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Improving asthma management among African-American children via a community health worker model: findings from a Chicago-based pilot intervention.
J Asthma. 2012 May; 49(4):380-9.JA

Abstract

OBJECTIVES

Asthma affects 25-30% of children living in certain disadvantaged Chicago neighborhoods, a rate twice the national prevalence (13%). Children living in poor, minority communities tend to rely heavily on the emergency department (ED) for asthma care and are unlikely to be properly medicated or educated on asthma self-management. A pilot project implemented and evaluated a community health worker (CHW) model for its effectiveness in reducing asthma morbidity and improving the quality of life among African-American children living in disadvantaged Chicago neighborhoods.

METHODS

Trained CHWs from targeted communities provided individualized asthma education during three to four home visits over 6 months. The CHWs also served as liaisons between families and the medical system. Seventy children were enrolled into the pilot phase between 15 November 2004 and 15 July 2005, of which 96% were insured by Medicaid and 54% lived with a smoker. Prior to starting, the study was approved by an institutional review board. Data on 50 children (71.4%) who completed the entire 12-month evaluation phase were analyzed using a before and after study design.

RESULTS

Findings indicate improved asthma control. Specifically, symptom frequency was reduced by 35% and urgent health resource utilization by 75% between the pre- and post-intervention periods. Parental quality of life also improved by a level that was both clinically and statistically significant. Other important outcomes included improved asthma-related knowledge, decreased exposure to asthma triggers, and improved medical management. The intervention was also shown to be cost-effective, resulting in an estimated $5.58 saved per dollar spent on the intervention.

CONCLUSIONS

Findings suggest that individualized asthma education provided by a trained, culturally competent CHW is effective in improving asthma management among poorly controlled, inner-city children. Further studies are needed to affirm the findings and assess the model's generalizability.

Authors+Show Affiliations

Sinai Urban Health Institute, Sinai Health System, Chicago, IL 60608, USA. helen.margellos@sinai.orgNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

22348448

Citation

Margellos-Anast, Helen, et al. "Improving Asthma Management Among African-American Children Via a Community Health Worker Model: Findings From a Chicago-based Pilot Intervention." The Journal of Asthma : Official Journal of the Association for the Care of Asthma, vol. 49, no. 4, 2012, pp. 380-9.
Margellos-Anast H, Gutierrez MA, Whitman S. Improving asthma management among African-American children via a community health worker model: findings from a Chicago-based pilot intervention. J Asthma. 2012;49(4):380-9.
Margellos-Anast, H., Gutierrez, M. A., & Whitman, S. (2012). Improving asthma management among African-American children via a community health worker model: findings from a Chicago-based pilot intervention. The Journal of Asthma : Official Journal of the Association for the Care of Asthma, 49(4), 380-9. https://doi.org/10.3109/02770903.2012.660295
Margellos-Anast H, Gutierrez MA, Whitman S. Improving Asthma Management Among African-American Children Via a Community Health Worker Model: Findings From a Chicago-based Pilot Intervention. J Asthma. 2012;49(4):380-9. PubMed PMID: 22348448.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improving asthma management among African-American children via a community health worker model: findings from a Chicago-based pilot intervention. AU - Margellos-Anast,Helen, AU - Gutierrez,Melissa A, AU - Whitman,Steven, Y1 - 2012/02/21/ PY - 2012/2/22/entrez PY - 2012/2/22/pubmed PY - 2012/9/5/medline SP - 380 EP - 9 JF - The Journal of asthma : official journal of the Association for the Care of Asthma JO - J Asthma VL - 49 IS - 4 N2 - OBJECTIVES: Asthma affects 25-30% of children living in certain disadvantaged Chicago neighborhoods, a rate twice the national prevalence (13%). Children living in poor, minority communities tend to rely heavily on the emergency department (ED) for asthma care and are unlikely to be properly medicated or educated on asthma self-management. A pilot project implemented and evaluated a community health worker (CHW) model for its effectiveness in reducing asthma morbidity and improving the quality of life among African-American children living in disadvantaged Chicago neighborhoods. METHODS: Trained CHWs from targeted communities provided individualized asthma education during three to four home visits over 6 months. The CHWs also served as liaisons between families and the medical system. Seventy children were enrolled into the pilot phase between 15 November 2004 and 15 July 2005, of which 96% were insured by Medicaid and 54% lived with a smoker. Prior to starting, the study was approved by an institutional review board. Data on 50 children (71.4%) who completed the entire 12-month evaluation phase were analyzed using a before and after study design. RESULTS: Findings indicate improved asthma control. Specifically, symptom frequency was reduced by 35% and urgent health resource utilization by 75% between the pre- and post-intervention periods. Parental quality of life also improved by a level that was both clinically and statistically significant. Other important outcomes included improved asthma-related knowledge, decreased exposure to asthma triggers, and improved medical management. The intervention was also shown to be cost-effective, resulting in an estimated $5.58 saved per dollar spent on the intervention. CONCLUSIONS: Findings suggest that individualized asthma education provided by a trained, culturally competent CHW is effective in improving asthma management among poorly controlled, inner-city children. Further studies are needed to affirm the findings and assess the model's generalizability. SN - 1532-4303 UR - https://www.unboundmedicine.com/medline/citation/22348448/Improving_asthma_management_among_African_American_children_via_a_community_health_worker_model:_findings_from_a_Chicago_based_pilot_intervention_ L2 - http://www.tandfonline.com/doi/full/10.3109/02770903.2012.660295 DB - PRIME DP - Unbound Medicine ER -