English

Medical Research: What is the background for this study?

Dr. Hsu: Asthma is a leading cause of missed school days related to chronic illness.This study is based on survey data from 2006 to 2010 on children aged 17 years and younger with asthma from 35 states and the District of Columbia. 

Medical Research: What are the main findings?

Dr. Hsu: Approximately half of children in school with current asthma missed at least one school day because of asthma in the past 12 months. These children were more likely to be Black or Hispanic and live in households with incomes of less than $25,000 per year, compared with children with asthma who did not miss school for asthma in the past year. Reports of not being able to buy asthma medication or see a doctor for asthma because of cost were more frequent among children who missed school because of asthma. Also, reported signs of mold in the home in the past 30 days were more common among children who missed school for asthma, compared to those who did not.

Medical Research: What should clinicians and patients take away from your report?

Dr. Hsu: For clinicians, reports of missing school because of asthma in the past 12 months by children or their families might be useful for identifying children with specific needs, such as assistance in overcoming cost as a barrier to asthma-related health care or in assessing their homes for mold. Other interventions recommended by 2007 National Asthma Education and Prevention Program guidelines might also benefit these children.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Hsu: Further understanding of asthma-related missed school, including extended and repeated absences, could establish how to most effectively use information about missed school as a health status indicator.

Citation:

Am J Prev Med. 2016 Feb 9. pii: S0749-3797(15)00792-8. doi: 10.1016/j.amepre.2015.12.012. [Epub ahead of print]

Asthma-Related School Absenteeism, Morbidity, and Modifiable Factors.

Hsu J1, Qin X2, Beavers SF2, Mirabelli MC2.

Article can be found here: http://medicalresearch.com/asthma/minority-kids-with-asthma-likely-to-miss-days-of-school/22002/

Introduction

Health care reform activities since the 2010 passage of the Affordable Care Act have resulted in significant and innovative shifts in health service delivery and reimbursement – with an overall movement towards increased value, coordination, and accountability in care. Accompanying these changes, many of the traditional roles and services of providers such as physicians, nurses, and other health care workers have expanded and evolved. In addition, some emerging, new occupations are playing an increasing role in patient-centered medical homes (PCMHs) and other team-based models for health care delivery.1

Although community health workers (CHWs) have been embedded in community-based outreach programs for decades, significant national policy interest is emerging for this the occupation due to the potential ability of CHWs to improve health care access, service delivery, and care coordination, and to provide enhanced value in health care investments. 2 Although there is some variability in how the U.S. Department of Labor3 and other organizations4 define a “Community Health Worker,” a CHW is typically a frontline public health worker who is a trusted member of, and/or has an unusually close understanding of, the community served. This trusting relationship enables the worker to serve as a link between community members and needed health and social services within their community. CHWs hold a unique position within an often rigid health care system in that they can be flexible and creative in responding to specific individual and community needs. Their focus is often on the social, rather than the medical, determinants of health – addressing the socioeconomic, cultural practices, and organizational barriers affecting wellness and access to care.5 CHWs are known by numerous names in their communities and in the health literature, including Promotores de Salud, Community Health Advisors, and related titles, 6,7,8 reflecting their widely variable roles and responsibilities. This variability can present a challenge for demonstrating their value through outcomes research and for attempts to standardize CHW educational pathways, certification, and reimbursement.9,10

This report reviews select health services research findings on CHW utilization that are relevant to U.S. policymakers and considers the key challenges to fully realizing and quantifying the potential for CHWs to improve health care delivery. Although not intended to be a comprehensive and critical analysis of the full body of research around CHWs, this paper builds on information from a number of recent reports from across the Department of Health and Human Services (HHS) – including a 2009 systematic review by the Agency for Healthcare Research and Quality (AHRQ),11 a 2014 evidence assessment published by the Centers for Disease Control and Prevention (CDC),12 a 2015 CDC policy brief on CHW interventions for chronic disease management,13 and a 2015 summary of findings by the CDC-supported Community Preventive Services Task Force on cardiovascular disease interventions.14 This material is supplemented with select additions from the primary health literature and reports by health policy research organizations. 

Read the full brief here: https://aspe.hhs.gov/sites/default/files/pdf/168956/CHWPolicy.pdf

Many families live in homes that cause or contribute to illness. Moisture damage, microbial contamination, combustion gases, chemicals from cleaning products, and lead paint are among the many culprits.   

The tribes, partners and staff of the Tribal Healthy Homes Network work to address those hazards, but the scale and cost of remediating homes is enormous. While that remains our long-term goal, we believe that small fixes can make a big difference, and that empowerment leads to prevention .

The toolkits include 11 different low cost instruments, and cue cards that promote preventative home maintenance. The Tribal Healthy Homes Network team can help your tribe place an order, develop an Outreach Plan, or set up training. 

Learn more here: http://www.yourairmatters.org