230716 Children's Hospital Boston Community Asthma Initiative: Reducing Health Disparities in Boston ( as part of the proposed panel REACHing for Social Justice: Highlights of REACH Programs Working to Advance Health Equity)

Tuesday, November 9, 2010 : 11:06 AM - 11:24 AM

Susan J. Sommer, MSN, RNC , Division of Adolescent/Young Adult Medicine, Children's Hospital Boston, Boston, MA
Urmi Bhaumik, MBBS, MS, DSc , Office of Child Advocacy, Children's Hospital Boston, Boston, MA
Elaine Chan, BA , Division of Adolescent/Young Adult Medicine, Children's Hospital Boston, Boston, MA
Ngozi Moses, MSc , Brooklyn Perinatal Network, Brooklyn, NY
April J. Taylor, MPH , Division of Adult & Community Health, CHAPs Branch, REACH US, Centers For Disease Control & Prevetion, Atlants, GA
Simona Kwon, DrPH, MPH , Institute of Community Health & Research, New York University School of Medicine, New York, NY
Objective: Because asthma is the leading cause of hospitalization at Children's Hospital Boston, the Community Asthma Initiative (CAI) was developed to provide nurse case management, home visits, and community connections to reduce health disparities for children with asthma in Boston.

Methods: Services provided included nurse case management for an individualized care plan, coordination with primary care, allergist, and community resources; and home visits, including environmental assessment, integrated pest management, and asthma education. In the first four years of the program, baseline and 12-month follow-up questionnaires were completed. Data analysis included the McNemar's test for dichotomous variables and paired t-test for continuous variables to assess hospitalizations, emergency department (ED) visits and missed school/work days.

Results: This CDC REACH US program served 441 children with a mean age of 7.8 years old (+ 4.5 SD); 53.7% males; 47.8% African American, 44.8% Latino, 7.4% other. There were significant reductions in hospitalizations (81%), ED visits (65%), missed school days (39%), missed work days (49%), and a 71% increase in the number of children with a current asthma action plan (all p<0.001). The program has been successful implementing Community and Family Advisory Boards. This model of asthma care is generating information that is used for planning, advocacy, and policy efforts to reduce asthma health disparities.

Conclusion: CAI significantly decreased admissions, ED visits, missed school and missed work days at 12 months of follow-up, and provides a successful model of asthma care that can be replicated nationally and influence policy to address social determinants of health.

Learning Areas:
Administer health education strategies, interventions and programs
Advocacy for health and health education
Diversity and culture
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
To understand how to evaluate a community asthma program for health outcomes. To identify the role of community asthma programs in planning, advocacy and policy to address the social determinants of health. To be able to assess quality improvement follow-up information from the CAI.

Keywords: Asthma, Access and Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a staff member on the project and propose this abstract as a joint presentation
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.