Change in approach and delivery of medical care in children with asthma: results from a multicenter emergency department educational asthma management program.

Objectives: The Hawaii Child Asthma Research to Elevate Standards (CARES) Program implemented an emergency department (ED)-based education and management program to facilitate National Asthma Education and Prevention Program (NAEPP) guideline understanding among asthmatic children and their families, ED staff, and health care providers.

Methods: The multipronged approach used: (1) 2-phased prospective tracking system of ED asthma patients; (2) ED-based educational intervention for patients/families; and (3) asthma education for ED staff and community-based health care providers. Data were collected across 4 EDs during phase I (October 8, 2002, to October 1, 2003) and phase II (October 1, 2003, to July 8, 2004).

Evaluation of secondhand smoking characteristics in asthmatic children presenting to four emergency departments on O'ahu, Hawai'i.

Exposure to secondhand smoke causes adverse health outcomes particularly in vulnerable groups like children. This multi-centered prospective study examined the household exposure to secondhand smoke among asthmatic children presenting to emergency departments on O'ahu, Hawai'i. Findings revealed that asthmatic children of Samoan, Micronesian, Filipino, Part/Native Hawaiian and Other/Mixed Ancestry had a greater proportion of high exposure to secondhand smoke in the home compared to Japanese, Chinese and Caucasian ethnic groups.

Demographics and characteristics of wheezing/asthmatic children with repeat emergency department visits in O'ahu, Hawai'i.

A profile of Hawai'i's pediatric asthmatic patients who repeatedly visit the ED is lacking. This multi-centered prospective study found that repeat ED utilization occurs more frequently in a particular subset of patients. Characteristics of the asthmatic cohort can help health care providers, caregivers, children, and their families understand and better manage asthma as a chronic condition and improve quality of life.