199686 Evaluation of an asthma medication training program for Mexican community health workers

Wednesday, November 11, 2009: 8:30 AM

Molly A. Martin, MD , Department of Preventive Medicine, Rush University Medical Center, Chicago, IL
Giselle Mosnaim, MD , Department of Allergy and Immunology, Rush University Medical Center, Chicago, IL
Delia Rojas, BA , University of Illinois at Chicago, Chicago, IL
Olivia Hernandez , Centro Comunitario Juan Diego, Chicago, IL
Laura Sadowski, MD, MPH , Collaborative Research Unit/Department of Medicine, Stroger Hospital of Cook County/Rush Medical College, Chicago, IL
While community health worker (CHW) asthma interventions have been shown to reduce environmental asthma triggers and improve clinical outcomes, they have not improved medication usage. Our objective was to test if an intensive asthma training program focusing on self-management skills would improve asthma medication instruction abilities for CHWs.

Eleven CHWs participated in a 15-hour training course. The course covered asthma pathophysiology, reliever and controller medications, medication technique, and self-management skills. The CHWs were all women from Mexico. They spoke mainly Spanish and had 6-17 years of formal education. Before and after the training, CHWs completed a written asthma knowledge test. CHWs were tested on medication delivery technique using a demonstrator metered dose inhaler (MDI), spacer, and dry powder inhaler (DPI). After the training, CHWs performed a standardized role play to assess their ability to deliver medication instruction. They also completed a training evaluation questionnaire.

Knowledge improved significantly post-training (mean: pre=65%, post=81%, p<0.01). Before training, the median correct medication technique scores were: MDI=25%, spacer=0%, DPI=0%. Post-training, the median scores were: MDI=79%, spacer=71%, DPI=78% (p<0.01). On the role-plays, all promotoras were scored as “Demonstrates adequate understanding of a complicated skill” and 4 additionally were “Ready for the field on a clinical trial.”

This training improved asthma medication knowledge and delivery technique instruction abilities for Mexican CHWs. These CHWs will now begin the ultimate test of this training as they deliver an asthma medication intervention in the field. The CHWs will speak about which aspects of the training were unique and most useful.

Learning Objectives:
Identify barriers encountered with previous community health worker interventions involving asthma medications. Discuss the importance of self-management training for asthma educators and community health workers. Design a community health worker training curriculum on asthma medications for Spanish-speaking immigrant community health workers.

Keywords: Asthma, Community Health Promoters

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator of the study and conducted the training described.
Any relevant financial relationships? No

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.