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APHA Scientific Session and Event Listing

Laura Burns, RN, BSN, AE-C, CARMA, Bon Secours Richmond Hospital System, One Monument Avenue, 413 Stuart Circle Suite 210, Richmond, VA 23220, 804-213-0917, laura_burns@bshsi.com, Barbara Fleming, RN, MS, CHIP of Greater Richmond, 2922 W. Marshall St., Richmond, VA 23224, and Ryan Ehrensberger, MPH, CARMA, Bon Secours Richmond Health System, One Monument Avenue, 413 Stuart Circle, Suite 210, Richmond, VA 23220.

The Richmond metropolitan area has the highest per-capita rate of pediatric asthma hospitalizations in Virginia. The Central Virginia Asthma Coalition (CVAC) was created by community members to address the high asthma morbidity. In 2001, CVAC received a multi-year grant from the CDC as part of the Controlling Asthma in American Cities Project. Controlling Asthma in the Richmond Metropolitan Area (CARMA) is managed by one of CVAC's participating organizations, Bon Secours Richmond Health System. Children's Health Involving Parents of Greater Richmond (CHIP) is a non-profit community-based case management agency that collaborates with caregivers to improve the health of families at or below 200% of the federal poverty level. CARMA provides funding to CHIP for case management of pre-school and school age children who have asthma, and organized a formal evaluation of effectiveness, including enrollment and follow-up surveys of symptom severity and service utilization. Most enrolled children and their families have multiple social and economic problems that make it difficult to address the child's asthma management. CHIP with its unique teams composed of a community health nurse plus a lay family intervention specialist (FIS) case manages enrolled families for one to two years. FISs are trained to assist families with access to primary care medical and dental providers and preventative health care services, referrals for specialty services and other family needs including housing, education and employment. In 2004, CARMA funded CHIP case management services for 47 families; these families received more than 2165 contacts with CHIP including 980 home visits. Data on indicators of health status demonstrates the effectiveness of CHIP. Key indicators include reduction in emergency room visits, facilitation of Asthma Action Plans, and enrollment with Primary Care Physicians and health insurance plans. For example, children enrolled in CHIP's Asthma Project had 47 emergency room visits for respiratory problems in the year prior to CHIP enrollment. In the year after enrollment, these same children had only five visits to the emergency room for respiratory problems. This presentation will include detailed information on the collaborative process and the intervention process for reaching these high-risk, hard-to-reach families.

Learning Objectives: