217082 Outcomes associated with a hospital-community program aimed at reducing the burden of asthma among inner-city families

Monday, November 8, 2010 : 10:30 AM - 10:45 AM

Patricia Peretz, MPH , WIN for Asthma, New York Presbyterian Hospital/Columbia University Medical Center, New York, NY
Adriana Matiz, MD , Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY
Erline Ramirez-Diaz, BA , WIN for Asthma, New York Presbyterian Hospital/Columbia University, New York, NY
Robyn Scherer, MPH , WIN for Asthma, WIN for Asthma, New York Presbyterian Hospital/Columbia University, New York, NY
Sally E. Findley, PhD , Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY
Mary McCord, MD, MPH , General Pediatric, Columbia University Medical Center, New York, NY
Childhood asthma rates in Northern Manhattan are four times the national average. The complexity and fragmentation of local health systems, combined with conflicts between cultural and clinical values, create significant challenges for this largely foreign-born, low-income community. In 2005, local hospital and community partners applied the principles of community-based participatory research to design and implement the Washington Heights Inwood Network (WIN) for Asthma: a comprehensive program aimed at reducing the burden of asthma in the community. Program goals were to identify families of children with poorly controlled asthma, to increase caregiver self-efficacy, and to reduce preventable asthma-related emergency department (ED) visits, hospitalizations, and missed school days. Families were referred to the program via an established hospital-community communication and referral system. Bilingual community health workers (CHWs) offered family-focused asthma education, addressed household asthma triggers, and linked families to the clinical and social resources required to facilitate effective and sustainable asthma management. Caregiver interviews at baseline, 6 months, and 12 months and descriptive statistics were used to assess the impact of the intervention on caregiver self-efficacy and key asthma morbidity indicators. Over a period of 3 years, CHWs enrolled 360 families of children with poorly controlled asthma. After 12 months in the program, caregiver confidence in controlling their child's asthma increased by 40%, ED and hospitalization rates decreased by more than 50%, and child school absenteeism decreased by 30%. Evaluation results thus demonstrate that a family-centered, community-based asthma prevention program can make a significant impact among high-risk children with asthma.

Learning Areas:
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Public health or related research

Learning Objectives:
1. Understand the critically important role of community health workers (CHWs) in the delivery of culturally-relevant services 2. Discuss the benefits and challenges associated with building effective and sustainable hospital-community partnerships

Keywords: Community-Based Partnership, Evaluation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Masters-level public health professional with more than 6 years' experience developing, implementing, evaluating and managing public health programs. I currently manage the program about which I will present evaluation findings.
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.