Baseline characteristics of children enrolled in a preschool-based asthma intervention in New York City

The highest rates of asthma hospitalizations are among young children and in underserved, minority populations. High asthma prevalence and associated morbidity have been reported in preschool programs in these communities. An intervention study in subsidized preschools in the East Harlem, South Bronx and Lower East Side neighborhoods of New York City, assessed neighborhood-specific combinations of asthma surveillance, computerized monitoring, and individualized education to reduce asthma morbidity. A longitudinal study assessed individual and neighborhood-level factors at baseline, and 4, 8 and 12-month follow-up among 175 parents of children age 2-5 with asthma. From 2004-2006, asthma prevalence was 25% at preschools. Parent participants were 95% female and 64% Hispanic; 66% reported an income of under $2,000/month. In the past two weeks, 26% reported respiratory symptoms for five or more days. In the past two months 29% reported at least one Emergency Department visit and 36% had at least one unscheduled doctor's visit for asthma. 10% of parents administered inhaled corticosteroids (e.g., controller medications) 5-7 days/week while 38% administered any short-acting b2 agonist (e.g., quick-relief medications). Over half (56%) had an Asthma Action Plan. In terns of household characteristics, 56% lived in subsidized housing and 23% of children were cared for by daily smokers. Indoor cockroaches and rodents were reported by 66% and 31% of respondents, respectively. Asthma is a significant health issue among participating children, with high ED use and low utilization of inhaled corticosteroids. Institutional-based interventions are needed to improve asthma detection and management in underserved, urban preschool populations.