Asthma, the most common chronic disease in children, places a tremendous burden on affected children and their families especially in poor, minority communities. Despite medical advancement, disparities persists in these communities where affected children experience higher rates of asthma inpatient and emergency visits as well as deaths.1 Previous studies have documented contributing factors which include poor housing stock, stress, neighborhood violence, and geographical isolation.5-6 Persistent challenges include linking patients to their medical home and reducing barriers such as access to transportation, housing issues and food insecurity. Asthma evidence-based interventions have been shown to improve outcomes for this population but are often implemented as individual interventions rather than in an integrated, comprehensive approach which would support and promote sustainability.
Our specific aims are:1) Through a community needs assessment utilizing triangulated data gathered from secondary data sources, focus groups and key informant interviews, develop a comprehensive understanding of the multitude of factors that influence childhood asthma among children living in the West Philadelphia target community. 2) On the basis of the needs assessment, continue to engage stakeholders in the community, home health care and school sectors in planning the implementation, integration, and assessment of evidence-based interventions toward the goal of creating an ACIP plan that is comprehensive, culturally relevant, responsive to identified needs, and feasible. Stakeholders will meet monthly as a group with the core investigators and additionally with the research team as needed. 3) Employing a pragmatic control design, we will develop a sustainable asthma care implementation program, (ACIP), targeting children ages 6-12 years in West Philadelphia, for the U01 application. The ACIP will integrate evidence-based interventions in the home (NationalCICAS or CAPP Home Visit Program), school (NAEPP Asthma School basics, student peer education, tools for schools, or intensive case management), medical home (Yes We Can or Easy Breathing) and community (CAPP Classes and/or support groups). These evidence-based interventions will be refined based on the results of the needs assessment and the consensus of the West Philadelphia Asthma Care Collaborative (WePACC), which includes stakeholders in all four sectors: health, home, school and community, who will guide the planning of the asthma care implementation program.
This proposal seeks to understand the needs of children with asthma in West Philadelphia. Partners from the home, health, community and school sectors will then design an asthma care implementation that helps children with asthma where they sleep, learn, pray and play.
