268311 Improving asthma control among African-American children: Evaluation of a Chicago based intervention to reduce health disparities

Tuesday, October 30, 2012 : 5:15 PM - 5:30 PM

Melissa A. Gutierrez, MS , Sinai Urban Health Institute, Sinai Health System, Chicago, IL
Helen Margellos-Anast, MPH , Sinai Urban Health Institute, Sinai Health System, Chicago, IL
Steve Whitman, PHD , Sinai Urban Health Institute, Sinai Health System, Chicago, IL
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.

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

Learning Objectives:
1. Describe the nature of asthma disparities in Chicago and nationally 2. Summarize the key components and findings of a CHW model intended to improve asthma management among inner-city children 3. Discuss some success and challenges of implementing and evaluating a CHW model

Keywords: Health Disparities, Asthma

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked in health disparities and asthma-related research, program development, and program implementation for the past six years. I currently serve as an Epidemiologist II and manage a community-based asthma program. I received my Master degree in Community and Behavior Health from the University of Iowa, College of Public Health. I have presented on this topic to various audiences
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.