249466 An Intervention to improve access and quality of asthma health care services in two communities in San Juan, Puerto Rico

Tuesday, November 1, 2011: 2:50 PM

Gilberto Ramos-Valencia, DrPH , Department of Biostatistics, University of Puerto Rico Graduate School of Public Health, San Juan, PR
Jesús Gonzalez-Gavillán, PhD , School of Public Health, UPR School of Public Health, San Juan, PR
Beatriz Morales , School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR
Marielena Lara, MD, MPH , RAND Health, Santa Monica, CA
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.

Learning Areas:
Chronic disease management and prevention
Implementation of health education strategies, interventions and programs

Learning Objectives:
To identify barriers for accesing asthma medications To identify characteristics related to treatment compliance and improvement in the quality of life of pediatric asthma patients.

Keywords: Access and Services, Asthma

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Principal Investigator of the Project.
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.