Full citation and abstract? Nicholas, Stephen W., Jean-Lous, Betina PhD, Ortiz, Benjamin MD, Northridge, Mary PhD, MPH, Shoemaker, Katherine MPP, Vaughan, Roger DrPH, MS, Rome, Michaela PhD, Canada, Geoffrey Med, Hutchinso, Vincent MD, and For the Harlem Children’s Zone Asthma Initiative, “Addressing the Childhood Asthma Crisis in Harlem: The Harlem Children’s Zone Asthma Initiative,” Am J Public Health, 2005 February; 95(2): 245-249.
The goal of the study was to determine the presence of asthma, estimated asthma symptoms and asthma management strategies used with children ages 0-12 years in Central Harlem. To do this, the children aged 0-12 years that live or attend the Harlem Children’s Zone Project (HCZ Project) and even participate in any of the programs held by the HCZ, were screened for asthma. The children that were found to have asthma or asthma-like symptoms were asked to participate in the intensive interventions program.
There were 1982 children screened for asthma or asthma-like symptoms, and of those children, 28.5% were told by a doctor or nurse that they have asthma, and 30.3% were told that they have asthma of asthma-like symptoms. At baseline, of the 229 children enrolled in the Harlem Children Zone Asthma Initiative, 24.0% missed school in the 14 days preceding the assessment due to asthma reasons. The study also concluded that the prevalence of children with asthma in the Harlem Children’s Zone Project is consistent with the reports of other poor urban communities. Lastly, the study looks into efforts that could reduce asthma symptoms in children, as well as improve their asthma management strategies.
Where do the authors work, and what are their areas of expertise? Note any other publications by the authors with relevance to the 6Cities project. Stephen W. Nicholas, Benjamin Ortiz, and Vincent Hutchinson are with the Department of Pediatrics, Harlem Hospital Center/Columbia University, New York, NY.
Betina Jean-Louis, Michaela Rome, Katherine Shoemaker, and Geoffrey Canada are with the Harlem Children’s Zone, Inc., New York. (Geoffrey Canada is especially important because he is head of the Harlem Children’s Zone).
Mary Northridge and Roger Vaughan are with the Harlem Health Promotion Center, Columbia University Mailman School of Public Health, New York.
What are the main findings or arguments presented in the article or report? Of the 1982 children that were screened to date, 28.5% were told by a doctor or nurse that they have asthma, and 30.3% were experiencing asthma or asthma-like symptoms. There was a higher prevalence for school-aged children, boys, Latinos, and children living with smokers.
For the 229 children enrolled in the asthma initiative, in the last 14 days preceding the assessment, 57.6% of the children experienced wheezing or other asthma symptoms, and 24.0% missed school because of such symptoms. In the 3 months preceding the assessment, 34.9% of children went to the emergency room and 8.3% were hospitalized for asthma-like symptoms. Less than half of the children at enrollment were using the proper asthma management skills, such as having a spacer devise, a peak flow meter, or an asthma action plan.
The article argues that not only is childhood asthma in Central Harlem highly prevalent and severe, but there is a great need for policy makers to find a way to pay for community-based asthma services. Children and families must be educated on how to prevent, as well as deal, with asthma symptoms should they arise.
Describe at least three ways that the argument is supported. The argument is supported bythe 57.6% of children that were found to have experienced wheezing or other asthma symptoms in the 14 days prior to the assessment, the 24.0% that missed school due to asthma-like symptoms during that time, as well as the fact that of the 1982 children screened, 28.5% were informed by a doctor or nurse that they had asthma, and 30.3% were have asthma or asthma-like symptoms, showing that there is in fact an asthma crisis in Harlem.
What three (or more) quotes capture the message of the article or report? “Childhood asthma in Central Harlem is not only highly prevalent, but also severe.”
“A series of medical, educational, environmental, social, and legal interventions is being delivered to program participants on the basis of their needs.”
“but our greatest challenge is to educate and support children and families to implement and sustain the effective symptom prevention and treatment services that are currently available. More translational research is needed, but action cannot wait.”
What were the methods, tools and/or data used to produce the claims or arguments made in the article or report? A screening questionnaire was given to the parents/guardians of the children aged 0-12 in the Harlem Children’s Zone, Inc, programs, which included Baby College, the child development workshop series for parents, Harlem Gems, the prekindergarten program, and Harlem Peacemakers, which consists on the college interns that work in the elementary school classrooms. The screening consisted of 22 items used exactly or slightly modified from standardized questions, including asthma diagnosis and symptoms from the National Health Survey and the National Cooperative Inner-City Asthma Study.
