Above 6th Grade

New Resource for TalkingQuality Users: Toolkit for Making Written Material Clear and Effective

Written by Jeanne McGee for the Centers for Medicare & Medicaid Services, the Toolkit provides a detailed and comprehensive set of tools to help you make written material in printed formats easier for people to read, understand, and use. This resource is referenced throughout the TalkingQuality site. It provides valuable guidance on

• Developing clear, effective and well-organized written materials. Learn more at http://talkingquality.ahrq.gov/content/learnmore/tips/tip2.aspx.
• Learning about design and working with design professionals. Learn more at http://talkingquality.ahrq.gov/content/learnmore/tips/resourcebasic.aspx.
• Testing your materials with your audience. Learn more at
  http://talkingquality.ahrq.gov/content/learnmore/tips/tip7.aspx.

The complete toolkit is available at http://www.cms.gov/WrittenMaterialsToolkit/.

Contact Us:  talkingquality@ahrq.gov

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Visit TalkingQuality at https://www.talkingquality.ahrq.gov/.

Asthma remains the most common chronic condition of childhood. Strong evidence has linked exposure to allergens and other triggers commonly found in homes to allergen sensitization and asthma incidence and morbidity. A growing body of evidence has demonstrated that a home visit strategy that includes an environmental component that addresses multiple triggers through multiple interventions is effective. Such home visits reduce exposure to triggers, decrease symptoms and urgent health-care use, and increase quality of life. To make home visits widely available will require health-care payor reimbursement, government and health plan funding, training and certification of home visitors, and active referrals from health-care providers. However, a strategy based solely on education and behavior change is limited, because it cannot adequately reduce exposures due to adverse housing conditions. Therefore, approaches that address substandard housing are needed. These include remediation of existing housing and construction of new asthma-friendly homes. Most studies of remediation have made relatively narrow and focused improvements, such as insulation, heating, or ventilation. Outcomes have been mixed. Studies of new asthma-friendly homes are in their infancy, with promising pilot data. Further investigation is needed to establish the effectiveness of improving housing. A final strategy is improving housing quality through policy change, such as implementation of healthy housing guidelines for new construction, enhancement and increased enforcement of housing codes, and assuring smoke-free multi-unit homes. The combina tion of home visits, improved housing construction, and policy change has great potential for reducing the global burden of asthma.

School-based health centers (SBHCs) have steadily increased in numbers across the United States over the last 3 decades.

The most recent SBHC census, conducted in 2004 to 2005 by the National Assembly of School Based Health Care, identified more than 1709 SBHC programs in the United States.  This shift in the delivery of health care for children is premised on the assumption that access to health services in school increases access to health care and improves health status among children, especially for those children whose access to care is otherwise limited.  Health status is often measured by health-related quality of life (HRQOL), which attempts to tap the current health perception of individuals.  HRQOL has been demonstrated in both social scientific and clinical research to predict future health status, health care utilization and costs, and even mortality.

For example, a study linking the 1992 Medicare Current Beneficiary Survey with the 1993 Medicare Continuous History Survey found that a person’s response to a selfrated health question accurately predicted that individual’s respective use of health care services over the next year.  Only a few studies, however, have examined the connection between HRQOL and health care utilization and health care cost savings among children.  The link between HRQOL and utilization among Canadian adolescents was examined by Vingilis et al. with a single measure of perceived general health status that asked children to rank their answer on a 5-point scale from excellent to poor.  They found that reductions in perceived health over time were associated with increases in physician services and declines in dental care. This anomaly in usage across service providers may reflect differences between preventive dental care (representing the majority of dental services), which is not covered by publicly funded Canadian Medicare, and insured, curative health services.