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Boston Children's Hospital Community Asthma Initiative (CAI): Comparing Changes in Caregiver Quality of Life (QOL) and Child Asthma Control, and Geographic Information Systems (GIS) Localization of Asthma Triggers
Methods: Home visits include asthma education as well as environmental assessment and remediation of asthma triggers. GIS to map home asthma triggers by zip code. Juniper’s Pediatric Asthma Caregiver’s QOL questionnaire, measuring overall, activity limitation, and emotional domains is administered to caregivers at two time points (baseline and 3rd home visit). The ACT identifies child asthma symptom control. Changes in patient’s ACT score and caregiver’s QOL were compared to quantify the effect of CAI home visit intervention over time using paired t-tests and Pearson’s Correlation.
Results: Sufficient data was available for analysis of 39 patients: mean age 6.8 years; 59% male; 44.7% Black, 47.4% Hispanic; 44.4% mild-persistent and 48.1% moderate-persistent asthma severity; and 95% had at least one common home environmental trigger for asthma. QOL scores on a 1-7 point scale improved 4.3 to 5.1 (p<0.01) overall from baseline to 3rd home visit: including 3.5 to 5.0 (p < 0.001) activity-limitation, and 4.6 to 5.1 (p = 0.056) emotional scores. The mean ACT score improved by 3.7 points (p < 0.01). Significant correlation existed between QOL and ACT scores during third visit (r=0.51, p< 0.01).
Conclusion: The CAI home visiting program has improved asthma outcomes with significant positive correlation between child’s asthma control and caregiver’s QOL over time in Boston neighborhoods with high asthma prevalence.
Learning Areas:
Assessment of individual and community needs for health educationChronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Environmental health sciences
Implementation of health education strategies, interventions and programs
Public health or related research
Learning Objectives:
Demonstrate improvement in patient health outcomes and caregiver quality of life with a targeted home visiting intervention.
Compare and analyze the correlation between patient health outcomes and caregiver quality of life over time.
Identify neighborhoods in Boston with high prevalence of common asthma triggers in the home using Geographic Information Systems mapping.
Keyword(s): Asthma, Quality of Life
Qualified on the content I am responsible for because: I have been the Research and Program Coordinator for the Boston Children's Hospital Community Asthma Initiative for two years, overseeing the data collection and management, and coordinating the home visiting and case management program that is the focus of this 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.