WIN for Asthma, New York Presbyterian Hospital

Childhood asthma rates in Northern Manhattan are four times the national average. Gaps in culturally appropriate asthma care and related supports have led to significant health risks for children with asthma and compromised quality of life for their families. To address these disparities, in May 2006, New York-Presbyterian hospital initiated the Washington-Heights Inwood Network (WIN) for Asthma – a hospital-community partnership designed to improve outcomes for children with poorly controlled asthma. Bilingual Community Health Workers serve as the single point of contact for families who require comprehensive asthma education, support, and multiple referrals for services such as housing, immigration, and mental health. The Community Health Workers are based at local community based organizations (CBOs), allowing them to remain anchored in the community while also maintaining a strong presence in the hospital where, during daily rounds, they connect with families who require immediate support.

The strengths of the Washington-Heights Inwood Network (WIN) for Asthma lie in an established communication and referral system that enables hospital and community partners to identify and engage families in multiple settings; to expand asthma educational opportunities for children and their parents; and to influence quality of asthma care among providers. The goal is to impact the delivery of care and improve the overall standard of care for all children with asthma in our community. Impact:

Since 2006, Community Health Workers have enrolled more than 1,200 families of children with high risk asthma who have received comprehensive asthma education, a home environmental assessment, trigger reduction tips, referrals for clinical and social services, and on-going support. Among all program graduates to date, hospitalizations decreased by 75%, emergency department (ED) visits decreased by 68%, missed school days decreased by 67%, and symptom days decreased by 61%.

Key to the Program’s success is the commitment and involvement of community partners from program inception to date. In addition, it has become clear that Community Health Workers who are linked to both hospital and community settings facilitate fluid interaction and support for families, and further strengthen hospital-community ties. Their intensive work with local families yields significant uptake of key asthma management behaviors among this typically hard-to-reach population. Finally, success can be attributed to the Program’s ability to support families who face myriad competing obstacles by connecting them to local services and support offered by community partners. These connections enable caregivers to address the social stressors that stand in the way of optimal asthma management and also create vital links that serve and support local families in the short- and the long-term.