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Improving teacher comfort and self-efficacy in asthma management

Reznik, Marina; Greenberg, Elana; Cain, Agnieszka; Halterman, Jill S; Ivanna Avalos, Maria
PMID: 31314614
ISSN: 1532-4303
CID: 5269682

The Principal and Nurse Perspective on Gaps in Asthma Care and Barriers to Physical Activity in New York City Schools: A Qualitative Study

Cain, Agnieszka; Reznik, Marina
BACKGROUND:School officials and nurses play an important role in facilitating asthma management in schools. Little is known about their perspectives on in-school asthma management and barriers to physical activity (PA) at school. AIMS:The goal of this study is to explore school officials' and nurses' perspectives on asthma care and barriers to PA in children with asthma attending New York City schools. METHOD:We conducted qualitative, semistructured interviews with 10 principals, 3 assistant principals, and 9 nurses in 10 Bronx, New York elementary schools. Sampling continued until thematic saturation was reached. Interviews were recorded, transcribed, and coded for common themes. The thematic and content review was subsequently used to analyze interview data. Emerging themes were discussed and agreed on by both investigators. RESULTS:Three main categories arose from the analysis: (1) procedures and policies around asthma management in school, (2) barriers to effective medication administration in school, and (3) barriers to PA in children with asthma. DISCUSSION:Participants identified gaps to in-school asthma management and barriers to PA participation: ineffective ways of identifying students with asthma; lack of written procedures for asthma management; difficulty in meeting the administrative requirements to administer asthma medication; lack of knowledge and training on asthma management for the parents, students, and school staff; parental limitation of children's PA; and schools not meeting the state physical education requirement. CONCLUSIONS:Our findings suggest the need for policy reform on asthma management and PA in urban schools and should be considered in the design of future interventions.
PMCID:5878996
PMID: 29084455
ISSN: 1552-6127
CID: 5269652

Parental Perspectives of Barriers to Physical Activity in Urban Schoolchildren With Asthma

Kornblit, Amy; Cain, Agnieszka; Bauman, Laurie J; Brown, Nicole M; Reznik, Marina
OBJECTIVE:Physical activity (PA) levels are low in today's youth and may even be lower in those with asthma. Barriers to PA have not been well studied in inner-city minority children with asthma. We conducted a qualitative study to characterize parental perceptions of barriers to PA and ways to improve PA levels in children with asthma. METHODS:We used the socioecologic model to inform development of our interview guide. Questions fell into 2 socioecologic model domains: interpersonal (parent, family) barriers and community (neighborhood, school) barriers. Qualitative semistructured interviews were conducted with 23 parents (21 mothers, 2 fathers) of inner-city children with asthma (aged 8-10 years) from 10 Bronx, New York, elementary schools. Sampling continued until thematic saturation was reached. Interviews were recorded, transcribed, and independently coded for common themes. Emerging themes were discussed and agreed on by investigators. RESULTS:Three themes surrounding interpersonal barriers to PA emerged: 1) parental fear of exercise-induced asthma due to lack of child symptom awareness, 2) nonadherence and refusal to take medications, and 3) challenges with asthma management. Four themes around community barriers to PA emerged: 1) lack of trust in school management of asthma, 2) lack of school PA facilities, 3) unsafe neighborhoods, and 4) financial burden of PA. CONCLUSIONS:A complex, multilevel set of barriers to PA exist in children with asthma. Addressing these barriers by involving stakeholders at the family, school, and community levels may improve PA levels in children with asthma.
PMCID:5889757
PMID: 29309846
ISSN: 1876-2867
CID: 5269662

Pilot Project to Integrate Community and Clinical Level Systems to Address Health Disparities in the Prevention and Treatment of Obesity among Ethnic Minority Inner-City Middle School Students: Lessons Learned

Rieder, Jessica; Cain, Agnieszka; Carson, Erica; Benya, Andrea; Meissner, Paul; Isasi, Carmen R; Wylie-Rosett, Judith; Hoffman, Neal; Kelly, Colleen; Silver, Ellen J; Bauman, Laurie J
Effective obesity prevention and treatment interventions are lacking in the United States, especially for impoverished minority youths at risk for health disparities, and especially in accessible community-based settings. We describe the launch and pilot implementation evaluation of the first year of the B'N Fit POWER initiative as a middle school-based comprehensive wellness program that integrates weight management programming into existing onsite preventive and clinical services. Consistent with the existing implementation science literature, we focused on both the organizational structures that facilitate communication and the development of trust among stakeholders, students, and families and the development of realistic and timely goals to implement and integrate all aspects of the program. New implementation and programming strategies were developed and tested to increase the proportion of students screened, support the linkage of students to care, and streamline the integration of program clinical and afterschool components into routine services already offered at the school. We report on our initial implementation activities using the Standards for Reporting Implementation Studies (StaRI) framework using hybrid outcomes combining the Reach element from the RE-AIM framework with a newly conceptualized Wellness Cascade.
PMCID:5903332
PMID: 29850232
ISSN: 2090-0716
CID: 5269672

Possible Pilocytic Astrocytoma Presenting as Migraines and Bilateral Cervical Myalgia in Adulthood: A Case Report [Meeting Abstract]

Cain, Agnieszka M; Shah, Nirvi; Mandalaywala, Neil; Seo, Young Il; Kim Charles; Portugal, Salvador; Scackheim, Kimberly A
ORIGINAL:0015760
ISSN: 1934-1482
CID: 5295082

Bringing adaptive sports to the Bronx

Cain, Agnieszka
ORIGINAL:0015761
ISSN: n/a
CID: 5295092

Asthma management in New York City schools: A classroom teacher perspective

Cain, Agnieszka; Reznik, Marina
OBJECTIVE:Classroom teachers play an important role in facilitating asthma management in school but little is known about their perspectives around asthma management. We examined the perspectives of classroom teachers around barriers to school asthma management. METHODS:We conducted key informant interviews with 21 inner-city classroom teachers from 3rd to 5th grades in 10 Bronx, New York elementary schools. Sampling continued until thematic saturation was reached. Interviews were recorded, transcribed, and independently coded for common themes. We used thematic and content review to analyze interview data. RESULTS:Seven themes representing teachers' perspectives on in-school asthma management emerged: (1) the problematic process of identifying students with asthma; (2) poor familiarity with the city health department's asthma initiative and poor general knowledge of school policies on asthma management; (3) lack of competency in managing an acute asthma attack in the classroom and poor recognition of symptoms of an asthma attack; (4) lack of confidence in dealing with a hypothetical asthma attack in the classroom; (5) lack of quick access to asthma medication in school; (6) limited communication between school staff; and (7) enthusiasm about learning more about asthma management. CONCLUSIONS:Our results revealed several barriers contributing to suboptimal in-school asthma management: ineffective ways of identifying students with asthma, lack of teacher knowledge of guidelines on asthma management, lack of comfort in managing students' asthma, inadequate access to asthma medication in school, and limited communication between school staff. These issues should be considered in the design of interventions to improve in-school asthma management.
PMCID:4992552
PMID: 27031532
ISSN: 1532-4303
CID: 5269642

Echogenic Intracardiac Foci in an Urban Population: A 10-Year Retrospective Experience [Meeting Abstract]

Davidson, Sasha; Cain, Agnieszka; Oben, Ayamo; Gaither, Kecia
ISI:000398934900390
ISSN: 0029-7844
CID: 5269702