The Fresno Asthma Project: A Model Intervention to Control Asthma in Multiethnic, Low-Income, Inner-City Communities

Abstract

The Fresno Asthma Project targeted the entire low-income, inner-city, multiethnic population of Fresno, California. For 36 months following a 6-month planning phase, continuing education was provided to a high proportion of physicians, pharmacists, nurses/respiratory therapists, emergency medical technicians, school personnel, and allied health professionals involved in asthma care in Fresno, including virtually all those providing care/services to the target population. Small group patient education was made available and provided in age- and culturally appropriate formats to patients/families in clinics, hospitals, and schools. General and ethnic media and a Speakers Bureau were used to raise public awareness of asthma as a serious but controllable health problem. This community intervention model is particularly appropriate to multiethnic communities. It is relatively low cost (total direct costs were $140,000 per year), uses existing educational resources, and appears to have minimized counterproductive competition. Although morbidity and mortality trend data are not yet available to monitor program impact, penetration into the target community has been substantial: community physicians refer patients to asthma classes, asthma educator training is ongoing through the local American Lung Association chapter, hospitals and managed care systems serving low- income/MediCal patients offer asthma classes, and public schools and HeadStart are institutionalizing asthma awareness and self-management classes.

Influence of Sociodemographics on the Health-Related Quality of life of Pediatric Patients with Asthma and Their Caregivers

“…The specialty clinics participating in this study offer a multidisciplinary educational component for the patient and caregiver. Programs that provide patient education and appropriate prescribing have been demonstrated to improve the outcomes of asthma (40,41).…”

Understanding Frequent Emergency Room Use by Medicaid-Insured Children with Asthma: A Combined Quantitative and Qualitative Study

“…As in studies of Medicaid-insured and Head Start children, 9 -12 members of health maintenance organizations, 13 and inner-city communities, 14,15 asthma was a common and serious health problem for Medicaid-insured children in Kansas. The estimated annual 1074 ER visits per 10,000 children under 5 years of age significantly exceeds the reported national average and makes the Healthy People Target of 80 per 10,000 seem unattainable by 2010.…”

A systematic review to examine the impact of psycho-educational interventions on health outcomes and costs in adults and children with difficult asthma

“…However, in the absence of any further information being obtained or identified, 33 studies (23 in children, five in adults [213][214][215][216][217] and five in which the age group targeted was unclear [218][219][220][221][222] ) were not reviewed beyond the study classification stage on the basis that they were not formal evaluations and simply described characteristics of an individual psychoeducational programme, presented data on characteristics of participants at baseline only or reported narrative case studies of patients recruited to such programmes. Brief descriptions of patients targeted and details on the components of the interventions in these studies are provided in Appendix 10.…”