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APHA Scientific Session and Event Listing

Recorded presentation

Micaela H. Coady, MS, Angela M. Bucciarelli, MPH, and Sebastian Bonner, PhD. Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, 212-822-7277, mcoady@nyam.org

Although high rates of asthma hospitalizations and Emergency Department (ED) care are reported among young children in low-income, underserved neighborhoods such as East Harlem (EH), the South Bronx (SB) and the Lower East Side (LES) of NYC, little information is available about asthma prevalence and related morbidity in subsidized preschools in these areas. As part of an intervention involving subsidized preschools, programs in these three neighborhoods adopted a standardized method of surveillance: (i) case detection using a validated instrument (the Brief Respiratory Questionnaire (BRQ)), and (ii) a policy requiring Asthma Action Plans (AAPs) for children identified with probable asthma (case positives). We trained program staff to both administer the instrument (in English, Spanish and Chinese) and enforce a policy requiring that parents obtain AAPs from their medical provider. To date, of 1,368 BRQs administered, 371 (27%) were positive, indicating asthma or probable asthma (24% in EH, 36% in the SB and 25% in the LES). Overall, 50% were male; 60% Black, 24% Hispanic, and 14% Asian; mean age was 3.7 years. Compared to BRQ-negative children, BRQ-positives were more likely to be: from the SB (p=0.0006); male (p=0.0002); and Black (p=0.0019). In the past year 66% of the BRQ-positive children visited the ED for asthma and 48% were currently not under a physician's care for asthma. Asthma is a significant health issue in this under-served population, with high ED use and low utilization of primary care. This institutional-based program has the potential to improve asthma detection and treatment in preschool populations.

Learning Objectives:

• 1.Describe the case identification instrument, asthma action plans and surveillance procedures
• 2.Describe the demographic characteristics, prevalence of asthma, asthma morbidity and access to health care in subsidized preschools in three NYC neighborhoods
• 3.Apply these infrastructure elements to address other public health issues in preschools (e.g., obesity)

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation