156898 Lessons learned: Utilization of prescreening surveys and pulmonary function testing in population health screenings for COPD and asthma

Sunday, November 4, 2007

Sally Fontamillas Shaw, DrPH , Community Services, Glendale Adventist Medical Center, Glendale, CA
Bruce Nelson, MA , Community Services, Glendale Adventist Medical Center, Glendale, CA
Lenna Monte, MPH , CHES , Cultural and Linguistic Services, L.A. Care Health Plan, Los Angeles, CA
Kin C. Wong, MD , Respiratory Care Services, Glendale Adventist Medical Center, Glendale, CA
Jean Anderson, RN , Respiratory Care Services, Glendale Adventist Medical Center, Glendale, CA
An estimated 24 million adults in the U.S. remain undiagnosed for chronic obstructive pulmonary disease (COPD) and asthma. Especially in Los Angeles County, many community residents are at high risk for COPD and asthma due to the proximity of unhealthful particle pollution levels and other risk factors. In 2006, Glendale Adventist Medical Center implemented a screening strategy that allows for large-scale outreach to high-risk individuals in target populations. A self-scored risk-assessment survey was utilized to prescreen community residents. Participants scoring above an identified threshold are considered to have a moderate or higher risk for COPD/asthma and then receive pulmonary function testing to further evaluate their risk. Additionally, those who are symptomatic are referred to medical care providers and risk reduction classes. Of the 1,646 prescreened so far, 45% were identified as at-risk for COPD/asthma. Of the 242 clinically screened via pulmonary function testing, 37% showed mild to high risk FEV1/FVC and FVC% predicted levels-- indicators for pulmonary disease. These participants are also further evaluated for COPD/asthma risk with 88% identified as symptomatic for COPD/asthma. Only 12% indicated no pulmonary-related symptoms. In a four-month follow-up phone call (n=102), 35% made changes to their nutrition/diet, 10% increased their physical activity, 28% did a combination of exercise and nutrition to lose weight, while 4% made other changes to their health. Our model demonstrates a comprehensive integration of public health through community outreach, risk screenings, and referral case management, into the traditional health care system.

Learning Objectives:
1. Discuss the importance of early detection of COPD and asthma 2. List 3-4 risk assessment strategies to reduce pulmonary disease risk 3. Discuss the integration of public health strategies into a traditional health care system

Keywords: Asthma, Chronic Diseases

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.