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The Common Data Elements and Demographic survey instruments were created to collect
standardized outcome information from patients enrolled in the five MCAN sites. The Manual of
Operations provides instructions for administering the surveys, data entry and coding, formatting and
storage, delivery of the data to RTI International, and the schedule for data delivery. Appendix A
provides English and Spanish versions of the instrument and Appendix B provides an example of
coded data.

Abstract Background: A substantial proportion of low-income children with asthma living in rural western North Carolina have suboptimal asthma management. To address the needs of these underserved children, we developed and implemented the Regional Asthma Disease Management Program (RADMP); RADMP was selected as one of 13 demonstration projects for the National Asthma Control Initiative (NACI). Methods: This observational intervention was conducted from 2009 to 2011 in 20 rural counties and the Eastern Band Cherokee Indian Reservation in western North Carolina. Community and individual intervention components included asthma education in-services and environmental assessments/remediation. The individual intervention also included clinical assessment and management. Results: Environmental remediation was conducted in 13 childcare facilities and 50 homes; over 259 administrative staff received asthma education. Fifty children with mild to severe persistent asthma were followed for up to 2 years; 76% were enrolled in Medicaid. From 12-month preintervention to 12-month post-intervention, the total number of asthma-related emergency department (ED) visits decreased from 158 to 4 and hospital admissions from 62 to 1 (p50.0001). From baseline to intervention completion, lung function FVC, FEV1, FEF 25–75 increased by 7.2%, 13.2% and 21.1%, respectively (all p50.001), and average school absences dropped from 17 to 8.8 days. Healthcare cost avoided 12 months post-intervention were approximately $882 021. Conclusion: The RADMP program resulted in decreased ED visits, hospitalizations, school absences and improved lung function and eNO. This was the first NACI demonstration project to show substantial improvements in healthcare utilization and clinical outcomes among rural asthmatic children.

Objectives. We sought to estimate the return on investment of a streamlined version of an evidence-based community health worker (CHW) asthma home visit program.

Methods. We used a randomized parallel group trial of home visits by CHWs to Medicaid-enrolled children with uncontrolled asthma versus usual care.

Results. A total of 373 participants enrolled in the study (182 in the intervention group and 191 in the control group, of whom 154 and 179, respectively, completed the study). The intervention group had greater improvements in asthma symptom–free days (2.10 days more over 2 weeks; 95% CI =  1.17, 3.05; P < .001) and caretakers’ quality of life (0.43 units more; 95% CI = 0.20, 0.66; P < .001) and a larger reduction in urgent health care utilization events (1.31 events fewer over 12 months; 95% CI = −2.10, −0.52; P = .001). The intervention arm compared with the control arm saved $1340.92 for the $707.04 additional costs invested for the average participant. The return on investment was 1.90.

Conclusions. A streamlined CHW asthma home visit program for children with uncontrolled asthma improved health outcomes and yielded a return on investment of 1.90. (Am J Public Health. Published online ahead of print August 13, 2015: e1–e7. doi:10.2105/AJPH.2015.302685)

Read More: http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2015.302685?journalCode=ajph