Indigenous healthcare worker involvement for Indigenous adults and children with asthma

Chang, Anne B., Taylor, Brett, Masters, I. Brent, Laifoo, Yancy and Brown, Alexander D. H. (2007) Indigenous healthcare worker involvement for Indigenous adults and children with asthma. Cochrane Database of Systematic Reviews, 4: CD006344.1-CD006344.18. doi:10.1002/14651858.CD006344.pub2


Author Chang, Anne B.
Taylor, Brett
Masters, I. Brent
Laifoo, Yancy
Brown, Alexander D. H.
Title Indigenous healthcare worker involvement for Indigenous adults and children with asthma
Journal name Cochrane Database of Systematic Reviews   Check publisher's open access policy
ISSN 1469-493X
Publication date 2007
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1002/14651858.CD006344.pub2
Issue 4
Start page CD006344.1
End page CD006344.18
Total pages 18
Place of publication Oxford, United Kingdom
Publisher John Wiley & Sons
Language eng
Formatted abstract
Background: Asthma education is regarded as an important step in the management of asthma in national guidelines. Racial and socio-economic factors are associated with markers of asthma severity, including recurrent acute presentations to emergency health facilities. Worldwide, indigenous groups are disproportionately represented in the severe end of the asthma spectrum. Appropriate models of care are important in the successful delivery of services, and are likely contributors to improved outcomes for people with asthma.
Objectives: To determine whether involvement of an indigenous healthcare worker (IHW) in comparison to absence of an IHW in asthma education programmes, improves asthma related outcomes in indigenous children and adults with asthma.
Search strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Airways Group Specialised Register, MEDLINE and EMBASE databases, review articles and reference lists of relevant articles. The latest search was in December 2008.
Selection criteria: All randomised controlled trials comparing involvement of an indigenous healthcare worker (IHW) in comparison to absence of an IHW in asthma education programmes for indigenous people with asthma.
Data collection and analysis: Two independent review authors selected data for inclusion, a single author extracted the data. Both review authors independently assessed study quality. We contacted authors for further information. As it was not possible to analyse data as "intention-to-treat", we analysed data as "treatment received".
Main results: Only a single study was applicable for this review, and included 24 children randomised to an asthma education programme involving an IHW, compared to a similar intervention without an IHW. Twenty two of these children completed the trial. Only one outcome (asthma knowledge in children, mean difference of 3.30 units, 95% CI 1.07 to 5.53) significantly favoured the IHW involvement group. However, although not statistically significant, all the outcomes favoured the group that had IHW involvement in the asthma education program. There were no studies in adults.
Authors' conclusions: The involvement of IHW in asthma programs targeted for their own ethnic group in one small trial was beneficial for some but not all asthma outcomes. Thus there is insufficient data to be confident that the involvement of IHW is beneficial in all settings. Nevertheless, given the complexity of health outcomes and culture as well as the importance of self-determination for indigenous peoples, the practice of including IHW in asthma education programs for indigenous children and adults with asthma is justified, but should be subject to further randomised controlled trials.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ
Additional Notes Article # CD006344

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: ERA 2012 Admin Only
School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 7 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 12 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Tue, 20 Dec 2011, 10:21:05 EST by Jane Medhurst on behalf of Child Health Research Centre