by inner-city primary care providers and on resultant asthma morbidity. This was a randomized, controlled clinical trial in 5- to 11-year-old children (n = 937) with moderate to severe asthma receiving health care in hospital- and community-based clinics and private practices in 7 inner-city urban areas. The caretaker of each child received a bimonthly telephone call to collect clinical information about the child's asthma. For a full year, the providers of intervention group children received bimonthly computer-generated letters based on these calls summarizing the child's asthma symptoms, health service use, and medication use with a corresponding recommendation to step up or step down medications. We measured the number and proportion of scheduled visits resulting in stepping up of medications, asthma symptoms (2-week recall), and health care use (2-month recall). RESULTS. In this population, only a modest proportion of children whose symptoms warranted a medication increase actually had a scheduled visit to reevaluate their asthma treatment. However, in the 2-month interval after receipt of a step-up letter, 17.1% of the letters were followed by scheduled visits in the intervention group compared with scheduled visits 12.3% of the time by the control children with comparable clinical symptoms. Asthma medications were stepped up when indicated after 46.0% of these visits in the intervention group compared with 35.6% in the control group, and when asthma symptoms warranted a step up in therapy, medication changes occurred earlier among the intervention children. Among children whose medications were stepped up at any time during the 12-month study period, those in the intervention group experienced 22.1% fewer symptom days and 37.9% fewer school days missed. The intention-to-treat analysis showed no difference over the intervention year in the number of symptom days, yet there was a trend toward fewer days of limited activity and a significant decrease in emergency department visits by the intervention group compared with controls. This 24% drop in emergency department visits resulted in an intervention that was cost saving in its first year. CONCLUSIONS. Patient-specific feedback to inner-city providers increased scheduled asthma visits, increased asthma visits in which medications were stepped up when clinically indicated, and reduced emergency department visits. KEY WORDS. asthma, clinical trial, provider feedback, access to care, inner city., URL: [...]

Published
2006

43. A Randomized Clinical Trial of Clinician Feedback to Improve Quality of Care for Inner-city Children With Asthma

Author

Kattan, Meyer, primary, Crain, Ellen F., additional, Steinbach, Suzanne, additional, Visness, Cynthia M., additional, Walter, Michelle, additional, Stout, James W., additional, Evans, Richard, additional, Smartt, Ernestine, additional, Gruchalla, Rebecca S., additional, Morgan, Wayne J., additional, O'Connor, George T., additional, and Mitchell, Herman E., additional

Published
2006
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