Improving asthma control among African-American children: Evaluation of a Chicago based intervention to reduce health disparities

Asthma prevalence rates are again on the rise, affecting 13.8% of children nationally. However, in some disadvantaged Chicago communities 25% of children have asthma. Children in these communities do not only have asthma, but they suffer disproportionately with asthma hospitalization rates of 548.5 per 100,000, compared to the national rate of 211.3 per 100,000. With funding from the CDC, the Sinai Urban Health Institute implemented a comprehensive intervention, addressing asthma disparities through a multi-pronged approach, aiming to improve asthma by educating families to better manage asthma medically, while also addressing the disproportionate presence of asthma triggers in the home. This is done through the expertise of Community Health Workers (CHWs), who make six home visits over a year. During eighteen months of recruitment, 266 children were enrolled into the intervention. Data were analyzed using a pre-post test evaluation design as well as a repeated measures analysis to determine the trajectory of change and the variability across subjects and over time. Findings from both methods of analysis will be presented for 151 participants who completed the 12-month intervention. Findings demonstrate significantly improved asthma control and are associated with medical cost-savings. Specifically, symptom frequency has been reduced by 43%, emergency department visits have been reduced by 69%, and activity-limited days have been reduced by 37%. The intervention is also associated with cost-saving of $3,275.13 per participant after accounting for program costs. Overall, study findings suggest that asthma severity can be reduced through case specific, one-on-one asthma education delivered by a trained CHW.