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APHA Scientific Session and Event Listing

Micaela H. Coady, MS, Jessica Purmort, BA, 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

The highest rates of asthma hospitalizations and Emergency Department care are among young children and in low-income, minority populations. High asthma prevalence and associated morbidity have been reported in subsidized preschool programs in these communities. As part of an intervention study involving subsidized preschools across NYC, preschool staff in the South Bronx (SB) and the Lower East Side (LES) 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). Before the intervention, asthma symptoms or diagnoses were ascertained thru medical history forms and there was no enforced policy to obtain AAPs. After 6 months 75% of children in the SB and the LES had BRQs on file (n=479). The SB had a 76% increase in children identified with asthma (from 21-37%) and the LES a 200% increase (from 11-33%). At both sites 30% of case positives had AAPs. The surveillance program was already in place in East Harlem (EH), and included an additional computerized monitoring system which tracked surveillance progress and helped improve preschool staff compliance with case identification and parent compliance with obtaining AAPs. EH achieved a 97% BRQ completion rate (n=419) and 63% of case positives had AAPs (n=56). Through this innovative strategy to identify children with asthma or probable asthma and a policy requiring AAPs, these infrastructure elements have the potential to improve asthma detection and treatment in preschool populations.

Learning Objectives:

• Describe the case identification instrument, asthma action plans and surveillance and monitoring procedures
• Assess the impact of the monitoring system on BRQ and AAP compliance rates in a diverse sample of preschool children
• Apply these infrastructure elements to address other public health issues in preschools (e.g., obesity)

Presenting author's disclosure statement:

Not Answered