The 131st Annual Meeting (November 15-19, 2003) of APHA

The 131st Annual Meeting (November 15-19, 2003) of APHA

3270.0: Monday, November 17, 2003 - 2:30 PM

Abstract #70975

Improving clinical and environmental outcomes in minority, underserved asthmatic children from Community/Migrant Health Centers (C/MHC) in NY, NJ, PA, MO, PR, and VI

Diana S. Catz, PhD, MPH, Clinical Directors Network, Inc., 54 West 39th Street 11th Floor, New York, NY 10018, 212-382-0699 Ext 230, dcatz@CDNetwork.org

Learning objectives: To assess the feasibility and effectiveness of clinical-based and environmental/home-based interventions, to improve clinical and environmental outcomes in a population of minority asthmatic children aged 12 to 19 with mild persistent to severe persistent asthma treated in C/MHC. Methods: Patients were randomized to either the experimental group (home visits with asthma education and products) or a control group. Clinical-based interventions included provider education and medication review. Results: (1) Cross-sectional analysis: medical records reviews (N=681) showed regional differences in medication use, emergency room visits, hospitalizations and urgent visits to the physician. Less than 1% of the patient charts reviewed contained written asthma action plans. Nearly 40% were very overweight (BMI > 95th percentile) and had low levels of physical activity. (2) Intent-to-treat analysis (N=220): the environmental intervention increased significantly the use of mattress and pillow covers, changed some cleaning habits, such as dusting in the presence of an asthmatic child, and reduced significantly the problem of cockroaches in the experimental group. Emergency room visits, urgent visits to the primary care physician and the number of days of school missed because of asthma were reduced significantly in both groups. Peak flow meter use and patients with a written asthma management plan were significantly increased in both groups, but the number of asthma action plans was higher in the experimental group. Conclusions: These results indicate the feasibility of using a combination of clinical and home/environmental interventions in improving asthma outcomes in a population of minority children treated in C/MHCs.

Learning Objectives:

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Please include this topic as part of Abstract # 70857--Improving the Quality of Asthma Care: Stressing Environmental Management of Asthma.
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Children’s Environmental Health & Vulnerable Populations - Improve the Quality of Asthma Care – Stressing Environmental Management of Asthma

The 131st Annual Meeting (November 15-19, 2003) of APHA