There was active surveillance of the Harlem Hospital Center inpatient, emergency room, clinical records, block-by-block canvassing for recreational programs, and day care centers. The parents/guardians were given the opportunity to have their child examined for asthma by a doctor or nurse from Harlem Hospital. Families of children with either self-reported asthma or asthma-like symptoms were asked to participate in the Harlem Children’s Zone Asthma Initiative.
Children with more severe asthma were targeted as first priority in the study. Spacer devices were given to children to train them on their proper use, each child in the program had their own asthma action plan, “asthma basics 101” was reinforced with the parents and children as an educational intervention, parents and children were informed of the ways in which they can avoid common triggers of asthma, and program participants were provided with dust cover for bed mattresses and pest remediation which served as an environmental intervention.
In addition, a database management system was designed to organize and track the different intervention components, which were medical, educational, environmental, social, and legal. A geographic information system was developed in order to allow for the mapping of results for special analysis. SAS software was used to estimate item responses. Chi-square tests were used to look for any existing differences between groups defined by the following characteristics: age, gender, race/ethnicity, regular source of health care, health insurance, and household environmental tobacco smoke exposure.
How (if at all) are health disparities or other equity issues addressed in the article or report? Health disparities are addressed with regards to the medical, educational, environmental, social, and legal impacts on children and families with asthma in Harlem.
Can you learn anything from the article or report’s bibliography that tells us something about how the article or report was produced? Due to the fact that Geoffrey Canada, head of Harlem Children’s Zone, is one of the authors of the article, it tells the reader that there is a possible existing bias in the research and results found in the study.
What three points, details or references from the text did you follow up on to advance your understanding of how air pollution science has been produced and used in governance and education in different settings? -Current asthma prevalence in Harlem -Current asthma initiative of the Harlem Children’s Zone -Whether or not the asthma initiative has had a positive impact on the children with asthma in Harlem
Full citation and abstract?
Nicholas, Stephen W., Jean-Lous, Betina PhD, Ortiz, Benjamin MD, Northridge, Mary PhD, MPH, Shoemaker, Katherine MPP, Vaughan, Roger DrPH, MS, Rome, Michaela PhD, Canada, Geoffrey Med, Hutchinso, Vincent MD, and For the Harlem Children’s Zone Asthma Initiative, “Addressing the Childhood Asthma Crisis in Harlem: The Harlem Children’s Zone Asthma Initiative,” Am J Public Health, 2005 February; 95(2): 245-249.
The goal of the study was to determine the presence of asthma, estimated asthma symptoms and asthma management strategies used with children ages 0-12 years in Central Harlem. To do this, the children aged 0-12 years that live or attend the Harlem Children’s Zone Project (HCZ Project) and even participate in any of the programs held by the HCZ, were screened for asthma. The children that were found to have asthma or asthma-like symptoms were asked to participate in the intensive interventions program.
There were 1982 children screened for asthma or asthma-like symptoms, and of those children, 28.5% were told by a doctor or nurse that they have asthma, and 30.3% were told that they have asthma of asthma-like symptoms. At baseline, of the 229 children enrolled in the Harlem Children Zone Asthma Initiative, 24.0% missed school in the 14 days preceding the assessment due to asthma reasons. The study also concluded that the prevalence of children with asthma in the Harlem Children’s Zone Project is consistent with the reports of other poor urban communities. Lastly, the study looks into efforts that could reduce asthma symptoms in children, as well as improve their asthma management strategies.
Where do the authors work, and what are their areas of expertise? Note any other publications by the authors with relevance to the 6Cities project.
Stephen W. Nicholas, Benjamin Ortiz, and Vincent Hutchinson are with the Department of Pediatrics, Harlem Hospital Center/Columbia University, New York, NY.
Betina Jean-Louis, Michaela Rome, Katherine Shoemaker, and Geoffrey Canada are with the Harlem Children’s Zone, Inc., New York. (Geoffrey Canada is especially important because he is head of the Harlem Children’s Zone).
Mary Northridge and Roger Vaughan are with the Harlem Health Promotion Center, Columbia University Mailman School of Public Health, New York.
What are the main findings or arguments presented in the article or report?
Of the 1982 children that were screened to date, 28.5% were told by a doctor or nurse that they have asthma, and 30.3% were experiencing asthma or asthma-like symptoms. There was a higher prevalence for school-aged children, boys, Latinos, and children living with smokers.
For the 229 children enrolled in the asthma initiative, in the last 14 days preceding the assessment, 57.6% of the children experienced wheezing or other asthma symptoms, and 24.0% missed school because of such symptoms. In the 3 months preceding the assessment, 34.9% of children went to the emergency room and 8.3% were hospitalized for asthma-like symptoms. Less than half of the children at enrollment were using the proper asthma management skills, such as having a spacer devise, a peak flow meter, or an asthma action plan.
