Enhancing Care, Coordination and Capacity Across Community Sectors to Improve Asthma Outcomes in High-Risk Children in Hawaii: Planning Phase

University Of Hawaii At Manoa, Honolulu HI

Investigators

Abstract

? DESCRIPTION (PROVIDED BY APPLICANT): In economically challenged, rural, minority communities uncontrolled asthma exacts a huge toll on children, their families and the healthcare system in cost, school absenteeism, poor academic outcomes and, for parents, lost days at work. Asthma is a complex health condition, with numerous risk factors, that require solutions involving optimal healthcare and public health approaches to include family, environment and community needs. Federally qualified community health centers (FQHC) are well positioned to play a significant role in reducing asthma health disparities by coordinating clinical and public health approaches. Our goal is to reduce childhood asthma disparities in low-income, minority communities. We will develop a clinical trial to evaluate an Asthma Care Implementation Program (ACIP), coordinated at a large FQHC, in partnership with families, community partners and an at-risk public school district. The majority of students in this district are Native Hawaiian and Other Pacific Islanders and, overall, about 25% have asthma. The study will build on strong relationships formed between a FQHC, a public school district, the community, and the University established by the Principal Investigator, who is a community-based researcher and a long-time clinic pediatrician as well as an Assistant Professor of Pediatrics at the University of Hawaii. To best implement this multi-faceted study, we will conduct a needs assessment, using focus groups and key informant interviews, to ascertain the needs and barriers related to asthma care and distill possible community-based solutions. Strategies may include expanding school-based asthma care through the administration of asthma control medications, the delivery of asthma trigger control interventions to families at the school, and placing a FQHC nurse at schools to enhance communication and coordination of asthma care. Input from community thought leaders, families, schools personnel, public health nurses, and community pediatric healthcare providers will be sought. We will also examine current processes at the FQHC and at schools used to deliver asthma care, including electronic medical record systems, patient education materials and school based asthma action plans. Data will be used to refine the proposed ACIP. The specific aims of this one-year needs assessment and planning phase are as follows: 1. To identify healthcare and community health resources, needs and barriers related the optimal management of persistent childhood asthma, including needs at school and home. 2. To identify the most feasible, acceptable and sustainable methods and strategies, in healthcare, school, family and home, to address those needs and barriers. Summary: This proposed study will builds upon the strengths and commitment of a trusted and well- established FQHC, together with its University and community partners, in order to plan an effective, culturally appropriate, and sustainable ACIP.(End of Abstract)