EVALUATING HOME/ENVIRONMENTAL AND CLINICAL INTERVENTIONS FOR ASTHMA IN CLINICAL SETTINGS

Project Background and Goals:

Clinical Directors Network, Inc. (CDN) in collaboration with the US Environmental Protection Agency (EPA) and the Health Resources and Services Administration (HRSA), is conducting a project entitled “Evaluating Home/Environmental and Clinical Interventions for Asthma in Community/Migrant Health Centers” beginning in ten HRSA-funded Community/Migrant Health Centers serving low income and minority patients in New York, New Jersey, Pennsylvania, Missouri, Puerto Rico and the Virgin Islands. This demonstration project is testing the feasibility and effectiveness of two sets of treatment strategies, derived from the NIAID/NIEHS-funded Inner City Asthma Study and the Institute for Healthcare Improvement (IHI) Asthma Breakthrough Collaborative, and combines clinic-based and environmental/home-based interventions, in improving clinical outcomes of more than 200 children, aged 6 to 19 years who have mild-, moderate- to severe-persistent asthma. Clinic-based interventions include: establishment of an asthma action plan in collaboration with the primary care physician, and patient and family education. Environmental interventions include: home assessments, environmental-safe package (mattress and pillow covers, pest management products, cleaning and laundering products as well as counseling on home safety to prevent exposures and injuries). We are also evaluating the use and effectiveness of outreach workers counselors in the home and nurse counselors by telephone, using an electronic surveillance system for disease-management.

The 14 participating clinical sites are located in Brooklyn, Manhattan , Queens and Bronx in NY, Camden and Bridgeton in NJ, Philadelphia PA , San Juan , Patillas, Mayagüez and Castañer in PR, St. Croix, VI, and Kansas City , MO.

Major Partners include: EPA; HRSA; NJ Department of Environmental Protection, HUD; Universal Medical History and Information, Inc. (UMED); New Jersey Primary Care Association; Community Health Care Association of New York State; Visiting Nurse Service New York; Asthma and Allergy Foundation; National Jewish Medical and Research Center; The project strategies and findings will be disseminated to Community/Migrant Health Centers and other community-based practices serving low-income and minority patients.