Journal of Urban Health

, Volume 88, Supplement 1, pp 85–99 | Cite as

A Community-Based Strategy for Improving Asthma Management and Outcomes for Preschoolers

  • Sally E. Findley
  • Gloria Thomas
  • Rosa Madera-Reese
  • Natasha McLeod
  • Sreelata Kintala
  • Raquel Andres Martinez
  • Benjamin Ortiz
  • Elizabeth Herman
Article

Abstract

Although almost one in ten (8.6%) preschool children has been diagnosed with asthma, few asthma management programs are designed for parents of preschool children. The Asthma Basics for Children program addressed this need in 2003–2008 by implementing a multi-layered approach that offered educational activities to center staff, parents, and children and PACE training to physicians in 31 Northern Manhattan daycare centers. Following program participation, 85% of parents reported reducing their child's triggers, 89% said it was easier to talk to their child's physician, and 80% were confident in their ability to manage their child's asthma. Children's any daytime symptoms dropped from 78% to 42%, any nighttime symptoms from 81% to 49%, any daycare absences from 56% to 38%, any asthma-related emergency department (ED) visits from 74% to 47%, and any asthma-related hospitalizations from 24% to 11% (p < .001 for all differences). Outcomes varied by level of exposure. In the Center-Only group (no parent participation), the only reduction was from 19% to 10% (McNemar = 3.77, p = .052) in hospitalizations. Children whose parents participated in the program had significant reductions in daycare absences (62% to 38%, McNemar = 11.1, p < .001), ED visits (72% to 43%, McNemar = 19.2, p < .001), and hospitalizations (24% to 11%, McNemar = 5.54, p = .018). Children whose parents and healthcare provider participated had the greatest improvements with asthma-related daycare absences dropping from 62% to 32% (McNemar = 9.8, p = .001), ED visits from 72% to 37% (McNemar = 14.4, p < .001), and hospitalizations from 35% to 15% (McNemar = 8.33, p = .003). This study demonstrates that a multi-layered approach can improve asthma outcomes among preschoolers with a combination of parent and provider education having the greatest impact.

Keywords

Early childhood centers Asthma Self-management training Indoor trigger reduction Community-based interventions 

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Copyright information

© The New York Academy of Medicine 2010

Authors and Affiliations

  • Sally E. Findley
    • 1
  • Gloria Thomas
    • 1
  • Rosa Madera-Reese
    • 1
  • Natasha McLeod
    • 1
  • Sreelata Kintala
    • 1
  • Raquel Andres Martinez
    • 2
  • Benjamin Ortiz
    • 2
  • Elizabeth Herman
    • 3
  1. 1.Heilbrunn Department of Population and Family Health, Mailman School of Public HealthColumbia UniversityNew YorkUSA
  2. 2.College of Physicians and SurgeonsColumbia UniversityNew YorkUSA
  3. 3.Air Pollution and Respiratory Health Branch, Centers for Disease Control and PreventionAtlantaUSA

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