Asthma Education Program of Lutheran Medical Center’s Sunset Park Family Health Center

The Sunset Park asthma population escalated 38% in just two years, and the hospitalization rate for children was four times the national average.  The Asthma Education Program (AEP) increased the understanding of patients and their parents in assessment, preventive and self-care skills, so that after six months emergency department visits decreased 87%, walk-ins 77%, and hospitalizations 84%.

Specific Comments Included:

An effective single disease focus with strong community outreach.  Remarkably large effects of two modes of intervention in a well-designed chart review of emergency room visits, walk-in visits and hospitalizations before and after intervention.  Convincing evidence for cost savings from case management method and for education method.  Excellent potential for replication.  Excellent use of culturally appropriate education.

A community Asthma Education Program was developed for 0-11 year old children in high priority neighborhood with a state grant.  The multi-faceted program included case management, community education, and school health education components.  There were large decreases in health services use for asthma.  Cost data are quite convincing, as are the positive medical outcomes.  A much needed chronic disease management program.  The targeted 0-5 age group has yielded the greatest impact.  The School Asthma Program is a skills building, preventive intervention with a parent component included.  There is an outreach to individuals post-episode, inviting them to join an educational program.  The program materials are creative and appealing.  The intervention yielded strong results.  A great strength is that the program goes to schools to teach the youth.  There is a solid cost analysis report. 

Concerns mentioned included:   experimental design does not allow secular effects, regression to the mean, or age effects to be ruled out as confounders.  The level of participation of the eligible people appears somewhat weak.  There is a relatively short time horizon for the study, which is a before and after comparison.  The program could be strengthened by going after parental smoking behaviors.  Cost savings are estimates.  Documentation consists mostly of articles and newsletters and the program remains relatively small with a total of 50 in one group and 39 in the other.