Online Program

Addressing asthma health disparities: Results of a hybrid model linking clinics and coalitions

Tuesday, November 5, 2013 : 10:30 a.m. - 10:50 a.m.

Terry Greene, M.S., JSI Center for Environmental Health Studies, JSI Research & Training Institute, Inc., Boston, MA
Jing Guo, PhD, Bureau of Community Health and Prevention, Massachusetts Department of Public Health, Boston, MA
Matthew Sadof, MD, Pediatrics, Baystate Children's Hospital Tufts University School of Medicine, Springfield, MA
Laurita Kaigler-Crawlle, MS, Public Health Policy and Practice Department, Health Resources in Action, Boston, MA
Jean Kelley, M.D., Dorchester House Multi-Service Center, Dorchester, MA
Barbara Rogers, NP, Pediatrics, Dorchester House Multi-Service Center, Dorchester, MA
Jean M. Zotter, JD, Prevention and Wellness Trust Fund, Massachusetts Department of Public Health, Boston, MA
The Massachusetts Department of Public Health's Asthma Disparities Initiative (ADI) is defined by a unique collaboration between clinics and community-based asthma prevention coalitions, referred to as the ‘hybrid' model. The aim of the model is to bring the clinic and community closer, through sharing of resources, coordinated programming, joint outreach, and leveraged policy advocacy in the community. Additionally, the model employs use of a Community Health Worker (CHW) in clinics who support families at the health centers, conduct patient home visits, and who join and further the work of the community coalitions by sharing information and insights and by recruiting broader participation by family members whose children have asthma. Prior research has found positive gains from interventions that employ CHW to address asthma disparities. At the same time, meta-analysis of asthma coalition work has identified greater impact on health outcomes when coalitions are clinically-connected. Using the CDC formative evaluation framework which emphasizes broad stakeholder engagement throughout the process, two pilot ADI sites were evaluated to ascertain the challenges, benefits, and recommendations for implementing a hybrid model. While a number of factors affect launching such an approach, the evaluation found that CHW were able to serve as a bridge between clinics and communities, clinical teams benefited from what they learned from coalitions, and coalitions were able to leverage support from clinics in their local outreach and advocacy work. While working with a limited sample size, trends seem to indicate enhanced asthma self-management, reduction in asthma trigger factors, and improved health outcomes.

Learning Areas:

Advocacy for health and health education
Assessment of individual and community needs for health education
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Environmental health sciences
Planning of health education strategies, interventions, and programs

Learning Objectives:
Explain the components of a hybrid model for addressing asthma disparities. Evaluate elements for successful collaboration between community asthma coalitions and local clinics providing pediatric asthma services.

Keyword(s): Asthma, Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the Project Director for multiple federally-funded community-based asthma initiatives. Currently I serve as an evaluator for the Massachusetts Department of Public Health Asthma Prevention and Control Program (APCP). I have conducted an evaluation of the Asthma Disparities Initiative supported by APCP which is the topic of this presentation.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Massachusetts Department of Public Health Asthma Prevention and Control Program Consultant

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.