Master's Culminating Experience
Background: The Dayton Children’s Hospital Comprehensive Asthma Management Program incorporates Community Health Worker (CHW) interventions to improve child asthma control and reduce urgent health resource utilization.
Methods: Children in grades two to five with parent- or physician-identified asthma received one of three levels of intervention, based on self-selection by caregivers: (1) child asthma education; (2) child and caregiver asthma education; (3) child and caregiver asthma education, plus home assessments. Child Asthma Risk Assessment Tool (CARAT) scores were collected before intervention to assess risk. Childhood Asthma Control Test (C-ACT) scores and urgent health visit numbers were collected before and after intervention. Analysis followed a pre- and post-intervention design, with children serving as their own controls.
Results: The study sample included 174 children who received intervention level one (n=109), level two (n=47), or level three (n=18). Study participants were 44.3% (n=77) female, 76.4% (n=133) African American, and 8.9 ± 1.2 average years of age. The average overall CARAT score was 25.2, below the high-risk threshold of 30. There was a significant improvement in average C-ACT scores from 18.5 (inadequate control) before intervention to 20.0 (adequate control) after (p = .015). There were no significant improvements in urgent health visits, and no significant differences in outcomes between intervention levels.
Conclusion: This program evaluation found that CHW interventions are effective in significantly improving C-ACT scores from inadequate asthma control to adequate control, and in identifying and remediating home asthma triggers. Future evaluation can be improved by longer follow-up periods and enhanced data collection.
Welsh, S. (2017). Evaluation of a Childhood Community-Based Comprehensive Asthma Management Program. Wright State University, Dayton, Ohio.
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