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ABSTRACT 2634 Characteristics of Asthma Programs with

Rationale: To better understand successful asthma programs, the Asthma Health


Outcomes Project (AHOP) identified national and international asthma programs Positive Health Outcomes
(n=500). Programs that included an environmental component and reported a positive
impact on asthma-related health outcomes (n=223) were examined to identify factors Friedman AR MPH; Lachance L PhD; Stoll S MPH; Awad D MA; Clark N PhD
associated with success. Methods: Through telephone interviews, program documents
and published literature, data were gathered on program background, design, and
Center For Managing Chronic Disease, University of Michigan School of Public Health
administration, and evaluation design and findings. Descriptive frequencies provided an
45%
overall picture of work in the field, and bivariate relationships between programmatic
factors and health outcomes were analyzed using X2 statistics and Fisher's exact tests
(p<0.05), and unconditional logistic regression. Results: Descriptive data present a
METHODS 40%
35%
40%
Managing Organization
33% n=221
30%
snapshot of the current field of asthma programs. For example, strategies most
25%
commonly used by surveyed programs included asthma education (96%), home visits
20%
(43%), systems change (42%), and clinical quality improvement (37%). Initial findings Descriptive frequencies were drawn from the 223 surveyed programs that met the inclusion 15%
from bivariate analyses of 111 programs that had evaluation results reported in peer-
reviewed publications were grouped into programmatic categories. These findings
criteria: (1) focused on asthma; (2) included an environmental component (e.g., education about 10% 12%
9%
5% 7%
suggest that programs are more likely to report a positive impact on health outcomes if triggers, policy action to reduce trigger exposure); (3) completed an evaluation that showed a 0%
6% 5% 5%
1%

they: Work with health care providers; Have close ties to communities; Collaborate with positive impact on at least one health outcome. yst ic er cy rg ic an O y st
m th n O i n l B S
others; Follow established steps of program development in order to meet the needs of
S de e
nt Cl P C
lth a O Ag l u m l th i c ch
p /H /Ac ov
t
Vo m H
-c
li n
ol
/ S
the community; and are tailored to meet the needs of individual participants, particularly s i v G Co n o
Initial analyses found significant variation in program evaluations. A focused analysis was Ho Un No Sc
h
with regard to environmental trigger sensitivity. Conclusions: Preliminary analyses
suggest that particular program processes are associated with improving health conducted on programs that reported using randomized controlled trials with evaluation results 100%
outcomes. Key descriptors of successful programs are: community centered, clinically
connected, and continuously collaborative.
reported in peer-reviewed publications (n=65). Bivariate relationships between programmatic 90% 96%
Overall Program Strategies
80%
factors and health outcomes were analyzed with χ 2 statistics using Fisher's exact tests (p<0.05). 70% n=221-223
60%
Total Identified Programs 50%
n=532 40% 43% 42%
30% 37%

RESULTS 20%
10%
28% 25%

Eligible 1%
Ineligible 0%
n=427 . ov rd
n=105 d uc i si ts n ge pr o o n ge he
r
aE e V
Ch
a
l Im re
C
Ch
a Ot
m m m ua a y
th Ho ste t /C oli
c
As cQ
No Evaluation Available Evaluation Complete Associated programmatic factors and reported positive health outcomes S y
Cl
i ni
a se
M g P

n=194 n=233 C
(n=65): 100%

Not surveyed Program Survey Complete


Had an office Improvement to
90%
Environmental Triggers Addressed
Educated healthcare Improvement to
80% 82% 82%
n=223 81%
n=10 providers (including located in the hospitalizations 70% 71% n=218-223
school absences 68% 67%

Descriptive school nurses) 100% 92% target community and ED visits


60%
50%
62%

90% 51% 51%

Frequencies Unpublished Published 80%


78% 40%
30%
n=112 n=111 70%
20%
60% 51%
20%

Had a component that Improvement to 50% Designed their programs to Improvement to 10%
0%
took place in a doctor’s emergency 40% target a particular quality of life for r e i n e ity
Not RCT RCT 30% 29%
ite
s
de ok ol
d rg ns
id es
s
al nt
s
f ie
d
office/clinic department visits 30% race or ethnic group 24% parents m an sm M ll e I p n u
od
e ci
n=46 n=65 st D o A rg m irQ pe
20% u og c ch lle a A R s
6%
D
t /D b ac r oa rA
D
or Un
10% o o
Ca r .t o ck d oo ut
d
0% vi C ut O
En O
a er * p l* r
ov ers th e
Bivariate analysis of Collaborated with s thm Assessed
-giv Prtrigger
a l Poexposure
o n
Improvement to vid w/a amily/C th Care Gener ol Pers care W
ne
o r k OImprovement to
100%
associations between other agencies or id F as
Hl an environmental
ho y quality of life for
hospitalizations In Sc Da 90% 96%
Environmental Strategies
institutions strategy adults 80%
programmatic factors Health Care Utilization 70% 74% n=222-223
60%
and asthma health outcomes: Quality of Life 50%
Functional Status 40%
Collaborated with other Improvement to Tailored their intervention Improvement to 30% 40%
School/Work Loss 20%
Background agencies/organizations school absences based on an assessment quality of life for
Symptoms 10% 12% 7%
Planning and Design on policy action and medication use of trigger sensitivity children 0% n n
Lung Function e nt viro ng
e viro
Implementation tion sm en ha en
c a e s me y c ti t ut
Medication Use Ed
u
ea
s s
ge
ho
po
lic
e in
s
Administration po
su r
ha
n
viro
n
ha
n g
Self-Management Skills Ex t oc En t oc
Program Context Tailored their content or tion
s
tion
s
Use of an Asthma Action Plan Improvement to Improvement to asthma A c Ac
Impact and Sustainability Collaborated with delivery based on individual
Peak Flow Meter emergency symptoms and quality
governmental participants’ health or
Change in Clinical Actions department visits of life for adults Research funded by grant XA-83042901 from the Indoor
agencies educational needs
Environmental Outcomes Environments Division of the US Environmental Protection Agency
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