Asthma Program Manager

Facilitating Home Visit Referrals Using an Asthma Clinical Decision Support Tool within the Electronic Health Record: Key Considerations

Sponsoring Program Name:

Association of Clinicians for the Underserved

When integrated into the electronic health record (EHR) and clinical workflow, clinical decision support (CDS) can enhance health care quality and improve patient outcomes.1 Using computerized alerts, reminders, forms, templates, data reports, evidence-based protocols, and other tools, CDS organizes, filters, and presents clinical knowledge and patient-specific information to guide decisions at the point of care.2 This brief discusses how an asthma CDS tool can promote the consistent use of clinical practice guidelines for asthma, and how incorporating a referral form template can promote wider use of in-home asthma programs as an effective complement to asthma care in clinical settings.

File Attachment:

Issue Brief - acu_asthma_decision_support.pdf

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Resource Type:

Document (PDF, Word, Excel)

Target Audience:

Asthma Program Manager

Other Health Care Provider

Physician

Community Health Worker Home Visits for Medicaid-Enrolled Children With Asthma: Effects on Asthma Outcomes and Costs

Sponsoring Program Name:

Public Health – Seattle & King County, Seattle, WA

The King County Asthma Program in Seattle, Washington, developed a community health worker (CHW) home visit program (Healthy Homes) and demonstrated its effectiveness. They designed a streamlined version of the program that was simpler and cost less to implement to facilitate broad dissemination and adoption. Here they reported on the effectiveness, cost-effectiveness, and ROI of a streamlined Healthy Homes program.

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)

Contact Name:

Jim Krieger

Contact Email:

jkrieger@actionforhealthyfood.org

Contact Phone:

206-451-8186

Resource Category:

Community Health/Outreach Worker Tool

Resource Type:

Document (PDF, Word, Excel)

Target Audience:

Asthma Educator

Asthma Program Evaluator

Asthma Program Manager

Community Health Worker

Utilizing the Community Health Worker Model to communicate strategies for asthma self-management and self-advocacy among public housing residents

Sponsoring Program Name:

Sinai Urban Health Institute

The Helping Children Breathe and Thrive in Chicago’s Public Housing (HCBT) project was developed based upon previous asthma interventions implemented at SUHI, mainly the Healthy Home, Healthy Child (HHHC) initiative. HHHC has proven to be an effective model for addressing poorly controlled asthma in the primarily African American, underserved community of North Lawndale. HCBT built upon this model in order to translate it to Chicago Housing Authority (CHA) properties.

Abstract

Non-Hispanic Black children in the US experience a higher prevalence of asthma and are more likely to have severe and poorly controlled asthma than their non-Hispanic White counterparts. These disparities are particularly pronounced among those living in public housing compared to the general population. To combat these disparities, health care researchers collaborated with public housing management to deliver a year-long community health worker (CHW) asthma and healthy homes intervention to children with asthma in six public housing developments. CHWs, hired from the targeted housing developments, educated families to better manage asthma medically and address asthma triggers in the home, and served as a bridge to medical, social, and public housing services. This is the first time such a full spectrum asthma intervention has been implemented by CHWs in public housing. Fifty-nine children completed the intervention, 95% of whom were African American. Daytime asthma symptoms in the previous two weeks were significantly reduced between baseline (4.1) and 1-year follow-up (0.8). The percent of children making two or more urgent health resource utilization visits decreased significantly between baseline (42%) and 1-year follow-up (15%). Quality of life scores for caregivers of children increased significantly (by 0.7 points). The implementation of the CHW model in a public housing setting not only meets children where they live, but effectively bridges the gap between them and the health care system, reducing the disproportionate burden of asthma in these communities and improving overall quality of life.

Click here to read the full manuscript.

Contact Name:

Melissa Gutierrez

Contact Email:

melissa.gutierrez@sinai.org

Contact Phone:

773-257-5258

Resource Category:

Community Health/Outreach Worker Tool

Program Management/Evaluation

Other

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