While asthma affects children in every community across the country, low income and minority children bear the heaviest burden of the disease and its consequences, including death. Compared with white non-Hispanic children, asthma is 60% higher among African-American children and nearly 300% higher among Puerto Rican children. The Merck Childhood Asthma Network, Inc. (MCAN) targeted four high risk cities with nearly $4 million for programs that combined evidence-based science, case management and asthma trigger removal plans to manage a disease that requires more than the right medical care. Programs in Chicago, IL; Los Angeles, CA; Philadelphia, PA; and San Juan, Puerto Rico – all cities with high rates of childhood asthma – enrolled children and families in the most comprehensive asthma management research program ever designed for the community level. By the end of the programs’ funding period in 2014, over 1,200 children had enrolled in one of the four programs.
CMCD investigators are in the final analysis and dissemination phase of a cross-site qualitative and quantitative evaluation that assessed both processes and outcomes associated with the MCAN. There were two elements of the evaluation. Our evaluation has two goals, (1) identify the impacts of care coordination on patients and families, including impacts on access to care, care quality, and service use; and (2) identified the factors aiding and deterring translation of the key aspects of evidence-based interventions in real-world settings.
MCAN Program Sites
Chicago, IL:
Addressing Asthma in Englewood Project
A collaborative effort of the University of Illinois School of Public Health and the Respiratory Health Association of Metropolitan Chicago, this program centered around a community educator model that linked children with asthma to appropriate services, education programs in schools, community groups, and local agencies on the south side of Chicago. It included a home visit case management program to enhance asthma education and identification and mitigation of asthma triggers.
Los Angeles, CA:
Los Angeles Unified School District Asthma Program
Asthma nurses within the LA Unified School District, the nation’s second largest school district, provided services to children with poor control of symptoms. The program involved a care coordination and education model that extended beyond the immediate school clinic to include system changes between health, educational, and community settings. The program triaged students and families into the appropriate level of intervention, improved the coordination of care between schools, clinics, and community providers, and focused on measuring symptom reduction and school days missed.
Philadelphia, PA:
The Children's Hospital of Philadelphia Asthma Navigator Program
This Children’s Hospital of Philadelphia program utilized asthma health care navigators located within three of its primary care centers. Navigators worked with primary care providers as integral members of the family’s asthma care team, assisting families in the identification and reduction of asthma triggers in the home and providing self-management education and other support and resources for families of high risk children with asthma.
San Juan, Puerto Rico:
La Red de Asma Infantil de Merck de Puerto Rico
This program involved evidence-based interventions as part of an asthma care coordination program across home, health care, and community settings. A team from University of Puerto Rico and RAND Health implemented the program in the in partnership with the HealthproMed Federally Qualified Health Center in San Juan, Puerto Rico. “La Red” aimed to promote asthma-friendly communities throughout the island of Puerto Rico and to enhance access to quality asthma health care for this highly vulnerable and underserved community.
Chicago, IL:
Addressing Asthma in Englewood Project
A collaborative effort of the University of Illinois School of Public Health and the Respiratory Health Association of Metropolitan Chicago, this program centered around a community educator model that linked children with asthma to appropriate services, education programs in schools, community groups, and local agencies on the south side of Chicago. It included a home visit case management program to enhance asthma education and identification and mitigation of asthma triggers.
Los Angeles, CA:
Los Angeles Unified School District Asthma Program
Asthma nurses within the LA Unified School District, the nation’s second largest school district, provided services to children with poor control of symptoms. The program involved a care coordination and education model that extended beyond the immediate school clinic to include system changes between health, educational, and community settings. The program triaged students and families into the appropriate level of intervention, improved the coordination of care between schools, clinics, and community providers, and focused on measuring symptom reduction and school days missed.
Philadelphia, PA:
The Children's Hospital of Philadelphia Asthma Navigator Program
This Children’s Hospital of Philadelphia program utilized asthma health care navigators located within three of its primary care centers. Navigators worked with primary care providers as integral members of the family’s asthma care team, assisting families in the identification and reduction of asthma triggers in the home and providing self-management education and other support and resources for families of high risk children with asthma.
San Juan, Puerto Rico:
La Red de Asma Infantil de Merck de Puerto Rico
This program involved evidence-based interventions as part of an asthma care coordination program across home, health care, and community settings. A team from University of Puerto Rico and RAND Health implemented the program in the in partnership with the HealthproMed Federally Qualified Health Center in San Juan, Puerto Rico. “La Red” aimed to promote asthma-friendly communities throughout the island of Puerto Rico and to enhance access to quality asthma health care for this highly vulnerable and underserved community.
For more information about the Center for Managing Chronic Disease’s MCAN evaluation, contact Dr. Mary Janevic at mjanevic@umich.edu.
For more information about MCAN, visit their website.
Categories:
Asthma & Allergies, Children & Youth, Community
