PubMed Health⌕ Search

Biomedical subjects

V Niebuhr

Publications and source records attributed to V Niebuhr.

3 recordsLinked to original sources
PubMed1998

Principles for developing interdisciplinary school-based primary care centers.

A 50% increase has occurred in the number of school-based primary care centers (SBPCCs) in the United States since 1993-94. Public schools offer a well-established and respected community-based infrastructure within which health centers may feasibly be developed. SBPCCs have documented improved access to care for underserved children and some initial success in addressing the complex morbidities and associated behavioral risk factors of children and adolescents. This paper presents five working principles to help communities establish SBPCCs that link community health and social services with their educational system. The principles encompass community participation, early assessment of community needs, integration of health and human services with educational services through an interdisciplinary and interagency team approach, development of a business plan, and program evaluation. These principles reflect the experiences of 22 Texas communities which operate 76 SBPCCs. They should prove helpful to many other communities and states that propose to develop, finance, and evaluate school-based, interdisciplinary health care and prevention services.

Adolescent↗
PubMed1996

An asthma self-management program for children, including instruction in peak flow monitoring by school nurses.

A randomized trial of an instructional method was conducted in which school nurses taught children asthma self-management principles and skills, including peak flow monitoring, in 20-min, individual sessions over an 8-week period. Thirty-six children participated. An intervention group of 18 children received the teaching sessions. A control group of 18 children received regular care by the nurses, but no teaching sessions. The sample included 64% boys, 69% African-Americans, and 69% Medicaid recipients. The average age of subjects was 10.2 years. The two groups were demographically similar, but despite random assignment, the control group had a significantly earlier age of onset of asthma and tended to have had more asthma attacks in the preceding year. These factors were statistically controlled in outcome analyses. Results of group comparisons showed no significant differences in the number of postintervention emergency room visits and days absent from school. However, nurses reported that children who practiced breathing exercises had less anxiety during exacerbations, and the nurses' knowledge of the children's baseline peak expiratory flow rates facilitated care of the children. Nurses expressed the opinion that the individual sessions with students might be useful in motivating them to participate effectively in later group sessions. The intervention was well accepted by students, parents, and nurses. We believe that this intervention is promising as a practical, low-cost approach to enhancing children's asthma self-management skills and warrants further testing in a larger sample, with the intervention conducted over a longer period.

Absenteeism↗