The<i>Yes We Can</i>Urban Asthma Partnership: A Medical/Social Model for Childhood Asthma Management

Thyne, Shannon; Rising, Joshua P.; Legion, Vicki; Love, Mary Beth

doi:10.1080/02770900600925288

Cited by 48 publications

(50 citation statements)

References 41 publications

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“…Yet, the impact of La Red was not only comparable to that observed in the controlled experimental studies but in almost every case exceeded the original, separate interventions. 13,14 For example, the reduction in asthma symptoms was greater than that observed in ICAS, and health care utilization (hospitalizations and ED visits) was ∼50% lower for the La Red children as compared with the previous 12 months, a difference .3 times greater than the difference observed between the intervention and control groups in the ICAS project. Our results need to be evaluated in light of our study' s limitations, including the existing threats to internal and external validity.…”

Section: Discussionmentioning

confidence: 85%

“…14,18 For example, a critical structural component we retained was an interactive multidisciplinary team including a physician "asthma champion," a community nurse/coordinator, and a community health worker (CHW) who work with families to improve management of asthma using a medical/ social care model during regular visits to an asthma-specific clinic. The salaries of the community nurse/ coordinator and the CHWs were provided by the grant, as were small financial incentives for the physician asthma champions who found time from their busy practices for this role.…”

Section: Ywcmentioning

confidence: 99%

“…15 For the research reported here, we hypothesized that a novel combination of 2 evidence-based asthma interventions, the Yes We Can (YWC) 14 program and ICAS (Inner-City Asthma Study) 13 home environmental interventions, would be effective when implemented among children with moderate and severe asthma living in 2 housing projects in San Juan, Puerto Rico.…”

mentioning

confidence: 99%

“…The Merck Childhood Asthma Network (MCAN) initiative conducted translational research to evaluate the applicability and effectiveness of evidence-based asthma interventions, which were previously shown to be efficacious in reducing the asthma burden in experimentally controlled environments, [12][13][14] in communities with high rates of asthma prevalence, complex social issues, and infrastructure barriers. 15 For the research reported here, we hypothesized that a novel combination of 2 evidence-based asthma interventions, the Yes We Can (YWC) 14 program and ICAS (Inner-City Asthma Study) 13 home environmental interventions, would be effective when implemented among children with moderate and severe asthma living in 2 housing projects in San Juan, Puerto Rico.…”

mentioning

confidence: 99%

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Reducing Quality-of-Care Disparities in Childhood Asthma:La Red de Asma InfantilIntervention in San Juan, Puerto Rico

Lara

Ramos-Valencia²,

González-Gavillán³

et al. 2013

Pediatrics

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BACKGROUND AND OBJECTIVE: Although children living in Puerto Rico have the highest asthma prevalence of all US children, little is known regarding the quality-of-care disparities they experience nor the adaptability of existing asthma evidence-based interventions to reduce these disparities. The objective of this study was to describe our experience in reducing quality-of-care disparities among Puerto Rican children with asthma by adapting 2 existing evidence-based asthma interventions.

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Section: Discussionmentioning

confidence: 85%

Section: Ywcmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Reducing Quality-of-Care Disparities in Childhood Asthma:La Red de Asma InfantilIntervention in San Juan, Puerto Rico

Lara

Ramos-Valencia²,

González-Gavillán³

et al. 2013

Pediatrics

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“…CHWs in primary care settings have been effective in increasing access to care for underserved populations, leading to reduced ED visits and hospitalizations [25,28]. However, the heterogeneity of outcomes has been cited as a limitation of this evidence base [29,30].…”

Section: Introductionmentioning

confidence: 99%

Urban Patient Navigator Program Associated with Decreased Emergency Department Use, and Increased Primary Care Use, among Vulnerable Patients

Garbers¹,

Peretz²,

Greca³

et al. 2016

J Community Med Health Educ

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Background: Receiving non-emergent care in the Emergency Department (ED) setting may disrupt continuity of care, may lead to less effective preventive care, and often contributes to overcrowding. Community Health Worker (CHW)-driven patient navigator programs that connect patients to primary care are a promising approach to enhance quality of care for patients and to reduce preventable ED utilization.

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Community Health Workers Linking Clinics and Schools and Asthma Control

Bryant-Stephens,

Kenyon,

Tingey

et al. 2024

JAMA Pediatr

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ImportanceChildhood asthma is characterized by pervasive disparities, including 3-fold higher hospitalization rates and 7-fold higher death rates for Black children compared with White children. To address asthma disparities, one must intervene in all lived environments.ObjectiveTo determine if a community health worker (CHW) intervention to connect the primary care, home, and school for low-income minoritized school-aged children with asthma and their caregivers improves asthma control.Design, Setting, and ParticipantsThis study was a hybrid effectiveness/implementation trial using a 2 × 2 factorial, cluster randomized clinical trial design of 36 schools crossed with participant-level randomization into a clinic-based CHW intervention. The study was conducted from May 2018 to June 2022. The intervention took place in primary care offices, homes, and 36 West Philadelphia, Pennsylvania, public and charter schools. Children aged 5 to 13 years with uncontrolled asthma were recruited from local primary care practices.InterventionsAsthma management, trigger remediation, and care coordination occurred in school, home, and primary care settings. Children were followed up for 12 months. The Yes We Can Children’s Asthma Program, Open Airways For Schools Plus, and school-based asthma therapy were implemented.Main Outcomes and MeasuresImprovement in asthma control, as measured by the Asthma Control Questionnaire, comparing the mean difference between groups 1 year after randomization with their baseline (difference in differences). Both primary care and school interventions were dramatically disrupted by the COVID-19 pandemic; therefore, stratified analyses were performed to assess per-protocol intervention efficacy before the pandemic disruptions.ResultsA total of 1875 participants were approached, 1248 were excluded, and 1 was withdrawn. The 626 analyzed study participants (mean [SD] age, 8.7 [2.4] years; 363 male [58%]) self-identified as Black race (96%) and non-Hispanic ethnicity (98%). Although all groups had statistically significant improvements in asthma control from baseline to 12 months (P− group: −0.46; 95% CI, −0.58 to −0.33; P+ group: −0.57; 95% CI, −0.74 to −0.44; S− group: −0.47; 95% CI, −0.58 to −0.35; S+ group: −0.59; 95% CI, −0.74 to −0.44), none of the difference-in-differences estimates from the primary prespecified models showed a clinically meaningful improvement in asthma control. Analysis from the prepandemic interval, however, demonstrated that children in the combined clinic-school intervention had a statistically significant improvement in asthma control scores compared with control (−0.79; 95% CI, −1.40 to −0.18).Conclusions and RelevanceThis randomized clinical trial provides preliminary evidence that connecting all lived environments for care of children can be accomplished through linkages with CHWs.

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TheYes We CanUrban Asthma Partnership: A Medical/Social Model for Childhood Asthma Management

Cited by 48 publications

References 41 publications

Reducing Quality-of-Care Disparities in Childhood Asthma:La Red de Asma InfantilIntervention in San Juan, Puerto Rico

Reducing Quality-of-Care Disparities in Childhood Asthma:La Red de Asma InfantilIntervention in San Juan, Puerto Rico

Urban Patient Navigator Program Associated with Decreased Emergency Department Use, and Increased Primary Care Use, among Vulnerable Patients

Community Health Workers Linking Clinics and Schools and Asthma Control

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