An integrated approach to address asthma management in South Texas

Asthma is one of the most common chronic illnesses in the United States.  Hidalgo County, located in Health Service Region 11 in the Rio Grande Valley near the Texas-Mexico Border, has the highest asthma hospitalization rate in the state with an age-adjusted hospitalization rate of 16.8 % (15.3-18.4) per 10,000.

Purpose: The purpose of this study was to assess the impact of an asthma education intervention focused on an integrated holistic approach to 89 residents of colonias, including quality of life results, health care utilization, behavioral changes made after the educational intervention, and satisfaction of participants regarding education received.

Methodology: This study was a longitudinal, non-randomized design, which included an educational intervention and the delivery of five surveys to assess asthma knowledge, quality of life, asthma triggers and management, and satisfaction.

Results:  Results demonstrated improvements in knowledge, asthma symptoms, asthma management, quality of life, general knowledge of asthma, and health care utilization effectiveness.  Overnight hospital stays dropped from 6% at baseline to 1% at follow-up. The percentage of families reporting a clinic or a doctor visit dropped from 50% at baseline to 31% at follow-up. The percentage of families reporting asthma attack incidents decreased by 30% between the first and last visits, and those reporting symptoms of wheezing or whistling while breathing declined by 23%.

Conclusions: Assessment of the asthma intervention implementation shows that the intervention targeting high-risk families, using the promotora model, is effective in engaging these families over time. Families who live in environmentally unhealthy colonias may benefit from an integrated training approach.