This September, Centers for Disease Control and Prevention (CDC) awarded funds to 23 state health departments under the Funding Opportunity Announcement for “Comprehensive Asthma Control Through Evidence-based Strategies and Public Health—Health Care Collaboration” for a 5-year period. These awards focus on strategies to provide asthma care, such as connecting the awardees with innovative health care partners to reach populations that are disproportionately impacted by asthma.
What are the goals of the awards?
The award is meant to maximize the reach, impact, efficiency and sustainability of comprehensive asthma control services. These services include the three components with the strongest evidence of effectiveness—guidelines-based medical management, asthma self-management education, and home-based multicomponent, multitrigger reductions services—as well as connections and coordination between these components. The intent is that these components be made available as a package and offered in steps.
How will these goals be tracked?
Awardees are required to report on 18 performance measures, which are key to achieving and demonstrating value. The measures are not an evaluation tool, but a project management tool to be used in three ways:
- To serve as an early warning when strategies and activities are not working and warrant evaluation of what is wrong.
- To identify what is working and should be further developed and replicated.
- To document and demonstrate value on an ongoing basis.
What strategies will the awardees use?
Infrastructure strategies (leadership, strategic partnerships, strategic communications, surveillance and evaluation) encompass ongoing activities essential to the planning, delivery and evaluation of public health activities and collaboration with health care systems. The goal is to be as strategic as possible: all activities should support the state’s goals, such as identifying strategic partners working on asthma control in the state.
Services-based strategies expand access to comprehensive asthma control services using home- or school-based strategies that emphasize self-management education, environmental management, connections with health care organizations, asthma education for caregivers, and policies supportive of asthma control. Programs can deliver services in community or health care facility settings if those are needed to reach the target population.
- Most states have been using these services-based strategies. Now is the time to expand them into working with districts and counties instead of individual schools, so they can reach the highest administrative level.
- Connecting to guideline-based medical management is important, and the strategies should be applied in the context of new health system models (Medical Homes, Accountable Care Organizations, Community Health Improvement Plans, or Federally Qualified Health Centers) if the awardee has previous relationships with such organizations.
- Recognizing that some applicants may be at an earlier stage of collaboration with health systems, awardees are allowed the opportunity to expand and evaluate school- and home-based strategies independently during the first 2 years of funding while developing strategic partnerships with health care organizations. Collaboration with health care organizations is expected for all awardees during the 3rd through 5th years of the grant.
- Strategies within the same target population should be coordinated to ensure access to comprehensive asthma control services, delivered in a culturally competent manner.
Health systems – based strategies involve coordinating with health care organizations to improve the coverage, delivery and use of clinical and other services. This involves leveraging health care reform and innovative health care approaches to expand and sustain public health self-management and home-visit activities.
- Promotes a “stepwise” approach to asthma control.
- As with services strategies, focus efforts in populations with a disproportionate asthma burden and emphasize the importance of culturally competent care.
- There are three health system strategies: quality improvement; team-based care, including “health care extenders”; and promoting coverage for elements of comprehensive care with various health care organizations/payers.
To learn more about the CDC’s National Asthma Control Program Grantees, visit http://www.cdc.gov/Asthma/contacts/default.htm.
