An Intervention to improve access and quality of asthma health care services in two communities in San Juan, Puerto Rico

Purpose: La Red de Asthma Infantil de Puerto Rico is an evidenced based intervention project aimed to improve asthma-related health status among children of two low-income communities in San Juan. Objectives: The objectives of this project were to: (1) Improve access to and quality of asthma health care services for children, (2) Promote asthma-safe home environments, and (3) Promote schools more asthma-friendly. Methods: To accomplish these objectives we adapted and implemented three recognized evidence-based asthma interventions—the YES WE CAN Program, the Inner-City Asthma Study (ICAS) environmental intervention, and Open Airways for Schools (OAS). These adaptations were performed maintaining the scientific integrity of the original interventions. Results: A total of 245 children with moderate or severe persistent asthma participated in the project. After one year of follow up, the data collected suggest that our intervention was associated with a significant decrease in: asthma-related hospitalizations (51%); emergency department visits (52%); the use of preventive medications was tripled and the use of rescue medications was reduced by 60%; symptoms were reduced by 44%; and quality of life for child and caregiver improved by a factor of at least 2. Conclusions: We conclude that the evidenced-based interventions we choose could be implemented in our setting with minor adaptations and that they were effective in accomplishing our goal of improving the asthma-related health status of these children and reducing the need of hospitalization and emergency room visits.