PURPOSE OF THE STUDY.
To assess the effectiveness of using evidence-based asthma interventions in community health centers as part of the Community Healthcare for Asthma Management and Prevention of Symptoms (CHAMPS) study.
Children aged 5 to 12 years (N = 590) with moderate to severe asthma were enrolled in 3 intervention and 3 control sites within high-risk, low-income communities in Arizona, Michigan, and Puerto Rico.
Asthma intervention (environmental control) was tailored to each child’s allergen sensitivity and exposure and involved 4 visits over the course of a year. Study visits were electronically documented and prospectively monitored. Asthma symptoms and health care utilization were evaluated at baseline, 6 months, and 12 months.
The intervention group included 314 children, and there were 276 children in the control group. Nearly all children had allergy testing (96%) and home environmental assessments (89%) performed. A total of 70% of children completed all study activities (testing, assessments, and intervention visits). Symptomatic days in the previous 4 weeks were significantly reduced in the intervention group compared with the control group (−3.27 in the intervention group vs −2.28 days in the control group, or a −0.99 difference; P < .001). This is consistent with changes found in the initial rigorous, evidence-based interventions in other large studies.
Evidence-based interventions can be successfully used in community health centers that care for underserved, high-risk populations, leading to a reduction in asthma morbidity.
This study shows that evidence-based asthma guidelines can be successfully employed with positive clinical outcomes despite the challenges of high-risk asthmatic children in community health settings with limited financial resources. The results here mirror the results previously reported as part of the National Cooperative Inner-City Asthma Study (NCICAS) and the Inner-City Asthma Study (ICAS).
- Copyright © 2017 by the American Academy of Pediatrics