Parent Perspectives on Appointment Nonattendance: A Descriptive Study.

Appointment nonattendance is a phenomenon that has been studied in a variety of settings. Increased nonattendance rates may result in lost productivity, patient and provider dissatisfaction, and difficulty recruiting staff and physicians. In addition, needed care for patients may be delayed. The purpose of this descriptive study was to examine parental perspectives regarding appointment nonattendance in pediatric specialty care clinics in order to better understand the facilitators and barriers to successful appointment attendance. An exploratory, descriptive approach was chosen for this study. Eight parents of children ages five years and younger were interviewed regarding appointment attendance in specialty care clinics, and conventional content analysis was used to identify themes. Findings suggest that multiple factors are associated with nonattendance, including child/family system and provider/healthcare system factors. Reducing wait times for specialty appointments (from time of scheduling to appointment date), coordinating multiple services, and offering convenient appointment times may be beneficial in optimizing appointment attendance.

Asthma characteristics among older adults: using the California health interview survey to examine asthma incidence, morbidity and ethnic differences.

OBJECTIVE: The purpose of this study was to examine the incidence, characteristics of asthma morbidity and care, and ethnic differences that exist in older adults with asthma in California. METHODS: Data were from the 2009 California Health Interview Survey (CHIS). Characteristics of older adults (≥65 years) with and without asthma were compared using population-weighted estimates. Asthma-specific variables were compared among different ethnic groups. Multivariate analyses were preformed to determine factors associated with asthma status, asthma episodes/attacks, asthma symptom frequency and emergency department (ED) visits due to asthma. RESULTS: Asthma was present in 8.1% of older adults, among which, 67.3% reported taking medication daily for asthma. Asthma symptoms were experienced every day by almost 20%, with over 34% of seniors with asthma having symptoms at least once per week. Despite having a lower frequency of asthma symptoms, Hispanics were 5.31 times more likely to visit the ED due to asthma than were Caucasians. CONCLUSIONS: The findings from the study showed that older adults with asthma had difficulty with asthma control. We recommend a focus on asthma education so that when symptoms do occur, options are available to avoid costly ED visits. Further research should focus on specific asthma management skills and adherence to asthma treatment regimen among ethnic groups.

Self-report INH adherence measures were reliable and valid in Latino adolescents with latent tuberculosis infection.

BACKGROUND AND OBJECTIVE: To test the reliability and validity of 8-day and 30-day self-report measures of adherence to daily isoniazid (INH) for treatment of latent tuberculosis infection (LTBI). METHODS: Participants were 286 Latino adolescents (ages 13-18, 55.6% male) with LTBI recruited from 10 public middle and high schools in San Diego County. INH adherence was measured monthly for up to 9 months by interview and urine specimens at unannounced visits. Reliability and validity analyses were performed within 5 consecutive months. Reliability was assessed by correlating: (1) 8- and 30-day INH adherence measures within each month; and (2) each of the two adherence measures across months. Validity was assessed by correlating reported measures with biological assays within each month. RESULTS: Reliability tests yielded significant correlation coefficients (p < .05 to .001), both across measures (r = 0.71-0.93) and across time (r = 0.29-0.64 for 8-day recall; r = 0.32-0.69 for 30-day recall). Validity tests of both adherence measures were also significant (p < .05 to .001): 8-day recall (r(pb) = 0.52-0.72) and 30-day recall (r(pb) = 0.37-0.71). CONCLUSION: Results suggest that impromptu recall measures of INH adherence, combined with urine collection, are reliable and valid in Latino adolescents.