Community-Based Approaches to Controlling Childhood Asthma

Abstract

The prevalence and burden of childhood asthma remain high and are increasing. Asthma hot spot neighborhoods around the country face particular challenges in controlling the effects of the condition. Increasing attention is being paid to developing interventions that recognize the child and family as the primary managers of disease and to introducing assistance that reaches beyond the clinical care setting into the places where families live and work. A range of types of community-focused interventions has been assessed in the past decade in schools, homes, and community health clinics, and programs using electronic media and phone links have been evaluated. Stronger evidence for all these approaches is needed. However, school-based programs and community coalitions designed to bring about policy and systems changes show particular promise for achieving sustainable improvements in asthma control. Research is needed that emphasizes comparisons among proven asthma control interventions, translation of effective approaches to new settings and communities, and institutionalization of effective strategies.

The Child Opportunity Index and Disparities in Pediatric Asthma Hospitalizations Across One Ohio Metropolitan Area, 2011-2013

“…(22, 23) For example, with its association with population-level asthma morbidity, the COI may inform the design of census-tract level, asthma-specific interventions (e.g., medication delivery programs, school-based asthma symptom monitoring). (5, 24) The COI could similarly motivate opportunity-enhancing interventions that promote health and well-being in ways that are not directly clinical or condition-specific (e.g., community development programs, connections to community resources like job training programs). (25, 26) Moreover, bringing indices like the COI together with health outcomes could highlight populations and patients at risk for “double jeopardy” – limited opportunity and heightened risk for morbidity.…”

Cyclic AMP concentrations in dendritic cells induce and regulate Th2 immunity and allergic asthma

“…However, the failure to translate drug candidates identified in such models to humans with those diseases raises questions regarding the utility of those models and emphasizes a need for new models that more accurately reflect human immunology and genetics (49). The increasing prevalence of allergic diseases during recent decades imposes significant public health challenges and has substantial health care-related costs (50)(51)(52). The pathophysiology of Gnas ΔCD11c mice mimics that observed in allergic/asthmatic patients: Gnas ΔCD11c mice are atopic, develop spontaneous Th2 response and a progressive chronic allergic phenotype that is akin to what occurs in patients with allergic asthma.…”

Primary care visits for asthma monitoring over time and association with acute asthma visits for urban Medicaid-insured children

“…Community-based approaches have been studied, and, while some have been successful in improving outcomes, not all attempts have had equal success. [25] In Washington, DC, an ED-based asthma follow-up clinic has been associated with some improved outcomes. [26]…”