NHLBI funds asthma coalitions to improve care among high risk populations

Asthma coalitions in seven communities with exceptionally high asthma death rates have been awarded contracts by the National Heart, Lung, and Blood Institute (NHLBI). The contracts are designed to establish partnerships between the NHLBI and local asthma coalitions to develop innovative, model programs for improving asthma care. The coalitions will implement activities to eliminate disparities in asthma morbidity and mortality in their communities, especially among children, minorities, and low-income individuals.

According to NHLBI Director Dr. Claude Lenfant, "We now know enough about asthma so that no one should die from it any more. Yet people are still dying from asthma. Why? Because the information about how best to treat and control it is not being widely used. By forging partnerships with coalitions in high-risk communities, we can bring this information directly to the people who need it most."

"This is the first step in a broader plan to build a network of coalitions in high-risk communities to work together towards achieving the Healthy People 2010 goals of eliminating racial and ethnic disparities in health care," he added.

The NHLBI has a lead role in achieving the Healthy People 2010 goals in the Respiratory Diseases focus area. Eliminating racial and ethnic disparities in health care is a major Healthy People 2010 goal.

Asthma is a chronic lung condition that disproportionately affects children, minorities, and low-income individuals. Minority populations, particularly African Americans and Hispanics, account for a disproportionate share of asthma deaths, as well as emergency department visits and hospitalizations. Asthma also continues to be one of the leading causes of school absenteeism, limitations of activity, and disruption of family life in the U.S. The cost of asthma in the U.S. in 1998 was estimated at $11.3 billion.

The NHLBI created the National Asthma Education and Prevention Program (NAEPP) to improve awareness, early detection, and treatment of asthma. In 1997, it released the second U.S. "Guidelines for the Diagnosis and Management of Asthma," an Expert Panel Report that provides up-to-date comprehensive science-based information on the diagnosis and treatment of asthma. The Guidelines were disseminated widely to physicians and other health care professionals to help them improve the way they treat patients with asthma.

The contractors and their projects are:

• Arkansas Asthma Coalition/Arkansas Children's Hospital Research Institute, Little Rock, AR

This project aims to develop a multifaceted asthma education intervention for primary care providers, their office staff, and school nurses with the goal of improving asthma diagnosis and treatment in a rural population of low-income children with persistent asthma.

• Central California Asthma Project/San Joaquin Valley Health Consortium, Fresno, CA

To increase asthma awareness and improve asthma care for low-income, rural communities with large populations of Hispanics and Southeast Asians, this project will create a multi-tiered intervention involving use of mass media, health care provider training, and outreach to schools and other community organizations.

• Chicago Asthma Consortium, Chicago, IL

Targeting three communities with large African American populations, this project will develop a "community activation" program designed to mobilize community leadership for policy changes and asthma awareness activities to increase the percentage of schools, churches, child care centers, and other local organizations that implement asthma-friendly programs and policies.

• Columbia University Asthma Coalition/Columbia University College of Physicians and Surgeons, New York, NY

This project seeks to reduce overutilization of emergency department services by asthma patients by creating a long-term culturally appropriate asthma management system that incorporates effective medical care, asthma education, psychosocial screening, environmental assessment, and referrals to appropriate social service agencies for adult asthma patients in a predominantly Hispanic and non-English speaking neighborhood in New York City.

• Asthma Community Development Coalition/Health and Hospital Corporation of Marion County, Indianapolis, IN

This project will provide comprehensive asthma education to school staff and students in Indianapolis's elementary and middle schools and Head Start programs with a goal of improving community awareness and family involvement in understanding asthma and asthma care and strengthening links between schools and health care providers in this low-income, predominantly African American community.

• Southeast Regional Clinicians' Network/Morehouse School of Medicine, Atlanta, GA

This project will provide physician education that combines techniques for changing clinical practice behaviors, applying patient-centered education approaches, and making office systems changes for primary care physicians and staff in 16 Federally funded community health and migrant health centers in 8 southeastern states to improve asthma care delivery to their low-income minority patient population.

• Tacoma-Pierce County Asthma Prevention Partnership, Tacoma, WA

This project aims to reduce asthma emergency room and unscheduled office visits in this low-income, ethnically diverse community by using outreach workers and volunteers to provide education and action related to reducing environmental triggers of asthma in the home, extending educational opportunities to families and health care providers, and promoting the use of personalized asthma management plans.

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The NHLBI is a component of the National Institutes of Health, located in Bethesda, MD.

For more information on asthma, visit the NHLBI Web site at www.nhlbi.nih.gov

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