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A Community-Based Strategy for Improving Asthma Management and Outcomes for Preschoolers

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Abstract

Although almost one in ten (8.6%) preschool children has been diagnosed with asthma, few asthma management programs are designed for parents of preschool children. The Asthma Basics for Children program addressed this need in 2003–2008 by implementing a multi-layered approach that offered educational activities to center staff, parents, and children and PACE training to physicians in 31 Northern Manhattan daycare centers. Following program participation, 85% of parents reported reducing their child's triggers, 89% said it was easier to talk to their child's physician, and 80% were confident in their ability to manage their child's asthma. Children's any daytime symptoms dropped from 78% to 42%, any nighttime symptoms from 81% to 49%, any daycare absences from 56% to 38%, any asthma-related emergency department (ED) visits from 74% to 47%, and any asthma-related hospitalizations from 24% to 11% (p < .001 for all differences). Outcomes varied by level of exposure. In the Center-Only group (no parent participation), the only reduction was from 19% to 10% (McNemar = 3.77, p = .052) in hospitalizations. Children whose parents participated in the program had significant reductions in daycare absences (62% to 38%, McNemar = 11.1, p < .001), ED visits (72% to 43%, McNemar = 19.2, p < .001), and hospitalizations (24% to 11%, McNemar = 5.54, p = .018). Children whose parents and healthcare provider participated had the greatest improvements with asthma-related daycare absences dropping from 62% to 32% (McNemar = 9.8, p = .001), ED visits from 72% to 37% (McNemar = 14.4, p < .001), and hospitalizations from 35% to 15% (McNemar = 8.33, p = .003). This study demonstrates that a multi-layered approach can improve asthma outcomes among preschoolers with a combination of parent and provider education having the greatest impact.

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The findings and conclusions in this manuscript are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

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Authors and Affiliations

  1. Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, 60 Haven Ave, B-2, New York, NY, 10032, USA

    Sally E. Findley PhD, MURP, MA, Gloria Thomas, Rosa Madera-Reese, Natasha McLeod & Sreelata Kintala

  2. College of Physicians and Surgeons, Columbia University, New York, NY, USA

    Raquel Andres Martinez & Benjamin Ortiz

  3. Air Pollution and Respiratory Health Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Elizabeth Herman

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  1. Sally E. Findley PhD, MURP, MA
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  2. Gloria Thomas
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Correspondence to Sally E. Findley PhD, MURP, MA.

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Findley, S.E., Thomas, G., Madera-Reese, R. et al. A Community-Based Strategy for Improving Asthma Management and Outcomes for Preschoolers. J Urban Health 88 (Suppl 1), 85–99 (2011). https://doi.org/10.1007/s11524-010-9479-8

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  • DOI: https://doi.org/10.1007/s11524-010-9479-8

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