The article argues that not only is childhood asthma in Central Harlem highly prevalent and severe, but there is a great need for policy makers to find a way to pay for community-based asthma services. Children and families must be educated on how to prevent, as well as deal, with asthma symptoms should they arise.
Describe at least three ways that the argument is supported.
The argument is supported by the 57.6% of children that were found to have experienced wheezing or other asthma symptoms in the 14 days prior to the assessment, the 24.0% that missed school due to asthma-like symptoms during that time, as well as the fact that of the 1982 children screened, 28.5% were informed by a doctor or nurse that they had asthma, and 30.3% were have asthma or asthma-like symptoms, showing that there is in fact an asthma crisis in Harlem.
What three (or more) quotes capture the message of the article or report?
“Childhood asthma in Central Harlem is not only highly prevalent, but also severe.”
“A series of medical, educational, environmental, social, and legal interventions is being delivered to program participants on the basis of their needs.”
“but our greatest challenge is to educate and support children and families to implement and sustain the effective symptom prevention and treatment services that are currently available. More translational research is needed, but action cannot wait.”
What were the methods, tools and/or data used to produce the claims or arguments made in the article or report?
A screening questionnaire was given to the parents/guardians of the children aged 0-12 in the Harlem Children’s Zone, Inc, programs, which included Baby College, the child development workshop series for parents, Harlem Gems, the prekindergarten program, and Harlem Peacemakers, which consists on the college interns that work in the elementary school classrooms. The screening consisted of 22 items used exactly or slightly modified from standardized questions, including asthma diagnosis and symptoms from the National Health Survey and the National Cooperative Inner-City Asthma Study.
There was active surveillance of the Harlem Hospital Center inpatient, emergency room, clinical records, block-by-block canvassing for recreational programs, and day care centers. The parents/guardians were given the opportunity to have their child examined for asthma by a doctor or nurse from Harlem Hospital. Families of children with either self-reported asthma or asthma-like symptoms were asked to participate in the Harlem Children’s Zone Asthma Initiative.
Children with more severe asthma were targeted as first priority in the study.
Spacer devices were given to children to train them on their proper use, each child in the program had their own asthma action plan, “asthma basics 101” was reinforced with the parents and children as an educational intervention, parents and children were informed of the ways in which they can avoid common triggers of asthma, and program participants were provided with dust cover for bed mattresses and pest remediation which served as an environmental intervention.
In addition, a database management system was designed to organize and track the different intervention components, which were medical, educational, environmental, social, and legal. A geographic information system was developed in order to allow for the mapping of results for special analysis. SAS software was used to estimate item responses. Chi-square tests were used to look for any existing differences between groups defined by the following characteristics: age, gender, race/ethnicity, regular source of health care, health insurance, and household environmental tobacco smoke exposure.
How (if at all) are health disparities or other equity issues addressed in the article or report?
Health disparities are addressed with regards to the medical, educational, environmental, social, and legal impacts on children and families with asthma in Harlem.
Where has this article or report been referenced or discussed? (In some journals, you can see this in a sidebar.)
This article is cited by the follow articles:
Asthma in Inner-City Children at 5–11 Years of Age and Prenatal Exposure to Phthalates: The Columbia Center for Children’s Environmental Health Cohort
Asthma and Adaptive Functioning among Homeless Kindergarten-Aged Children in Emergency Housing
Polycyclic Aromatic Hydrocarbon Exposure, Obesity and Childhood Asthma in an Urban Cohort
The Association between Parental Perception of Neighborhood Safety and Asthma Diagnosis in Ethnic Minority Urban Children
Childhood Exposure to Fine Particulate Matter and Black Carbon and the Development of New Wheeze Between Ages 5 and 7 In an Urban Prospective Cohort
A Community-Engaged Approach to Select Geographic Areas for Interventions to Reduce Health Disparities
Asthma Morbidity Among Children Evaluated by Asthma Case Detection
Can you learn anything from the article or report’s bibliography that tells us something about how the article or report was produced?
Due to the fact that Geoffrey Canada, head of Harlem Children’s Zone, is one of the authors of the article, it tells the reader that there is a possible existing bias in the research and results found in the study.
What three points, details or references from the text did you follow up on to advance your understanding of how air pollution science has been produced and used in governance and education in different settings?
-Current asthma prevalence in Harlem
-Current asthma initiative of the Harlem Children’s Zone
-Whether or not the asthma initiative has had a positive impact on the children with asthma in Harlem