Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #114349

Sebastian Bonner, PhD¹, Micaela H. Coady, MS¹, Tinka Markham Piper, MPH, CSW², Rosemary Obiapi, MA³, Kim Van Atta, RN, BSN⁴, and Evie Andreopoulos¹. (1) Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, Fifth floor, New York, NY 10029, 212-822-7281, sbonner@nyam.org, (2) Center for Urban Epidemiologic Studies (CUES), New York Academy of Medicine, 55 West 125th Street, 13th Floor, New York, NY 10027, (3) Childcare Services, Union Settlement Association, 237 East 104th Street, New York, NY 10029, (4) Early Childhood Programs, Grand Street Settlement, 294 Delancey Street, New York, NY 10002

Objective: High asthma prevalence and associated morbidity have been reported in subsidized preschool programs that provide child care to parents in low-income, minority communities. NIH guidelines recommend written asthma action plans (AAPs) for children with asthma, and inhaled corticosteroids (ICS) for children as young as 2 years old with persistent asthma. We sought to improve adherence to these guidelines in treament of children at most risk. Methods: We conducted a pilot study with two NYC subsidized preschool programs, one in East Harlem (EH) and one in the Lower East Side (LES). Each program adopted a standardized method of surveillance: (i) case identification using a validated instrument, and (ii) a policy requiring AAPs of parents of children identified with probable asthma (case positives). We trained program staff to administer the instrument and to encourage parents to obtain AAPs from their medical providers. Results: At baseline in both programs, 0% of children had AAPs, and <3% were prescribed ICS. After 10 months, both preschools had administered the instrument to 95% of all enrolled parents (enrollment: EH=394, LES=158). In the EH program, 20% of children were case positives, 73% of positives had AAPs, and 38% of positives were prescribed ICS. In the LES preschool, 30% were case positives, 52% of the positives had AAPs, and <1% had ICS. Conclusion: Differences may have been due to longstanding attention to asthma in East Harlem. These infrastructure elements have the potential to improve asthma treatment in preschool populations and to identify community obstacles to care.

Learning Objectives:

• Identify the components of an infrastructure to implement public health guidelines relating to asthma within subsidized preschool programs in communities hard hit by asthma.
• Evaluate the outcomes of this infrastructure in terms of identifying obstacles to achieving public health goals.
• Apply these infrastructure elements to address other public health issues in preschools (e.g., obesity) or to address public health issues in K-12 schools.

Keywords: Asthma, Public Health

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation