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Student perspectives on asthma management in schools: a mixed-methods study examining experiences, facilitators, and barriers to care.

ABSTRACT: Objective: Children spend nearly a third of their day at school, making it a critical point of intervention for those with asthma. This study aimed to illuminate minority students' experiences with asthma at school and perceptions of facilitators and barriers to care. Methods: A mixed-methods study was conducted with elementary students with asthma. Participants completed a 24-question survey, drawing exercise to depict experiences caring for their asthma at school, and focus group discussion. Drawings were analyzed for narrative and pictorial themes. Discussions were audio-recorded, transcribed, and independently coded for themes. Results: Fifteen children with asthma (8-11?years) participated from two Chicago schools with predominately African-American populations. Most students (79%) indicated they had control of asthma at school, while 85% identified asthma as a problem when exercising. Half (53%) received help with asthma care at school. Drawings depicted cooperative management with adults or peers and the central role of inhalers as part of everyday asthma care in school. Finally, focus groups produced six key themes within the domains of facilitators: 1) support of others, 2) self-efficacy; 3) perception of being normal; and barriers: 4) lack of support from others; 5) difficulty accessing inhaler; 6) perception of being different. Conclusions: This study suggests asthma care plays an important role in students' school experiences. Stigma around inhaler use, lack of concern by school staff, and limited access to medications remain as barriers to school-based asthma management. Although facilitators, such as support from teachers and peers, do exist, future interventions must address existing barriers.

SUBMITTER: Naman J

PROVIDER: S-EPMC6491275 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Student perspectives on asthma management in schools: a mixed-methods study examining experiences, facilitators, and barriers to care.

Naman Julia J Press Valerie G VG Vaughn Dagny D Hull Ashley A Erwin Kim K Volerman Anna A

The Journal of asthma : official journal of the Association for the Care of Asthma 20181030 12

<i>Objective</i>: Children spend nearly a third of their day at school, making it a critical point of intervention for those with asthma. This study aimed to illuminate minority students' experiences with asthma at school and perceptions of facilitators and barriers to care. <i>Methods</i>: A mixed-methods study was conducted with elementary students with asthma. Participants completed a 24-question survey, drawing exercise to depict experiences caring for their asthma at school, and focus group ...[more]

PMID: 30376385

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Project description:BackgroundApp-based treatment for urinary incontinence is a proven effective and cost-effective alternative to care as usual, but successful implementation requires that we identify and address the barriers and facilitators associated with app use.ObjectiveThe goal of the research was to explore the factors influencing app-based treatment for urinary incontinence and identify which barriers or facilitators are associated with treatment success or failure.MethodsWe used a sequential explanatory mixed methods design to connect the results of a randomized controlled trial with data from semistructured interviews. This previous RCT had shown the noninferiority of app-based treatment compared with care as usual for urinary incontinence over 4 months. Participants who reported success or failure with app-based treatment, as measured by the change in International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form symptom score, were selected for telephone interview by purposive sampling (n=17). This study reports mainly on the qualitative component of our mixed methods study. Qualitative analyses were conducted in two ways. First, we analyzed the qualitative data of all interviewed participants and discussed the relationships between the main themes. Second, the experiences between the success (n=9) and failure group (n=8) were compared and contrasted to explore factors that were positively or negatively associated with the quantitative effect of app-based treatment. These factors were then interpreted as barriers to and facilitators of successful app-based treatment.ResultsFour interrelated themes were identified as affecting the app based treatment effect: adherence, personal factors, app factors, and awareness. Qualitative analyses of the relationships between the themes showed that adherence-related factors directly influenced treatment effect in both a positive and negative matter. In turn, adherence was also positively and negatively influenced by the other 3 themes. Additionally, awareness was positively influenced by the treatment effect. Within these themes, several factors were identified that acted as barriers (eg, unrealistic expectation of time investment and interfering personal circumstances), facilitators (eg, strict integration of exercises and prior pelvic floor muscle therapy), or both (eg, personality traits and increased awareness of symptoms).ConclusionsThis study shows that the effect of app-based treatment for urinary incontinence is mainly influenced by adherence, which in turn is affected by personal factors, app-based factors, and awareness. The identified factors could function as both facilitators and barriers depending on the user and interaction with other themes. Insight into these facilitators and barriers could lead to improved implementation and increased treatment effectiveness by targeting women most likely to benefit and through further development of the app.International registered report identifier (irrid)RR2-10.1002/nau.23507.

Project description:BACKGROUND:A large number of mobile health (mHealth) apps have been created to help users to manage their health or receive health care services. Many of these mHealth apps have proven to be helpful for maintaining or improving their users' health. However, many people still choose not to use mHealth apps or only use them for a short period. One of the reasons behind this lack of use is the concern for their health information security and privacy. OBJECTIVE:The goal of this study was to determine the relationship between users' characteristics and their security and privacy concerns and to identify desired security features in mHealth apps, which could reduce these concerns. METHODS:A questionnaire was designed and validated by the research team. This questionnaire was then used to determine mobile app users' security and privacy concerns regarding personal health data in mHealth apps as well as the security features most users' desire. A semistructured interview was used to identify barriers to and facilitators of adopting mHealth apps. RESULTS:In total, 117 randomly selected study participants from a large pool took part in this study and provided responses to the validated questionnaire and the semistructured interview questions. The results indicate that most study participants did have concerns about their privacy when using mHealth apps. They also expressed their preferences regarding several security features in mHealth apps, such as regular password updates, remote wipe, user consent, and access control. An association between their demographic characteristics and their concerns and preferences in security and privacy was identified; however, in most cases, the differences among the different demographic groups were not statistically significant, except for a few very specific aspects. These study participants also indicated that the cost of apps and lack of security features in mHealth apps were barriers for adoption, whereas having free apps, strong but easy-to-use security features, and clear user protection privacy policies might encourage them to use mHealth apps in their health management. CONCLUSIONS:This questionnaire and interview study verified the security and privacy concerns of mHealth app users, identified the desired security and privacy features, and determined specific barriers to and facilitators of users adopting mHealth apps. The results can be used to guide mHealth app developers to create apps that would be welcomed by users.

Dataset Information

Student perspectives on asthma management in schools: a mixed-methods study examining experiences, facilitators, and barriers to care.

Publications

Student perspectives on asthma management in schools: a mixed-methods study examining experiences, facilitators, and barriers to care.

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