Effects of a community agency intervention on care management, health services use, and quality of life of children with asthma

The study assesses the effects of a community agency intervention, Asthma H.E.L.P., on diagnosed asthmatic children's care management, health services use, and perceived quality of life. Populations of 80 children at two sites of a community agency received visits throughout the year. Asthma-educated social workers gathered information about the children's activities at each visit through a detailed checklist, and on their quality of life through an annual Juniper Survey. Two years of data have been collected. The intervention, Asthma H.E.L.P., provides families with support in the home regarding health care and asthma, environmental triggers, and suggestions for the prevention of asthma episodes. The population includes children in St. Louis inner-city areas whose parents sought assistance through the community agency. The Asthma H.E.L.P. intervention significantly impacted the process of care through the provision and use of asthma action plans for both sites, and the provision and use of bed covers at one site. Controller usage also increased across sites. The intervention produced appropriate declines in services usage, which may indicate reduced asthma morbidity for these children. Declines in use of both emergency departments and hospitals occurred at both sites but did not reach statistical significance. The Asthma H.E.L.P. program demonstrates that an asthma management program can be integrated into the casework process of a community agency in which social workers have received asthma education. Such an integrated program can decrease the use of emergency departments and hospitals, reducing the cost of care of clients and third party payers.