Articles |

The National Asthma Education and Prevention Program*: Partnering With Local Asthma Coalitions To Implement the Guidelines FREE TO VIEW

Diana K. Schmidt, MPH; Robinson Fulwood, MSPH; Claude Lenfant, MD, Honorary FCCP
Author and Funding Information

*From the National Asthma Education and Prevention Program (Ms. Schmidt), Office of Prevention, Education, and Control (Mr. Fulwood), National Heart, Lung and Blood Institute (Dr. Lenfant), National Institutes of Health, Bethesda, MD.

Correspondence to: Diana Schmidt, MPH, National Asthma Education and Prevention Program, National Heart, Lung, and Blood Institute, Office of Prevention, Education, and Control, National Institutes of Health, Building 31, Room 4A16, 31 Center Dr, MSC 2480, Bethesda, MD 20892-2480; e-mail: schmidtd@nih.gov

Chest. 1999;116(suppl_2):235S-236S. doi:10.1378/chest.116.suppl_2.235S
Text Size: A A A
Published online

The National Asthma Education and Prevention Program (NAEPP) was initiated in March 1989 to address the growing problem of asthma in the United States. The NAEPP was charged to lead and coordinate the assessment of research advances and to identify their significance and usefulness in the prevention and treatment of asthma. An important role of the NAEPP is to bring federal agencies and voluntary and private-sector organizations together to evaluate current scientific findings and to develop a common foundation for applying research-based health information to professional, patient, and public audiences.

A key strategy of the NAEPP is to work with intermediaries. Representatives from 38 major scientific, professional, governmental, lay, and voluntary health organizations constitute the NAEPP Coordinating Committee. The Coordinating Committee provides input on overall program direction and develops consensus documents, clinical practice guidelines, public awareness campaigns, professional and patient education activities, and materials to improve the diagnosis and management for persons with asthma. Representatives of member organizations often spearhead the implementation of NAEPP broad-based education initiatives and routinely facilitate the dissemination of NAEPP materials using their national networks.

During the past year, at the recommendation of the Coordinating Committee, the NAEPP began working with intermediaries at the local level, namely local asthma coalitions. Local coalitions offer a unique perspective and expertise in implementing creative solutions to problems. They have access to population groups with poorly controlled asthma who are often left out of the information loop, namely, ethnic and racial minorities and people who are medically underserved and socioeconomically disadvantaged. The NAEPP understands that interventions must be customized to reflect the needs of individual communities and that the sustaining power of interventions comes from the support, energy, and resource mobilization that occur at the local level. Existing coalitions, such as the Chicago Asthma Consortium featured in this supplement, exemplify how communities can take charge of important health issues and have a lasting positive impact.

In the summer of 1998, the NAEPP conducted a survey of community asthma coalitions across the country. In October 1998, 44 coalitions had been identified. Most had been organized for < 2 years. The majority had no paid staff and consisted of ≤ 25 member organizations. The emergence of local asthma coalitions is a nascent phenomenon that, if nurtured, has tremendous potential to shape public policy, to reach patients with programs and services, and to educate health-care providers.

In an exciting move to support grassroots asthma control efforts, the NAEPP, coordinated by the National Heart, Lung, and Blood Institute convened a workshop in November 1998 called “Strengthening Asthma Coalitions: Thinking Globally, Acting Locally.” The workshop brought together representatives from the NAEPP and 40 asthma coalitions from around the country. Its goals included promoting networking among asthma coalitions, identifying effective local interventions, and finding opportunities for the NAEPP to further support coalition efforts. The workshop featured several breakout groups that allowed attendees to compare notes on their challenges and successes.

The challenges frequently mentioned by participants were securing funds and other resources to plan and implement asthma activities; identifying and accessing pertinent data to establish baseline status and monitor changes; defining common goals and objectives among coalition partners; clarifying partner roles and responsibilities; sustaining stakeholder commitment; and measuring outcomes.

The successes cited by participants included raising public awareness about asthma; establishing a shared vision, collaborative planning, and valuable discussion forums among influential community leaders; developing educational materials for patients and the public; and initiating new programs and services in the community.

Coalition participants eagerly responded to the opportunity to provide the NAEPP with ideas on how the NAEPP might facilitate collaborative asthma activities at the community level. At the top of their list were the following suggestions: locate or stimulate funding sources; facilitate networking; organize additional coalition meetings; synthesize and disseminate information from coalitions; provide NAEPP materials for coalitions to disseminate; provide press releases and promotional materials ready to be personalized and printed by coalitions; provide tip sheets on how to work with the media; develop a common definition of asthma; and standardize data collection and analysis to allow comparisons of data across communities.

In response to their suggestions, the NAEPP has already launched a new Web site, the NAEPP Asthma Coalition Exchange (www.nhlbisupport.com/asthma/coalitioncorner/index.htm). This site has become a focal point through which coalitions can learn about each other, communicate through discussion forums, and join a coalition e-mail list. This site will also be used to post announcements of new initiatives by the NAEPP. Also, the NAEPP has joined forces with other national organizations to help organize additional coalition meetings in 1999, has offered funding support to develop a framework for asthma surveillance, and continues to provide NAEPP materials to local coalitions.

The workshop was an important first step toward gaining a better understanding of community asthma coalitions and what future direction the NAEPP should take to lead collaborative activities at the local public health level. A major thrust currently is to stimulate and develop a series of asthma education activities in high-risk communities to make certain there is widespread dissemination and adoption of existing asthma knowledge.

The “Expert Panel Report 2: Guidelines for the Diagnosis and Management of Asthma” (EPR-2) documents existing medical technology and educational methodology that, if applied, would allow persons with asthma to live a quality life, unfettered by limits on physical activity, cough, shortness of breath, nighttime awakening, or irreversible lung damage. These “simple” guidelines (EPR-2) are simply not being implemented. Of particular concern are high-risk communities in which morbidity and mortality from asthma and the associated costs are disproportionately burdensome.

Although the NAEPP welcomes the opportunity to strengthen alliances with all local asthma coalitions, a current priority is to make certain that existing knowledge (EPR-2) is applied more fully in communities with high-risk, low-income, or minority populations. Local asthma coalitions play a pivotal role in building community networks to assess local needs, mobilize resources, plan needed activities, disseminate critical messages of the NAEPP, and institutionalize those activities proven to be effective. The NAEPP seeks to develop innovative performance-based interventions through local asthma coalitions designed to improve clinical practice skills, improve patient adherence to medical and educational advice (emphasizing self-management skills), enhance provider-patient partnerships, and promote programs and policies that support asthma-friendly environments (especially in schools and child-care centers).

Without question, local asthma coalitions hold great promise in the effort to improve the quality of life for people with asthma and to decrease asthma-related morbidity and mortality. Coalitions are uniquely positioned to harness and focus collective talents, expertise, and resources in a way that effects lasting change. The NAEPP plans continued support of their important work by offering scientific guidance; patient, professional, and public education materials; technical assistance in developing intervention strategies and evaluation; networking opportunities; data updates; and advocacy for asthma-friendly policies.

Abbreviation: NAEPP = National Asthma Education and Prevention Program




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543