Not One More Life (NOML) is a volunteer program targeted at urban faith communities whose purpose is to identify and reduce the burden of asthma.
NOML programs are scheduled at local churches through contact with clergy and faith ministers. The NOML experience builds trust with individuals within faith communities through a relational approach that is free of government and industry bias. Program participants hear a short presentation, complete a confidential symptom survey, and undergo spirometry. On-site physicians review the results with participants, and when appropriate suggest follow up medical care. NOML donates an internet-ready computer to each church.
We screened 228 African Americans at 6 churches located outside of the Atlanta perimeter highway, and 6 inner city churches. 65% of participants were women, 8% current smokers, 20% past smokers, and the median age was 41 years (range 3-84 years). The overall prevalence of self-reported asthma was 21%, and was greater in participants 6-12 years of age (37%), participants with normal body mass (25%), and those attending programs at inner city churches (23%). Total symptom scores were significantly higher in asthmatics (median score 4) versus non-asthmatics (2). Mean FEV1 for participants was 91 ± 21% predicted, was lowest among current smokers (78±22%), but not significantly different between participants with (91±20%) and without (90±21%) asthma. There was a striking prevalence of increased body mass index (67%), but increased BMI did not correlate with the prevalence of asthma, respiratory symptoms, or reduced FEV1. Overall, we found abnormal lung function in 33% of participants, including 16% who had no respiratory symptoms and were unaware of any lung disease.
The burdens of asthma and asymptomatic abnormal lung function are highly prevalent in urban African Americans attending asthma screening programs held at local churches. This is not attributed to excessive smoking or obesity, but more likely a consequence of reduced health literacy.
Interventions to improve disparate asthma outcomes in urban African Americans should include education regarding health literacy and symptom recognition.
L.M. Graham, None.