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Windber Research Institute (WRI, Center for Health Promotion & Disease Prevention

Health Promotion in a Pediatric Asthma Clinical Setting: the Expanded Chronic Care Model

Articolo pubblicato il 31.05.2012 in  AREA MEDICI COLLABORAZIONI

The prevalence of pediatric asthma is increasing worldwide (The Merck Childhood Asthma Network, Inc., 2010) and is often underdiagnosed (de Marco, Cerveri, Bugiani, Ferrari, & Verato, 1998). This is despite a rather sophisticated advancement in clinical management, and to some degree, educational support to this population. (Guarnaccia et al., 2007). What we are now realizing is that the clinical pathway represents only one part of what is necessary to care for children with asthma.
The relationship of smoking and asthma has been demonstrated at multiple levels (Gomez, Vollmer, Caceres, Jossen, & Baena-Cagnani, 2009). More recent research has also demonstrated a relationship between obesity and newly diagnosed asthma in school aged children; television viewing and exercise (Corbo et al., 2008). In addition, children with asthma are certainly placed in that category of children with special needs; thus, being exposed to other social challenges such as school-based bullying (Blackman & Gurka, 2007). 
Since 1999 and under the direction of Dr. Sebastiano Guarnaccia, the Laboratorio Clinico Pedagogico e Ricerca Biomedica, Spedali Civili, has been  active in developing a comprehensive clinical environment serving the children of Brescia (Guarnaccia et al., 2007). In addition, this third largest health care system in Europe has been committed to the development and practical use and institutional dissemination of the Chronic Care Model (CCM). The relationship between the two, pediatric asthma and the chronic care model, has been positively demonstrated in that the implementation of the CCM has resulted in better outcomes for this population (Mangione-Smith et al., 2005). Most recently, an electronic database has been developed by Dr. Sebastiano Guarnaccia and his team at the Ospedale dei Bambini, Spedali Civili, Brescia, Italy.  The database is able to document the demographics, clinical management and progress of the identified patient population. In addition, it is intended to integrate with the clinical practices of the physicians of the region.
The Center for Health Promotion and Disease Prevention at the Windber Research Institute is nationally and internationally recognized for the implementation, monitoring and evaluation of evidence-based programs in a community, especially in schools. This Pediatrician/Public Health Professional-led Center has been quite active in addressing the public health issues of childhood obesity and school-based bullying.
Since 2010, and with support from Pfizer, Inc., the two centers, both members of the WHO-HPH Network, have worked cooperatively to develop a clinical health promotion database, Expanded Chronic Care Model.
These indicators will allow the clinical/health promotion team to document and follow important health/social issues impacting the life of a pediatric asthma patient on. This two year collaboration has now allowed for the development of an initiative that will provide a health promotion component to the existing pediatric clinical environment in Spedali Civili; with both components supporting the new database.

Windber Research Institute Center for Health  Promotion and  Disease Prevention Annual Review 2011

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Le parti interessate (Stakeholders)

1. Il Laboratorio Clinico Pedagogico e Ricerca Biomedica (LCPeRB), Az. Spedali Civili, Bs;
2. L’Associazione ALCP e RB;
3. L’ Azienda Spedali Civili di Brescia;
4. Il Windber Research Institute, PA - USA;
5. L’Istituto Farmacologico di Ricerca Mario Negri;
6. L’Università Cattolica del Sacro Cuore di Brescia;
7. L’Università Statale di Brescia;
8. L’Ufficio Scolastico Regionale;
9. Il Comune di Brescia, la Provincia, la Regione;
10. Gli Ordini professionali (medici, farmacisti, infermieri….)
11. Il Rotary club Brescia Sud-Ovest Maclodio-Distretto 2050
12. La Fondazione della Comunità Bresciana

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