Improving Childhood Asthma Self-Management through Community Partnerships: Lessons from the Asthma Basics for Children Program in New York City

Problem: School-based programs for asthma often address only part of the asthma management system. Programs are needed to integrate contributions from all members of the asthma management team.

Methods: In 2003-8 we implemented a community-based, comprehensive intervention adapted from the NCICAS study. At 10 schools in NYC, we trained 524 teachers and staff to recognize and respond to asthma and to lead asthma educational activities. We provided the physician asthma care education program (PACE) to 353 medical providers. The schools identified 4081 children with symptomatic or diagnosed asthma, and 63% of their parents (n=2581) participated in educational workshops. We assessed changes in asthma management competencies of teachers and providers with pre/post tests and changes in asthma outcomes for the parents and children from completed baselines and follow-ups from 898 of the participating parents.

Results: 85% of the staff increased their knowledge of appropriate asthma management steps, and they implemented games and other asthma educational activities for 45% of the children with asthma (CWA). 53% of the children were seen by PACE trained physicians, of whom 84% reported changes in asthma management procedures. 57% of the parents took steps to reduce asthma triggers in the home, and 60% reported increased confidence in managing their child's asthma. 37% had reduced symptom days and nights, 43% had reduced asthma-related school absences, 61% had reduced ED visits, and 85% had reduced hospitalizations. Reductions were greatest for those parents who fully participated in the program and whose children were seen by PACE-trained physicians.