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Are Asthma Programs Positioned for Impact?

Factors associated with success


Lachance L, PhD; Friedman AR, MPH; Stoll S, MPH; Awad D, MA; Clark N, PhD
CENTER FOR MANAGING CHRONIC DISEASE, UNIVERSITY OF MICHIGAN, ANN ARBOR, MICHIGAN

BACKGROUND RESULTS CONCLUSIONS

Programs and services aimed at improving the health and


quality of life for those with asthma have proliferated, and 14 programmatic
Clinically Connected Responsive to Need Collaborative Community Centered
the complexity of asthma has shaped the variety of
approaches designed to address the disease. The Asthma
factors were found to
Health Outcomes Project (AHOP) collected data from
national and international asthma programs to identify Program Factor Improved Outcome Program Factor Improved Outcome Program Factor Improved Outcome Program Factor Improved Outcome
be associated with
programmatic factors associated with successful health one or more positive
outcomes and describe how widely program practices are Involved
implemented across the field. Correlated Educated healthcare
School absences
Conducted a needs School absences/ Collaborated with
Hospitalizations
community- Health care health outcomes.
(1) providers (including (4) and/or resource work loss (8) other agencies or
(g) (12) based utilization
programmatic school nurses)
(p=0.02)
assessment (d) (p=0.02) institutions
(p=0.02)
organizations in
planning the
(p=0.03) Descriptive categories
factors and of successful
METHODS Component
program
reported positive of a program Emergency
health outcomes (2) took place in department
Assessed trigger
(5) exposure as an
Quality of life
for adults (9)
Collaborated with
governmental
Emergency
department (13)
Collaborated with
community-based
Health care
utilization
programs are:
a doctor’s visits
Through a wide-reaching outreach campaign, AHOP
identified 532 asthma programs worldwide, 223 of which
(n=111) office (p=0.01)
environmental strategy (p=0.02) agencies visits (p=0.04)
(h) organizations (p=0.04)
clinically connected,
or a clinic (e)
met the inclusion criteria: (1) focused on asthma; (2) Quality of life
Tailored content or Hospitalizations
responsive to need,
included an environmental component (e.g., education
about triggers, policy action); (3) completed an evaluation
(3)
Tailored intervention
based on an
for children
and/or
delivery based
(6) on individual
Asthma symptoms
(p=0.03) and quality of
Collaborated with
other
(10) agencies/orgs
School absences
(p=0.01) and
(14)
Had an office
located in the
(p=0.04), ED visits
(p=0.04), and
continuously
assessment of parents/caregivers medication use target
that showed a positive impact on at least one health
outcome.
trigger sensitivity and/or adults
participants’ health or
educational needs
life (p<0.01)
on policy action (i)
(p=0.04) community
health care
utilization (p=0.01)
collaborative, and
(p<0.01)
(f) community centered.
Collaborated with
Designed
Quality of life for other agencies or Health care
ANALYSIS (7)
program to target
parents/caregivers (11) organizations (j)
utilization

How are these


a particular race
or ethnic group
(p=0.02) on technical
assistance
(p=0.04) Among the 14 factors
A focused analysis was conducted on programs with factors reflected significantly
evaluation results reported in peer-reviewed publications
(n=111). Relationships between programmatic factors and in the field? associated with
health outcomes were analyzed with chi-square statistics
using Fisher's exact tests. (p < 0.05) Yes No Yes No Yes No Yes No
positive health
Data from both published and unpublished programs were
outcomes, ten were
(4) 130 51 (8) 163 18
used to describe how widely these factors were (1) 110 104 (12) 104 50 reported by 50% or
implemented among the programs studied. Percent of
programs
more of the relevant
(5) 164 58 (9) 91 72
Total Programs reporting programs for which
n=532 (2) 107 113 (13) 66 97
programmatic
(6) 168 32 (10) 69 90
data were available.
Not Eligible
n=105
Eligible
n=427
factors
(n=223)
(3) 44 9 (14) 163 12
Not Evaluated Evaluated* (7) 45 176 (11) 95 65
n=194 n=223
Research funded by grant XA-
Unpublished Published** 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% 83042901 from the Indoor
n=112 n=111
Percent of Responding Programs Percent of Responding Programs Percent of Responding Programs Percent of Responding Programs Environments Division of the US
* Frequencies to describe current practice Environmental Protection
** Analysis of program factors and asthma health outcomes Agency